There's also the issue of fairness, they say. Some employers argue that the drug copayment programs are an attempt to circumvent their efforts to manage health care costs. Most annual copay assistance limits for MS drugs, if available, are between $9,000 and $12,000, Talente says. "Most have different mechanisms of action, different administration and different side effect profiles." And generics, when they're available, are pricey too - typically costing $60,000 or more annually, she says. "Generally the multiple sclerosis drugs are not substitutable," she says. That last argument misses an important point, according to Bari Talente, executive vice president for advocacy at the National Multiple Sclerosis Society. But, she says, her family can't afford to pay nearly $9,000 a year out-of-pocket for the foreseeable future. In Catton's case the change meant that after she hit the drug manufacturer's payment cap for the copay assistance in April, she's had to pay the entire co-payment herself - roughly $3,800 - and will have to continue to pay it until her health plan's pharmacy deductible is met.įor May, Catton has put the $3,800 copay on a credit card. Under the copay accumulator programs introduced by some health plans in 2018, the process has changed. Through such programs, consumers typically have owed nothing or have had modest monthly copays for pricey drugs, thanks to a financial contribution by the drugmaker that chips away at the consumer's deductible and out-of-pocket maximum limits until the health plan starts paying the whole tab. Her health plan changed the way it handles Novartis' payments, and the money no longer counts toward that deductible.Ĭatton is one of a growing number of consumers taking expensive medicine who are discovering they are no longer insulated by copay assistance programs that used to help cover their costs. The drug's price: $90,000 each year.īut his year, Catton got a shock. Hospital nurse Kristen Catton relies on medication to keep her multiple sclerosis in check. Until recently those payments by the drug company helped Catton save money on her medical out-of-pocket expenses, because they counted toward her family's $8,800 annual pharmacy deductible on their health plan. Novartis, the company that makes Gilenya, helps defray that cost for Catton and other patients by making their copayments directly to the patient's health plan Catton's copay for the medicine is roughly $3,800 a month. The drug is expensive - about $90,000 a year. This is a big step forward two drugs she previously tried failed to control her physical symptoms or prevent repeated flare-ups. Thanks to the medicine, she says, she's able to walk comfortably, see clearly and work part time as a nurse case manager at a hospital near her home in Columbus, Ohio. Since Kristen Catton started taking the drug Gilenya two years ago, she's had only one minor relapse of her multiple sclerosis, following a bout of the flu. Accessed May 9, 2019.ĭisclosures: Hardy reports receiving clinical research funding to his institution from Amgen, Gilead Sciences, Janssen, Merck and ViiV/GlaxoSmithKline, and serving as an advisor or on an advisory board for Gilead, Merck, ViiV/GlaxoSmithKline, CSL Behring (Calimmune) and Enochian.As the price of specialty drugs continues to rise, some health plans are shifting more of the cost to patients. Official statement responding to Gilead Sciences’ announcement that it will allow Teva to manufacture a generic version of Truvada. The Trump administration has made increasing the use of PrEP a focal point of its 10-year plan to end the HIV epidemic in the U.S. “More immediate actions also are needed to significantly reduce the price and associated medical costs of PrEP, in addition to investments in provider education and capacity building in medically underserved urban and rural areas - particularly in the southern region of the country,” Hardy said. David Hardy, MD, chair of the HIV Medicine Association, told Infectious Disease News. “The news that a generic version of Truvada - the only medication currently approved for PrEP - will be available in 2020 rather than 2021 is welcome, but we are unlikely to see a dramatic drop in the price until there is meaningful competition and options for PrEP since one generic manufacturer will have exclusive rights for a period of time,” W. A Teva spokesperson did not immediately respond to a question asking how much it would charge. According to the PrEP4All Collaboration, a group of activists seeking wider access to the HIV prevention medication, Gilead charges between $1,600 and $2,000 for a 1-month supply of FTC/TDF.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |