5 ms·

Humira really is a life-changing drug - but it is offensively, eye-wateringly expensive. Each auto-injector pen costs approx. £500; and I have to take one every

by cnewey 9y ago

Humira really is a life-changing drug - but it is offensively, eye-wateringly expensive. Each auto-injector pen costs approx. £500; and I have to take one every 2 weeks. To put that in perspective, that's a cost of about £1000 per month - which is considerably more than my mortgage. My house costs less than my medical treatment. Fortunately for me, I live in the UK, where the NHS is able to help absorb these costs. In the US, I guess they aren't so lucky - if I lived there, my Humira treatment would financially destroy me - and probably my entire family, too. It's morally reprehensible for a company to have access to such a life-changing treatment and then proceed to charge such disproportionately vast sums of money (certainly, far beyond the cost of R&D). I suppose you could say that instead of crippling its patients physically (like their medical problems do), Humira cripples its patients financially - and I'm not sure that's a great deal better.

rayiner 9y ago
> It's morally reprehensible for a company to have access to such a life-changing treatment and then proceed to charge such disproportionately vast sums of money (certainly, far beyond the cost of R&D). I don’t really understand. If there is a moral obligation to help cure other peoples’ diseases, shouldn’t it be even more morally reprehensible to spend billions on things like TV serieses, cell phones, and social media websites, which could’ve been used to cure diseases instead? By your logic, isn’t Apple like the most evil company in the world, because they spend billions of dollars that could be used for drug research on making iPhones instead? Why is it somehow worse to make a profit curing people, than to make a profit not curing people?
- Majestic121 9y ago
  Because the profit made by "curing people" is actually done by keeping others from curing people, via aggressive patenting, FUD over generics, lobbying against legislation that would make prices reason able... There's also the fact that public health is not a simple economic market, where customers can simply not buy your product. In a lot of cases, it is a life or death situation, and real human have to be treated, so it should be considered a public service.
  - rayiner 9y ago
    > Because the profit made by "curing people" is actually done by keeping others from curing people, via aggressive patenting It’s not like the treatment was just out there until AbbVie monopolized it. Chron’s disease was medically characterized in 1932. Anyone could’ve come along and developed this treatment and gave it away for free or cheaper. > lobbying against legislation that would make prices reason able... That just begs the question of what’s “reasonable.” What single payer does is create a monopsony (single buyer situation). Obviously it lowers prices, that’s what monopsonies do. But like it’s counterpart, the monopoly, it’s economically inefficient.
- monsieurbanana 9y ago
  Because we have to draw the line somewhere. "If you're in the health sector don't prey on sick people" is as good a place as any to draw that line. What's your point? That since phone companies don't try their best to cure the world, nobody should do it?
  - barry-cotter 9y ago
    Can you propose another way of financing the cost of drug discovery, research and testing for safety? The current system works reasonably well but if all you’ve got is outrage I would prefer at least outrage and a plan.
    - cnewey 9y ago
      Read the findings from [1] - it appears that in a very considerable number of cases, there's actually a disconnect between the cost to research, develop, and produce a drug - and the price that's charged to customers (or insurance). The conclusion is that the price is mostly determined by "what the market will bear", rather than much else. This suggests (to me, at least) that in cases of a particularly expensive drug like Humira, a large proportion of the profits are not reinvested into R&D. [1]: https://jamanetwork.com/journals/jama/article-abstract/2545691 https://jamanetwork.com/journals/jama/article-abstract/25456...
      - barry-cotter 9y ago
        I suggest reading a microeconomics textbook. In the absence of price controls price will be set such that supply equals demand. It does not surprise me in the slightest that a drug that people really, really need and that is still under patent protection is very, very expensive. Prices are what makes supply equal demand. Blockbuster successes, massive profit makers are what pays for all the many, many failures of drug development. There’s quite a bit of research on the economics of drug development but the thing that I find the most convincing is that the big drug companies aren’t exceptionally profitable. They’re pretty much in line with what you’d expect of multinationals of their size, 10% or so profit on revenue per year. Scientific publishers like the accursed Elsevier earn supernormal profits, 33%.
phonon 9y ago
> In the US, I guess they aren't so lucky - if I lived there, my Humira treatment would financially destroy me - and probably my entire family, too. What makes you say that? Either private insurance would cover it, or Medicaid (for low income people) or they essentially give it away to uninsured people through a non-profit foundation. (AbbVie Patient Assistance Foundation) https://www.humira.com/humira-complete/cost-and-copay https://www.humira.com/humira-complete/cost-and-copay
- cnewey 9y ago
  I'm not especially familiar with the structure of the US health insurance system, but I think that the lower costs mentioned on the page you linked largely depends on either receipt of considerable amounts of state aid, or having pretty high-quality insurance. Certainly, if you were to flick through various forums for those with Crohn's disease (e.g. [1]), you'd find many stories of people paying hundreds (or even thousands) of dollars for a month's Humira treatment. [1]: https://www.healingwell.com/community/default.aspx?f=38&m=2272681 https://www.healingwell.com/community/default.aspx?f=38&m=22...
  - maxerickson 9y ago
    Under current law (the ACA), the maximum annual payment would be $7,350 (on top of monthly insurance premiums). That's for the lowest benefit, qualifying ACA plans and assuming the prescription is covered. The "cash" price is ~$4000 a month (https://www.goodrx.com/humira https://www.goodrx.com/humira ) so even the lowest benefit plans are kicking in quite a bit of support (but probably also negotiating the price down quite a bit).
- pjc50 9y ago
  How did this happen, then? https://www.snopes.com/shane-patrick-boyle-died-after-starting-a-gofundme-campaign-for-insulin/ https://www.snopes.com/shane-patrick-boyle-died-after-starti...
- daturkel 9y ago
  This is how the payment structure was explained to me when i started taking the drug. Ultimately i pay $5/mo, my insurance pays some amount, and Abbvie i guess pays the difference. I'm not sure what set of circumstances leads to people paying higher prices, given the info the commenter above linked to.
isolli 9y ago
Counterpoint: in the US my employer-based insurance paid for it, while in the UK the NHS refused to cover it. I was also covered in France and Germany, so the UK is the odd one here.
blibble 9y ago
