albear99 said...
"How does one afford to pay upwards of $3,000 for each infusion/injection? if my math is right and you get an infusion every 8 weeks, you are paying close to $20,000 a year?
I feel like $150 a month is realistic, but are people really paying thousands of dollars every couple months on this medicine? I have insurance and all but how much would you peeps say you actually will spend in a given year on a biologic such as ramicade? do you need to be part of the millionaires club to have UC....
Most of us spend $5 an infusion, every 8 weeks or so, as our insurance covers the rest. Programs like RemiStart for remicade (the humira/simponi/entyvio and others have equivalents) pay the copays and deductables beyond that for each infusion.
In fact, we can actually pay less out-of-pocket for our biologic medications, then we had to when taking pills such as lialda/delzicol/apriso. Lialda can cost $1,200.00 for a 30-day supply, with copays and deductables (even with the copay assistance cards) we can end up paying hundreds or more a month. The biologic copay cards cover more each infusion.
The manufacturers do have other compassionate programs where they can give the meds away free to you if you don't have insurance and/or make less than a specified amount of income on an annual basis, as well.
clo2014 said...
This stuff scares me....the cost....the black label warnings.. If insurance denies...and they can deny for any reason...you are stuck for that bill. I about have a stroke every time I go.
It is just crazy. And people on Medicare not being able to get the co-pay assistance from pharmecuetical companies is wrong...just wrong. I still don't understand why they exclude them from the programs.
And people on Medicare are on a fixed income....some of them can not afford the copay on the medication. They go without and it kills some of them..slowly..and by causing other health problems. Aarrrggghhh!
Clo
There's a lot wrong with this world, the USA is particularly bad at villainizing those who use the safety-net programs, and using that as justification for cutting benefits or denying them entirely.
The black labels are there to state that small risks do exist of serious conditions. Generally things like lymphoma are 0.04% of patients (as opposed to 0.02% for healthy folks without medications), so there is an increased risk but it is hardly a major worry, benefits far outweigh that risk.
Does it weigh on me late at night that the total cost of my medications for one-year is greater than my salary? Sure. The pricing is insane for these medications, and they only get away with it because most of us never see or pay the prices, only insurance does pay for the vast majority of it with us paying small amounts. Then they say, well we have these patient assistance programs, and nobody pays the full price anwyays due to negotiated prices with insurance companies (the whole billed at X dollars, insurance agrees to pay only Y dollars bit which is usually 50% less). All smoke and mirrors, and frustrating to say the least.