prescription drug insurance

18 Aug: What is prescription drug insurance, anyway?

Journalist Carol M. Ostrom wrote a well-researched — and heartbreaking — story on prescription drug insurance that appeared in Sunday’s Seattle Times. Ostrom looks at the increase in the number of biotech specialty drugs that aren’t covered by traditional insurance co-pay plans. Instead, patients must pay a percentage of drug costs — which in some cases, can be financially devastating. Gary Claxton of the Kaiser Family Foundation tells Ostrom that such changes in insurance plans are threatening to defeat the purpose of health insurance in the first place. Says Claxton: The idea of prescription drug insurance is to protect people from catastrophic costs … At some point, people aren’t going to consider themselves insured if they’re at risk for a…

02 Jul: Will we have to hit bottom before we reform our healthcare system?

Drug addicts talk about having to “hit bottom” before they finally realize they have to do something about their problem. Are we about to see the U.S. healthcare system hit bottom? Today, UnitedHealth Group, the nation’s largest health insurer, cut its earnings forecast and said it would slash 4,000 jobs. Bloomberg reports: In the Medicare business for the elderly, for which UnitedHealth is the market leader, gross margins declined in plans that provide prescription drugs and specialized coverage for people with chronic diseases, the company said. The company forecast that its overall medical loss ratio, the percentage of premium revenue spent on medical care, would increase to 82.5 percent for the full year, up from its earlier prediction of 81.3…

16 May: Just how insured ARE you? Prescription drug co-pays are on the rise

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…

01 Oct: Insurance companies dropping prescription drug coverage

Elaine Moore writes, With the increasing costs of specialized drugs, some insurance companies are refusing to pay for drugs prescribed for off-label conditions … Health policy analysts caution that the benefits off-label drugs offer in conditions for which other drugs have failed will be seriously compromised by these new insurance regulations. Furthermore, off-label drugs such as naltrexone, which is relatively inexpensive at less than $100 per month, would be put in the same (unapproved for payment) category as Genetech’s Avastin (bevacizumab), which typically costs $4,400 per month. Avastin is approved for lung and colorectal cancers, but not for brain tumors because of limited evidence validating efficacy despite promising results in patients.