Who concerns themselves with $7.50? I found that I do. To my own detriment, I refused to give $7.50 for medication I need. That’s right, my Multiple Sclerosis medication co-pay was $7.50 and I refused the medication!
I was diagnosed with Multiple Sclerosis over 16 years ago. I have gone through many different forms of treatment that have included daily injections, one week IV infusions and most recently a twice daily pill. Simply take 1 in the morning and 1 at night. Simple, right? Well… money and my hatred of pharmaceutical companies and insurance companies have combined to even complicate taking medication daily. The medicine I am talking about is Tecfidera. The insurance company is Humana. If you had asked me a few months ago, I would have sang their praises.
What changed? Well, Tecfidera costs OVER $6,500 for a 30 day supply.Yeah… take that in. When my doctor suggested I start taking Tecfidera, I said, “It depends on what it costs me!” I said I would agree and start taking it if my insurance paid for it. Behind the scenes, Humana Specialty Pharmacy worked something out and I was able to start taking the medicine. Now keep in mind, this is only one of MANY meds I take to help treat my MS and symptoms. Each month I would get a call to remind me to refill the prescription and it would be sent to me. The call ended with a “and your co-pay will be $0”. This went on for months.
The call at the end of July for my August refill ended with, “Your co-pay will be $7.50.” The representative was assuredly surprised when I exclaimed “WHAT?” The rep remained polite and explained my assistance program had expired. I asked how to get it restarted. I was transferred and was told by this new rep that they would see if funds were available. It did not take long and I was told there was no funding available. I said, “Oh, I guess that is my indicator to stop this med.” She seemed surprised. I replied telling her the pill costs over $6,500 per month and somehow no funds were available to help me?
Did I have $7.50? Yes. But, the idea or principle of the matter for me is that – my $7.50 does not matter. Humana or Biogen, one or both should be making PLENTY of money on a $6,500 a month drug. Getting $7.50 out of my broke ass just seemed to paying for someone’s Starbucks. I just imagined whoever in the chain came up with my co-pay being $7.50 said, “I will be able to get me a Starbucks off Thomas each month.” Well, at my health’s expense, I refuse to buy someone charging over $6,500 a month for medicine a Starbucks. What “funding” or assistance program no longer had $7.50? It did not matter to me.
My protest over my $7.50 co-pay hurts no one but me, but I feel a satisfaction that Humana and Biogen are no longer getting their money either. If I remember right, the meds were $6,594.38 each month. The meds price had been increasing each month it seemed and at $6,594.38 I was fed up. It is RIDICULOUS for meds to cost that much. In my case, since Humana is my Medicare provider, I am saving the taxpayer roughly $6,586.88 ($6,594.38 – my $7.50). Someone is getting PAID and someone is PAYING. I no longer will participate in this scheme!
I have noticed extensive advertising for Tecfidera also. During the Price Is Right, I may see the ad a couple times. It runs regularly. My question is why should I ask my docotor about taking Tecfidera as the ad suggests? Shouldn’t my doctor ask me? Shouldn’t Biogen be telling the doctors about Tecfidera? I OFTEN see pharmaceutical “reps” parade in with their lunch for the doctor’s office and I’ve attended informational dinners sponsored by the pharmaceutical companies with my and other doctor’s being paid to speak at these dinners. So, there seems to be A LOT of waste for promoting medicines.This resentment may com from the fact I once wanted to be a pharmaceutical rep! lol
I will continue to treat my MS and symptoms with meds that are more affordable for the tax payer, the consumer and ME! With swindlers like pharmaceutical CEO Martin Shkreli raising the price of a HIV drug 5,000% and Heather Bresch raising life saving EpiPen more than 470% being rewarded with more and more money… I say NO MORE! I see pretty much ALL pharmaceutical companies and health insurance companies as nefarious, greedy, and futile (futile to all but their stockholders)!
With the choice between Hillary Clinton and Donald Trump, I see no hope to reign in rapacious corporations. Another reason I morn Bernie Sander’s departure from the election. I know Bernie would have instigated change. As long as pharmaceutical companies have lobbyist, patients will be screwed! I hope to see Bernie Sanders and Elizabeth Warren team up in the senate to attempt change but, I have little or no faith in the US government to protect me in matters of health.
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Well said. I say if you can deal with the other meds then I say bravo!