Co-Pay Plus from Humira?? | Arthritis Information

 

My doctor restarted me on Humira yesterday and Pharmacare Pharmacy called me yesterday even before I got home from the appointment. I called them back and they said my Co-Pay this time was going to be 0! I said "What?!?! That's more than double what I was paying before" they informed me that my insurance has changed it's coverage for these injectable medications. I was paying before.

Don't know about co-pay plus, but I do know that the cost of biologics co-pay is going to be increasing. This article from The New York Times deals with the latest trend with insurance companies and co-pays.



Health insurance companies are rapidly adopting a new pricing system for very expensive drugs, asking patients to pay hundreds and even thousands of dollars for prescriptions for medications that may save their lives or slow the progress of serious diseases.

With the new pricing system, insurers abandoned the traditional arrangement that has patients pay a fixed amount, like , or for a prescription, no matter what the drug's actual cost. Instead, they are charging patients a percentage of the cost of certain high-priced drugs, usually 20 to 33 percent, which can amount to thousands of dollars a month.

The system means that the burden of expensive health care can now affect insured people, too.

No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.

Insurers say the new system keeps everyone's premiums down at a time when some of the most innovative and promising new treatments for conditions like cancer and rheumatoid arthritis and multiple sclerosis can cost 0,000 and more a year.

http://www.nytimes.com/2008/04/14/us/14drug.html?_r=1&hp=&adxnnl=1&oref=slogin&adxnnlx=1208167342-0whLjKU0GdsOED4fvCOrog

You know, with the elections coming up and the push to regulate Pharma - this is only going to be a black eye for them.  Good!  It means that they'll trot out some of us sick people who can't afford these meds and we're going to get some sort of national health plan.  The timing could not be better! Lovie, I haven't heard of that, but I am starting Orencia and apparently my co-insurance (similar to a co-pay) is going to be 6 per infusion.  That's scary enough, but even scarier is that the nurse service providing them told me that Bristol Myers Squibb has a program to reimburse me that amount, making the net cost .  How much can they possibly be getting from my insurance that they're willing to reimburse my co-insurance?  That is really scary!I was sort of thinking the same thing InnerGlow. I know the cost of these biologics is rediculous. I've been off of Humira for a year but for two years I took Humira and for the last year and a half I took it every week. The actual cost was more than ,300 per month! I knew it wouldn't be long before the insurance companies would be looking for ways to avoid paying these cost. There are a lot of charities that help with expensive copays.  I actually contacted about 15 of them a few months back before I started remicaid as I found out that I have to pay 20% per infusion and it was going to be over 0 pout of my pocket.  My problem, is that I have sarcoidosis and remicaid is not fda approved for sarc so I did not qualify for any of the programs.  However, a lot of you will as the drugs you are getting are fda approved.  So, if you are facing high copays for these sort of drugs, googling copay assistance programs and you will find a lot of placing that could help.  Another thing to check is to see if you have an out of pocket insurance cap on copays.  It usually does not apply to drug copays but mine does apply to infusions. I pay for a 3 month supply of Humira.  Used to be .

When I was on humira there was no way I could afford 20% copay. My dr gave me a card that was good for a year and the manufacter pd for my co-pay. I am now on enbrel and same thing, dr gave me a card from makers and they pay co-pay for 6mnths then part of  it for 6 more months. I flat out told dr I couldn't afford it. They had them at the office and you have to call the number on it and get it activated.

My copay for Humira is 0 and we have the top PPO BCBS.  It's the pits because we make too much for any help, but yet the price of all of my medications and doctor's copays are killing us.  We have kids in college that cost us K a year and couldn't get help there either.  So, guess there goes our retirement.Lovie-I  am new here and also on Humira. My co-pay is I think 20% which came to about 0 every other week. But like CinDee the doctor gave me a card and the manufacter reimburses my for 80% of the cost of my copay. I would talk to your doctor and get on this program because there is no way that I would be able to afford it otherwise. Yeah; I got the Co-Pay plus card from my doctor's office. I received my Humira yesterday and I didn't have to pay anything. The way they explained it to me is that They'll pay 100% of my co-pay for 6 months and then 50% of my co-pay for 6 months after that. That's a HUGe savings.
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