Lialda Price Increase

The cost of the drug is the same. What has changed is the "preferred brand" status on many health plan formularies. I suspect your copay is now 50% instead of 20%. I think Dezical lobbied companies for this.

Post Edited (DBwithUC) : 1/29/2015 6:55:43 PM (GMT-7)

I have to agree with the others. I doubt Lialda's price skyrocketed. Even if you have the same insurance as last year the fine print may have changed and probably did. Whenever it is renewal time for insurance you can't assume anything, even if you don't make any changes. The insurance company might have.

There are both good and bad points to what we have compared to a single payer system. You can't just paint with a wide brush and expect to get what you want. Even though there are some advantages to a national single payer health care system there are way too many disadvantages for me. As I already said, there are no doubt some advantages but this is one of those things where you have to be careful of what you wish for because you might get it. While there are many, many problems that need to be addressed I would rather have what we have than go the single payer route. One way or another you have to pay the price. There is a price to pay for everything and that price isn't always money.

I am in a high deductible plan so no co-pay. I forget there are still plans out there with co-pays since everyone I know that does not work for the Federal Gov't has been moved to a high deductible plan.

The tiers for these drugs make no sense for me. My understanding is that the higher the tier the more expensive the drug. Yet when I check prices I have a tier 3 drug that is a decent bit less than the Lialda which is a tier 2 drug.

Like others my company deposits money in an HSA and when I meet my deductible the price goes down. Then when I hit max out of pocket it is all free.

Since I am getting Entyvio infusions it should not take me long to hit my deductible and out of pocket total. I am just galled at the sudden price increase for me and the large cost. It would be a bit different if it was a brand new drug but it has been around since 2007. More than enough time to recoup their marketing costs and their R&D.

Single payer would be a nightmare in many, many ways. The Fed's have not gotten VA healthcare right, they have not gotten Medicaid right, the have not gotten Medicare right. Why would anyone think this time would be different?

The CEO comment was off the cuff statement and not meant to taken tooth and nail seriously, but Please refrain from making attacking statements about peoples capacity and minds being corrupt, those type of attacks are useless and serve no meaningful purpose here, if you think I'm beyond repair I welcome you to actual get to know the person you attack, I might actually surprise you with my level of intelligence.

Bad Gut said...
The CEO comment was off the cuff statement and not meant to taken tooth and nail seriously, but Please refrain from making attacking statements about peoples capacity and minds being corrupt, those type of attacks are useless and serve no meaningful purpose here, if you think I'm beyond repair I welcome you to actual get to know the person you attack, I might actually surprise you with my level of intelligence.

Actually, it was directed towards the pharmaceutical companies and the bearucrats that collude with them for the profit incentive. Unless you are one of them, you took the comment the wrong way.

sorry my bad.

I blame the entire industry. And when I say the entire industry I am including the Federal Gov't for failing to pass reasonable laws, e.g. tort reform, allowing direct advertising, regularly extending patents, allowing for generics to be suppressed, etc. The ambulance chasing lawyers. The healthcare providers with their opaque and misleading billing. The Insurance companies that are not able to explain the formulas they use for reimbursement.

From my perspective the "healthcare reform" that has been passed over the last couple of years has significantly driven up my costs.

Now I don't spend much (okay really any) time looking at the healthcare systems in other countries but if you look at Australia and Britain as two examples even with their single payer system people still end up having to purchase additional insurance. Not to mention the wait times they can encounter.

If you want to talk about profit margins on Insurance companies here you go:
http://ycharts.com/companies/CI/profit_margin

Another factor not mentioned is the cost of a doctor's education. Many doctor's often have student loans in excess of $200,000 and of course they have to charge enough to pay them back. I think a lot of the national single payer systems run with less doctors and use more nurses and consultants.

garylouisville said...
Another factor not mentioned is the cost of a doctor's education. Many doctor's often have student loans in excess of $200,000 and of course they have to charge enough to pay them back. I think a lot of the national single payer systems run with less doctors and use more nurses and consultants.

In my case I have not had a complaint in the charges from a Doctor's office. Or any of the tests, procedures, etc. that either my GI or Primary Physician have done. I have considered the charges reasonable.

Now when you are dealing with a hospital and all of the charges that suddenly appear, how prices change, how they cannot often give you a detailed explanation of charges, etc. That is a different story.

Spoke to my doctors office today. They were not thrilled by the less expensive options I asked them about. They do not feel they are nearly as effective as Lialda. That being said they are going to see what options they can come up with to assist with the drug cost.

In this case it is not simply trying to placate me. They have come up ways to significantly offset exorbitant drug prices in the past. I am just looking for a bit of time until the Entyvio costs wipe out my deductible and/or total out of pocket.

I pay almost $1200 for a three month supply for Lialda for my mail order pharmacy. I'm on an HSA with a $3000 deductible. So pretty much my entire annual HSA contribution is used by just for 9 months of Lialda. I wish I was still on a co-pay program. Oh wait, I do pay co-pays even after reaching the deductible. I love it when HR sends out newsletters with helpful suggestions such as "order a generic instead". We might very well have a generic alternative now if Asacol had been allowed to go generic, instead of that whole Delzicol trick.