the price the NHS will be able to negotiate will be a lot lower too a natural result of the having an organisation that represents 65 million, backed up by leading researchers, instead of each individual completely on their own
- cnewey 9y ago
  Actually, I don't think that's quite correct. The specialists that prescribed me the Humira treatment were quite keen to impress upon me the cost of the drug - i.e. that it "costs the NHS over £400 per pen" (and this was back in 2015). Of course, this is purely anecdotal but I'm inclined to believe the source as they've no motivation to mislead me.
- DanBC 9y ago
  https://www.mims.co.uk/drugs/skin/psoriasis-seborrhoea-ichthyosis/humira https://www.mims.co.uk/drugs/skin/psoriasis-seborrhoea-ichth... 40mg/0.8ml soln for inj in vial (for paediatric use), 2=£704.28. 40mg/0.4ml soln for inj in pre-filled syringe or pre-filled pen, 2=£704.28.
ddorian43 9y ago
I think your mortgage/rent should be lower instead of the drug. Why do people think giving $ to landlords is better than scientists/doctors/researchers/business ?
- cnewey 9y ago
  Bearing in mind that accommodation is quite frequently the single largest outgoing in many people's finances (i.e. commonly approx. 30% of income), do you really think that the cost of medical treatment should exceed this? Do you really think that medical treatment should be an individual's single largest outgoing cost? As for giving money to scientists/doctors/researchers, that isn't really the case either. See [1] - the cost of prescription medication appears to be largely determined by "what the market will bear", rather than how much a drug costs to research and develop. [1]: https://jamanetwork.com/journals/jama/article-abstract/2545691 https://jamanetwork.com/journals/jama/article-abstract/25456...
  - ddorian43 9y ago
    I think medical treatment SHOULD be the largest cost. Do you really think something else is more important ? At least non-sick people will have money this way. I understand, what the market will bear. But that's for everything ? (market bearing rents in sf) Still, drug companies are more prone to invest their $$ in drugs compared to landlords, don't you agree ? Of course I'm not ok with spending 30% on rent + 30% on meds. But it's more insane that we do on rent, I think (or move house and commute 2 hours, waisting your life)
    - cnewey 9y ago
      I'm trying to fathom your point. Regardless of how much rent or mortgages cost, do you think it's acceptable or fair for individuals with chronic illnesses to bear the cost of a treatment which would cost them more than their rent (i.e. an additional cost which healthy people wouldn't have to pay?). That sounds like a pretty bad deal if you ask me - not only would one have to deal with a chronic disease, one would also have to budget for a (very considerable) additional expenditure which healthy individuals wouldn't have. At the end of the day, that is what makes the price of Humira unfair and immoral - its ability to severely financially disadvantage its patients (by being priced disproportionately compared to the cost of R&D / production). Now, if you're talking about spreading the cost of all medical care across the entirety of the working-age population (essentially, national insurance) - that's a more sensible proposition. In fact, that's (broadly speaking, of course) what the NHS does in the UK - and the system works quite well.
walshemj 9y ago
Yes as a chronic kidney disease patient I am glad I am in the UK id quite possibly be dead if I lived in the US. BTW before my transplant a single one of my meds (phosphate binder) was around £500 a month god only knows what serverlamer costs in the states - let alone the cost of my transplant.
- cuckcuckspruce 9y ago
  Some perspective from the US. My girlfriend has lupus - diagnosed at eight. The lupus destroyed her kidney by her fourteenth birthday. She got a transplant at sixteen. Her transplant was covered by her mom's insurance with the rest of the costs falling onto our state's medicaid because she was a minor and her mom, an RN, was not well to do. Her medications were also covered by her mom's health insurance and picked up by our state's medicaid program. She and her mom moved to another state when my girlfriend turned seventeen, so from that point it was her mom's insurance picking up the medication. She and I started dating when she turned eighteen. At that time, all of her drugs, including anti-rejection medications, were $5 per 90 day supply at the local pharmacy under her mom's insurance. Her mom lost her job when she was 21, so my girlfriend lost her insurance and was unable to afford COBRA. My girlfriend did not qualify for medicaid in this new state because she was not a minor, pregnant, or considered disabled by the federal government despite not being able to work with the lupus. At this time, our best option for her medications were discount mail order pharmacies, which cost $1000 per 30 day supply, which we could barely afford with my computer programmer salary, as I could not add her to my insurance due to us not being married. For awhile, she was on PCIP and then a plan made available on the ACA exchange. Her premiums were $400 per month, and that made her prescriptions $20 per 90 day supply. So it brought the costs from $1000 per 30 day supply to about $450 per month, counting insurance. We managed to make this work for a few months before I was laid off from my programming gig and lost my insurance. We moved back to the state she moved from due to a job offer. She still did not qualify for medicaid, but my new job allowed me to add someone to my insurance if we were married or domestic partners. So we got a domestic partnership, and her drugs now again cost $5 per 90 day supply. So I've been with someone on both sides in America - good insurance, no insurance, basic insurance, and then good insurance again. We really need to find a better system. We've survived by luck and really tight financial planning.
manyxcxi 9y ago
I take Remicaid, which has technically been on the market longer than Humira and still requires me to go in to an Infusion Center to get hooked up to an IV for 2hrs every 8 weeks. The ‘full price’ cost of my treatment: $16,000 just for the Remicaid. They have a co-payment plan that, for the most needy, would effectively make the drug free. For me, my insurance gets billed a few thousand and I would have a $250 copay, which they pay. It makes me wonder though, has anyone ever paid the full price, or is it just astronomically high to maximize the ‘charitable’ deduction side of their business?
- cnewey 9y ago
  I can't speak for the US, but I've been told by the clinical specialists at my local hospital that Humira cost £400+ per pen (this was back in 2015). I don't think that AbbVie can offset any of that price as a charitable donation, so I guess that price must be what they actually charge.
  - kgwgk 9y ago
    Note that the list price in the US is way higher than that (over $2000). But list prices are not actual prices (the average discount may be around 25% for Humira).
- blonky 9y ago
  I haven't had to pay full price. But, last year I had to pay 20% of the cost. It gets out of control fast since I have to take Remicade every 4 weeks. I was on the hook for about $6000. My bill was cut down because I qualified for charitable funds from my hospital. It's shocking to see the bill before insurance pays it's share. I was getting bills for $25k. !!!

