Tuesday, April 22, 2008

In the News: Higher Co-Payments for Expensive Drugs

In January, shortly after Robin Steinwand, 53, who has multiple sclerosis renewed her insurance policy with Kaiser Permanente, she went to refill her prescription for Copaxone. She had been insured with Kaiser for 17 years through her husband, a federal employee, and had had no complaints about the coverage.

She had been taking Copaxone since multiple sclerosis was diagnosed in 2000, buying a 30 days’ supply at a time. And even though the drug costs $1,900 a month, Kaiser required only a $20 co-payment.

Not this time. When Ms. Steinwand went to pick up her prescription at a pharmacy near her home in Silver Spring, Md., the pharmacist handed her a bill for $325.

There must be a mistake, Ms. Steinwand said. So the pharmacist checked with her supervisor. The new price was correct. Kaiser’s policy had changed. Now Kaiser was charging 25 percent of the cost of the drug up to a maximum of $325 per prescription. Her annual cost would be $3,900 and unless her insurance changed or the drug dropped in price, it would go on for the rest of her life.

“I charged it, then got into my car and burst into tears,” Ms. Steinwand said. She needed the drug, she said, because it can slow the course of her disease. And she knew she would just have to pay for it, but it would not be easy.

This is an excerpt from a New York Times article from April 14, 2008, on the increasing costs of co-payments for certain high-priced drugs. Read the complete article here.

3 comments:

Khaidji said...

What is too high? What is too expensive a price to pay to prevent any further episodes of this debilitating disease? We probably would pay fortunes and life savings to ensure that we wouldn’t get any more disabled. The problem is that while we pay these high prices we expose ourselves to another menace. According to reports on the side effects of some of these expensive drugs, there is still much consideration before undertaking these treatments. But this is also true to all medications.
Expensive Drugs

Every time I see the medication I take
‘Xpensive drugs it’s a sacrifice I make
Research could be faster and I wish it would too
Every time I take the drugs I get more subdue
Not just the hardship of financial strain
Such unrealistic pricing seem manageable, time and again
It’s the knowledge that I give more than I pay
Vast users experience vital organ decay
Essentially the drugs can drain an irreplaceable bounty
Deplete value that is worth more than money
Relapsing remitting Multiple Sclerosis
Usually requires high toxins by diagnosis
Good to delay episodes but sometimes more pay than salaries
Such Expensive Drugs might cost you a liver and kidneys

See other acrostic poems written on Multiple Sclerosis and other diseases at
The Bajan Poetry Society
By Khaidji

Anonymous said...

I'm in a situation identical to Ms. Steinwand (Kaiser Fed taking copaxone), except my co-pay in the Kaiser Rocky Moutain Region (Denver) went from $20 to $250 this January. I assume Kaiser's decision to suspend the co-pay increase for the Mid-Atlantic Region has something to do with Fed employees in Wash DC area, and it's not been done in any other region; I know it's still $250 here. I got the name of the complaints dept director for KP Rocky Mountain Region and wrote him a protest letter, copying the NY Times reporter, NMSS, U.S. Office of Personnel Mangement and my senators and congressmen. My friend who works in PR says what's needed is thousands of letters from people (Fed) in Kaiser regions other than mid-Atlantic, protesting the co-pay disparity. I know thousands of you just like me are out there. I'm happy to share my letter if anyone else wants to use it. Also if you know of particular congressmen active on this issue that would be worth sharing. My e-mail: jeffirwinmail@yahoo.com

jirwin said...

I'm in a situation identical to Ms. Steinwand (Kaiser Fed taking copaxone), except my co-pay in the Kaiser Rocky Moutain Region (Denver) went from $20 to $250 this January. I assume Kaiser's decision to suspend the co-pay increase for the Mid-Atlantic Region has something to do with Fed employees in Wash DC area, and it's not been done in other regions; I know it's still $250 here. I got the name of the complaints dept director for KP Rocky Mountain Region and wrote him a protest letter, copying the NY Times reporter, NMSS, U.S. Office of Personnel Management and senators and congressmen (especially those on National MS Caucus – see this site). My friend who works in PR says what's needed is thousands of letters from people (Fed) in Kaiser regions other than mid-Atlantic, protesting the co-pay disparity. I know thousands of you just like me are out there. I'm happy to share my letter if anyone else wants to use it as a model. My e-mail: jeffirwinmail@yahoo.com