Jo Hartley reports:
“Health insurance companies are currently revising their pricing systems for very expensive drugs and they are now requiring patients to pay hundreds and sometimes thousands of dollars for prescriptions for drugs that may save their lives or slow the progress of serious diseases.
“With the new pricing system, insurers have now abandoned the traditional arrangement in which patients pay a fixed amount for a prescription regardless of what the drug’s actual cost. Instead, now they are charging patients a percentage of the cost of certain high-priced drugs. This percentage is usually 20 to 33 percent and obviously this can amount to thousands of dollars a month for some patients.”
Hartley continues: “It is not known how many patients are affected, but hundreds of drugs are now being priced this new way. These drugs are used to treat diseases that are fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some kinds of cancer. Unfortunately, there are no generic equivalents for these drugs, so patients are being forced to pay these prices or go without.”
This is not a new phenomenon, but anecdotal reports suggest it is increasingly rapidly — both in the number of insurers who employ this cost-splitting approach and in the number of high-priced drugs included in such plans.
I have a friend on a oral chemotherapy drug who, despite being fully insured through her employer, was still forced to pay thousands of dollars for her medication. Needless to say, this came as a shock to her. It’s hard enough to go through chemo without having to pay thousands of dollars for a few bottles of pills.
Insurers keep moving the goalposts on the definition of “being covered” in this country. Standards of coverage pale in comparison to what they were 20 or even 10 years ago. And yet the premiums continue to increase far more rapidly than the inflation rate.
If you’re forced into a situation where you must pay a high percentage of your drug costs rather than flat prescription drug co-pays, we encourage you to consider shopping at eDrugSearch.com as an alternative. And please feel free to leave your comments below — we love letting people vent!