[Sure, why not. I just won’t eat for the next month or so.]
That was an actual call from my pharmacist after my health insurance company revised its drug formulary. Asacol HD, which I need for my ulcerative colitis, jumped from a $50 a month co-pay to the $400 a month co-pay noted above. My insurance prescription plan is three tiers – $15 for the first tier, $50 for the second tier, and 50% of the manufacturer’s price for the third tier. The third tier is generally reserved for experimental and/or non-generic drugs.
There is no generic equivalent for Asacol HD, and it used to be that if there was no generic equivalent, a drug was dropped into the middle tier on my prescription plan, but now it doesn’t matter. If it is a brand name drug, it’s top tier. Period. The insurance company doesn’t care if it is the ONLY drug that’s working for a patient’s particular condition.
Well, I don’t know about anyone else, but I can’t afford $400 a month for one drug. I had to call my GI specialist and beg him to find something cheaper for me. God bless the man, he was able to prescribe a drug with a $15 co-pay. It doesn’t work quite as well as the Asacol HD, but it’s better than nothing.
Bear in mind that these drug co-pays are on top of the premiums paid for the insurance (about $12,000 a year) and the deductible ($5,000 a year). Thank heavens my company pays the premiums and the deductible for me as part of my salary package. But I’m on my own for the prescriptions.
Who’s to blame for these outrageous costs? Do the drugs really cost that much to manufacture, or are the pharmaceutical companies just greedy? Is it the fault of the insurance companies, who want to keep as much profit as possible, thereby refusing to pay for necessary medications for their insureds? Is it my fault because I wasn’t born rich? Or married rich? Is it all of the above?
Unfortunately, retirement is totally out of the picture, at least for now. Sure, I could possibly take early retirement and squeak by on Social Security if I worked a part-time job, but there then would be the matter of carrying my own insurance costs until I become eligible for Medicare in a few years. I have no interest in changing my diet to cat food so that I can have enough money to pay for medical insurance.
Anyone else want to chime in on this subject? Are you also tired of being gouged by the drug companies and insurance carriers?
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