Thursday, August 21, 2008

We are Big Pharma

Ever feel like you're single-handedly supporting an industry? Back when E was getting sick constantly, I felt that surely we must have paid for her pediatrician's new car. These days, it feels like the pharmaceutical industry is all about building its profits on our backs.

Okay, it isn't really that bad. But yesterday, we got our monthly reminder call that DH needs to reorder his Enbrel. This is a med that helps keep his rheumatoid arthritis under control, and it would cost about $1400 per month if we paid for it out of pocket. That almost equals our mortgage payment. We don't pay full price, thanks to insurance, but co-pays are beginning to add up. Between the three of us, we take a total of 12 daily prescription meds. During the winter, it's 14 - E takes two additional meds in an attempt to stave off sinus infections and croup.

In an average month, we'll pay between $150 and $200 just for medications. And that's with pretty decent insurance! I know of far too many people who are underinsured, and the cost of drugs is dragging them down. More and more companies are instituting tier systems for their prescription formularies, and name-brand drugs like Enbrel are at the top. They're also putting caps on prescription costs, leaving even more of the cost on the shoulders of patients.

What's a person with a chronic condition to do? Tier 4 drugs like Enbrel generally don't have generic alternatives. If you shop around, the price is pretty much the same, no matter what pharmacy you go to. It's pretty prohibitive for middle-class folks, and downright impossible for anyone who is low-income.

There are a few options. You can research the manufacturer of your medication to find out if they have a payment assistance program - there are a couple of websites that can help you with this. and The Free Medicine Association can help with this. You can find out if you're eligible for government medical assistance programs, but it's often difficult to qualify for these. You can also go without your medication - not recommended but sometimes necessary.

If you're in this situation and your insurance is provided by your employer, make sure your employer hears about it. Talk to your HR department, and let them know that this is putting a strain on you financially and emotionally. There are still some companies out there that care about their employees, and even if they don't, they're often interested in things that can improve employee productivity.

Finally, you can contact your legislators. And you can vote. While this won't result in immediate results, it's the only path to systemic change for the healthcare system. Talk to your public servants at the state and federal level. Let them know how drug costs are affecting you, and ask them what they plan to do about it. Make sure you know where candidates stand on the issue before you vote for them. All our little voices together can make one BIG voice that will be heard, even if it doesn't always feel like it.



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