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Sixteen years ago, while working in a city I'd only recently moved to, I donated a pint of blood, as I have on occasion since college. I was floored learn a few weeks later that I had tested positive for Hepatitis 'C' (HCV) infection, The diagnosis was confirmed, but no overt symptoms were noted, so other than an advisory to go "on the wagon" (no booze for youse) I was to monitor the condition and nothing more.
Fifteen years passed; the first HCV drugs began to appear on the market; I passed my 65th birthday in 2014, qualified for Medicare, and after a routine exam, was advised of the availability of treatment, at a cost of $32,000 for a month's supply, with a 2-month regimen anticipated. Medicare 'D' would cover much of the bill, but with a "donut hole" of several thousand dollars.
Fortunately, I have a close friend who works from home for a specialty pharmacy attached to an oncology practice, and as a friend and sometimes-business partner of the family, It's been my privilege to look on as she negotiates a maze of manufacturers, providers and insurers to get many of her patients the needed help without consigning them to loss of their life's savings.
It can be difficult to explain to those unfamiliar with pharmacy practices exactly how the competitive pressures among those who develop new medicines led to the rise of non-profit foundations like Astra Zeneca and Patient Access Network, but let it suffice to say for now that the aid can find its way to those of modest means who need it, and that a patient can't always rely on the health-care bureaucracy -- you have to familiarize yourself with your own condition and options, and as with the pursuit of second opinions, research the people you're working with and the options offered.
But the principal reason I'm submitting this thread is that the coming of the Affordable Care Act will continue to affect the processes of drug development. The expansion of the patient/customer base might spur more research, but economies of scale will also give a lower-cost advantage to the major chains, (as opposed to the in-house specialty operations) and the impersonality inherent in any large-volume bureaucratic approach will probably cause more of the lesser-informed to "fall through the cracks".
Any change in regulatory practices and oversight of this size and volume is going to lead to conflicts in the practices and oversight of the pharmaceutical industry; I'm not going to take a particular side for the present, except to say that, as with the fighting between some segments of the energy industry a few years ago, any simplistic appeal that tries to place the blame with buzzwords like "big pharma" and "corporate greed" is over-simplifying. The struggle that's developing here is one between several groups of less-than-pure capitalists and government agencies, and not everyone is simply wearing a "white or black hat".
There are a lot of very good people out there as well -- l've been favored with a chance to watch, and occasionally, help one out on a semi-regular basis, but the responsibility is going to rest mostly with you and I -- the prospective patients.
Obamacare is also closing the Medicare donut hole, which would help someone like you.
And at some point, we will have to put our foot down and tell the world and pharmaceutical companies that we will not continue to pay for the bulk of biomedical research training, research, drug development through NIH funded research and allow pharmaceutical companies to charge US patients the highest costs of any country.
My thanks to our moderator for re-opening this discussion: As an advisory, I'm hoping that it won't be allowed to deteriorate into the usual partisan arguments common to other forums at this site.
I want to hear from other posters here who have faced this issue, and whether or not they managed to mitigate the effect, and if successful, how?; nothing more. Hopefully, some of us can learn from other members' experience.
Obamacare is also closing the Medicare donut hole, which would help someone like you.
And at some point, we will have to put our foot down and tell the world and pharmaceutical companies that we will not continue to pay for the bulk of biomedical research training, research, drug development through NIH funded research and allow pharmaceutical companies to charge US patients the highest costs of any country.
Crazy.... Just, crazy......
I don't think this is political at all. I'm just stating the current situation.
I have one expensive med and it would cost me 8K a month. I have medical coverage, which would bring it down, and I have a pay assist from the maker, so I just pay my normal co-pay which is low.
I was just prescribed a new med that my doc said was expensive, they had a coupon, so for the first month I didn't even have a co-pay and I've already signed up for the pay assist card from the pharma company.
A lot of pharma companies are doing this now.
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Obamacare is also closing the Medicare donut hole, which would help someone like you.
And at some point, we will have to put our foot down and tell the world and pharmaceutical companies that we will not continue to pay for the bulk of biomedical research training, research, drug development through NIH funded research and allow pharmaceutical companies to charge US patients the highest costs of any country.
Crazy.... Just, crazy......
With regard to the "donut hole", I was able to locate an assistance plan along the lines of Astra Zeneca which further reduced the burden -- It's my understanding that about a half-dozen of these have emerged in recent years. The single greatest factor in my own qualification was the reduction in income due to transition to semi-retirement.
My point at this stage being nothing more than that a very-complicated issue, involving several large factions, is still evolving. One thing I have been given to understand is that the expansion of the pharmacy market will favor a handful of major players such as CVS and Walgreen -- which may not bode well for the in-house pharmacies at specialized practices, and which dispense a disproportionate share of the emerging high-price/high cost medicines.
But I hope we can all learn more from each other if a respectful exchange can be maintained.
The assistance I received for the meds never even asked about income.
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My posts as a Mod will always be in red.
Be sure to review Terms of Service: TOS
And check this out: FAQ
Moderator: Relationships Forum / Hawaii Forum / Dogs / Pets / Current Events
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