Incredible costs for a prescription biologic

[COLGATE4]

My wife has suffered from Chrons Disease for ten years. In the past it was more or less controlled by infusions of Remicade but last year the Remicade failed to work, so her Gastroenterologist prescribed a different Biologic, STELARA. Unfortunately Stelara has a retail cost of more than $21,000.00 a dose and, in her case, must be administered once a month. There is no copay assistance for any patients who have Medicare. The cost of these products is both ridiculous and abusive. However given the present administration I have absolutely zero hope that anything will be done to address this. Wish we were Canadians.

[CharleyDog]

1. This is so terrible. like other third world countries, we are becoming like other third world

countries where medicine, cure and care, is only for the rich. I wish you the best, and all I can say is keep fighting, join together with others in this situation and organize, write your congresspeople, and don't give up.

[COLGATE4]

10. The saddest part is that many 'third world countries' have a better

health delivery/insurance system than we do. In Colombia, for example, all citizens are covered by a national health insurance plan. If you want to get fancier treatment, there are private doctors/hospitals available if you choose but the basic services guaranteed all are very good. And, as for pharmaceuticals, my BIL takes a blood pressure drug that costs $650 a month here. We bought him exactly the same drug from the same US manufacturer for US $38.00. "Third world?" Go figure.
"

[COLGATE4]

21. Charley - the saddest part is that in many "third world countriets" not only

do the poorest people have government provided health care but also the cost of pharmaceuticals is dramatically lower - and these are the very same pharmaceuticals you or I buy at Costco or Walgreens. My wife takes an antibiotic which sells for about $3,000 for 10 days supply. We bought the very same drug in Colombia - 3 months supply = less than US$300.00!

[BigmanPigman]

2. The GOP wants to bankrupt and kill us, in that order.

Greedy, sadistic bastards, all of them.

[Freethinker65]

3. Yep. Biologics are expensive.

I have been avoiding them for years (and some doctors have been very persistent in asking me to try biologics) and so far have been lucky managing my chronic autoimmune issues with much lesser priced non-biologics. I am on my spouse's health insurance, but as he is seven years older than me, I will need some private insurance to bridge into Medicare after he retires. Without the ACA, I will probably be unable to afford any insurance and will be forced to pay out of pocket or go without. There is no way I could afford a drug with a list price like Stelara, though I have heard many drug manufacturers are willing to offer financial assistance by reducing the costs? I did not know that was unavailable for Medicare patients.

I know there is a window of time in which pharmaceutical companies must recoup their research and development cost as well as make huge profits (some going back for R & D future costs) before their patent is up and lesser priced generics can enter the market. It is a business and the companies are in it for the money.

[democratisphere]

5. So what is BIG Pharma's excuse for the ever increasing price of

insulin? Don't be fooled by these plain old criminals!

[Freethinker65]

6. Oh. I am not fooled. I worked for a bit in a university oncology drug discovery lab.

We got federal grants in part to test private pharmaceuticals for efficacy. If we found something promising, we and the feds got really nothing from the discovery. That never made sense to me.

BIG pharma is out to make big money. It is a business. It pays its lobbyists well.

[democratisphere]

7. Don't forget the insane costs of wall to wall 24/7/365 advertising

for their products and services contributing to ever higher prices. BIG Pharma isn't a business, it is truly a Criminal Enterprise.

[democratisphere]

4. Until our political legislators quit taking campaign contributions aka bribes

from corrupt BIG Pharma and the American Criminal Enterprise Healthcare System nothing will change and the prices will continue to escalate. It is a GD shame that this travesty has occurred and been allowed to continue. America is one of the most corrupt countries in the world.

[Enoki33]

8. I thought their CPAs deducted all their development costs at tax time.

[COLGATE4]

9. They do. But all the TV marketing of the newer drugs

doesn't come cheap.

[elfin]

11. Stelara for me is $12,000 year WITH drug plan

Am not rich enough to have it not matter, nor poor enough to qualify for freebies.

Without my plan, (UHC PPO and Drug Plan), it would cost over $50,000 per year.

I might be able to switch plans, but my coverage is at least stable and many others do not cover it at all, or disallow it after it is started.

Have done so much research online and so many calls to insurance, Janssen, support plans etc. my brain bleeds.

The upside - it has been a miracle drug for me after trying others like Embrel-- this is for wild and crazy plaque/erythrodermic psoriasis that covered nearly my entire body and almost got me thrown into the hospital to regulate my body temp after all lotions/steroids etc. failed to work.

The immune system can turn on you and kill you. This stuff is IMPORTANT, but once something is relegated to a "special" pharmacy all rules and regs go away.

I want the pols running for office mention Big Pharma often as something to correct.

[COLGATE4]

12. I'm glad to hear that you're getting good results from the Stelara.

You're right - these auto immune diseases can make life a living hell. It's just too bad that those people suffering from these are subjected to the unscrupulous gouging of the big Pharma companies. We're in the same boat as you - not wealthy enough not to care and not poor enough to qualify for assistance. The best I've been able to come up with (insurance, secondary and Drug plan) is a little over $20,000 a year.

[demtenjeep]

13. that must be why my GI struggles to keep me on Remicade

I get it every 4 weeks WITH solucorteff administered right before to help it last out



I have begged for them to just take out the bad section...he won't

[COLGATE4]

14. I'd strongly advise you to try to stick it out on Remicade

as long as you can. The alternative is viciously expensive.

[demtenjeep]

15. My doc has diagnosed that Remicade has failed for me and Stelara is on deck

while looking it up, I found a website where makers have plans to ease cost to 5$ an injection.

I think it is Jennings?

I will look

how has she done on Stelara

[demtenjeep]

16. tool around this website.

https://www.stelarainfo.com/crohns-disease/starting-stelara/janssen-carepath

[demtenjeep]

17. https://www.stelarainfo.com/crohns-disease/starting-stelara/janssen-carepath

At Janssen, we don’t want cost to get in the way of treatment you need. We can help you explore options to lower your out-of-pocket medication cost for STELARA®. Janssen CarePath Care Coordinators are available by phone to review your health plan benefits to help answer questions you may have about insurance coverage for STELARA® and identify options that may help make STELARA® more affordable, if needed. Call 877-CarePath (877-227-3728), Monday-Friday, 8 AM to 8 PM ET. You may be eligible to pay just $5* for your STELARA® medication—enroll in the Janssen CarePath Savings Program and activate your card here. Or visit our cost and insurance page for more information.

If you're delayed or denied treatment from your insurance provider, we may be able to help. Contact 877-CarePath (877-227-3728) and ask about the Janssen Link Program.

[COLGATE4]

18. Unfortunately this offer is not available to

anyone on Medicare

[demtenjeep]

19. oh

I'm so sorry.

[COLGATE4]

20. Yep. Medicare rules. Thanks for the suggestion, though. Other folks

who read these posts may be able to use it.

[moriah]

23. okay, the one fund that has help for Crohns seems to be at TAF.

https://tafcares.org/program-listing/

They aren't open right now, but stalk the listings, or sign up for Fund Finder at https://fundfinder.panfoundation.org

They will alert you when it opens.

Good luck!

Edit to add: If you're in desperate need go ahead and try to call at [phone], they might be able to tell you when they expect to have openings again in the program. Yes, I verified and they do help Medicare recipents.

[COLGATE4]

24. Many thanks for the information and suggestions. Both

are most sincerely appreciated!

[moriah]

22. Gonna check if any of the copay assistance organizations has a Crohns fund for you...

will respond with the link to stalk if not currently accepting apps, or any open funds.

Copay assistance is what makes me able to afford my medication