Costs of RA Drugs | Arthritis Information

Shame on you and this forum!

AchingAudrey2008-11-30 21:17:04Sorry, I can't help you It has been a very long time since I used Enbrel. I sure someone else will know.

This info is posted on the AF board to help people. Ithought some here might be interested also.....

Financial assistance
https://www.pparx.org/Intro.php
https://www.helpingpatients.org/Intro.php
http://www.needymeds.com
http://www.themedicineprogram.com
Http://www.rxassist.org
http://www.medicationfoundation.com/
http://www.nami.org/Content/ContentGroups/Helpline1/Prescription_ Drug_Patient_Assistance_Programs.htm
http://www.qdrug.com/sf/
http://www.freemedicineprogram.com
http://www.rheumatology.org/public/acrast.asp?aud=pat
http://www.joniandfriends.org/helps/financia.shtml

Hi Aud,

I "think" the cost of enbrel is around ,500. I have good drug benefit coverage so I have a reasonable copay, but that could easily change as health care costs go up, and more costs are passed onto the insuree in higher premiums, copays, out of pocket expenses and drug formularies change with drugs being removed or copay/cost increased.

We all respond differently to these RA meds, but I've been on remicade, humira and like enbrel best. The others worked "okay" but for me, I think injecting enbrel twice a week (25 mg shots) helps control the RA better in my case.

There are assistance programs out there though I don't personally know of them. You might consider calling the enbrel people, they may have a person to discuss this subject. Good luck, take care and be well.

Humira offers a simular assistance program. I got it too. The first 6 months of the copay (mine would be 0) are they pay it all. The next 6 months they'll pay half. Your doctor can give you the information.

I think it's only for co-pay assistance. They may have a different program for the uninsured.

Shame on you and this forum!

AchingAudrey2008-11-30 21:17:21AchingAudrey,

My pharmacy charges my insurance 00+ too. It's ridiculous, isn't it? I've been on Enbrel since last December and I've yet to pay a copay. My QuickAssist has paid all so far. After the year is over, my insurance company charges per month. Well worth the price, but I could NEVER afford ,800+ a month!
I wonder if and when the price of these biologics will go down.
The process in making enbrel (biologics) is involved and complicated, more so than a drug made from chemicals. Its an expensive process, so even if they could ever make a generic, there might not be a big price drop.

But why the extreme difference in what we pay for these drugs? Someone with TRICARE, the insurance for active or retired military, or someone with a large group insurance plan, may pay a reasonable copay for these drugs, yet someone with a small group insurance plan or an individual plan may pay hundreds of dollars or not be covered at all. TRICARE and large group insurers, negotiate with drug companies for lower drug prices, can't something be done to make things more equitable, so everyone can afford to take the drugs they need.

I receive ,000 per year through the Patient Access Network Foundation for my Humira (which I may not be on any longer but thats another thread.) This is only to help me cover the cost of the drug while I am in the coverage gap of my medicare part D plan but it helps as I have to meet a ,050 out of pocket expense limit before coverage begins again with a maximum 5% copay.

Try the above or The Healthwell Foundation they may be able to help. Also, as everyone else has pointed out. The drug companies have patient access programs that you may qualify for to help get your drugs.

Good luck to you

Bob H.

[QUOTE=Joie]The process in making enbrel (biologics) is involved and complicated, more so than a drug made from chemicals. Its an expensive process, so even if they could ever make a generic, there might not be a big price drop. [QUOTE=JasmineRain] [QUOTE=Joie]The process in making enbrel (biologics) is involved and complicated, more so than a drug made from chemicals. Its an expensive process, so even if they could ever make a generic, there might not be a big price drop.

[/QUOTE]

The margins the drug wholesalers make are very, very small. They live on volume, not scalping individual drugs. There is little difference in price between different PBMs. The difference in price to the patient merely reflects what their individual plan pays. Not everybody (or their employer/insurance bill payer) pays the same premiums for the same risk group; of course the benefits will differ.
[/QUOTE]

Well, don't forget those million dollar salaries and golden parachutes for the lucky few at the top of the company's food chain.

Aud,

Just don't give your insurance company an excuse to drop you, always be sure to pay your premium on time, and keep proof. Once you get dropped and if you have a preexisting condition it would be difficult getting another individual health insurance plan. Another poster on this forum was dropped when the insurer said they didn't receive her payment on time, at question is whether the insurer will pick up the cost of the medical services she received during this lapse in coverage.

Consumer protection laws may differ from state to state, there might be a law about a grace period, or notifying the insuree they are going to be dropped, I don't know. Just something to keep in mind. Nowadays, in this environment of decreasing access to affordable health care, consumers especially those with pre existing conditions like RA, have to really stay on our toes when it comes to health insurance.

Hope the enbrel helps ya, and you don't have long time damage from the heart attack you got when you learned enbrel's cost. lol Take care and be well.

Shame on you and this forum!

AchingAudrey2008-11-30 21:18:07

I understand that biologics are more costly to manufacture, but does anyone have any ideas on why the big difference in their costs. I'm not talking the difference in what our various insurance co's cover, but the initial cost of the drug before insurance is factored in.

I see on on this post that Enbrel costs around 00 - 00. I am on Remicade, which according to my insurance statements costs 00+ per monthly infusion. Then the adjustment for my insurance company's negotiations with the drug co is applied bringing it down to around 00, then my insurance co pays all but , which I cover out of my pocket. Luckily I have good insurance through my employer, but how in the world do people without insurance get help with this disease?! And how can these drug companies justify a 00 per month price tag?! Something just isn't right here.