by cnewey 9y ago

rayiner 9y ago

> It's morally reprehensible for a company to have access to such a life-changing treatment and then proceed to charge such disproportionately vast sums of money (certainly, far beyond the cost of R&D). I don’t really understand. If there is a moral obligation to help cure other peoples’ diseases, shouldn’t it be even more morally reprehensible to spend billions on things like TV serieses, cell phones, and social media websites, which could’ve been used to cure diseases instead? By your logic, isn’t Apple like the most evil company in the world, because they spend billions of dollars that could be used for drug research on making iPhones instead? Why is it somehow worse to make a profit curing people, than to make a profit not curing people?

Majestic121 9y ago
Because the profit made by "curing people" is actually done by keeping others from curing people, via aggressive patenting, FUD over generics, lobbying against legislation that would make prices reason able... There's also the fact that public health is not a simple economic market, where customers can simply not buy your product. In a lot of cases, it is a life or death situation, and real human have to be treated, so it should be considered a public service.
- rayiner 9y ago
  > Because the profit made by "curing people" is actually done by keeping others from curing people, via aggressive patenting It’s not like the treatment was just out there until AbbVie monopolized it. Chron’s disease was medically characterized in 1932. Anyone could’ve come along and developed this treatment and gave it away for free or cheaper. > lobbying against legislation that would make prices reason able... That just begs the question of what’s “reasonable.” What single payer does is create a monopsony (single buyer situation). Obviously it lowers prices, that’s what monopsonies do. But like it’s counterpart, the monopoly, it’s economically inefficient.
monsieurbanana 9y ago
Because we have to draw the line somewhere. "If you're in the health sector don't prey on sick people" is as good a place as any to draw that line. What's your point? That since phone companies don't try their best to cure the world, nobody should do it?
- barry-cotter 9y ago
  Can you propose another way of financing the cost of drug discovery, research and testing for safety? The current system works reasonably well but if all you’ve got is outrage I would prefer at least outrage and a plan.
  - cnewey 9y ago
    Read the findings from [1] - it appears that in a very considerable number of cases, there's actually a disconnect between the cost to research, develop, and produce a drug - and the price that's charged to customers (or insurance). The conclusion is that the price is mostly determined by "what the market will bear", rather than much else. This suggests (to me, at least) that in cases of a particularly expensive drug like Humira, a large proportion of the profits are not reinvested into R&D. [1]: https://jamanetwork.com/journals/jama/article-abstract/2545691 https://jamanetwork.com/journals/jama/article-abstract/25456...
    - barry-cotter 9y ago
      I suggest reading a microeconomics textbook. In the absence of price controls price will be set such that supply equals demand. It does not surprise me in the slightest that a drug that people really, really need and that is still under patent protection is very, very expensive. Prices are what makes supply equal demand. Blockbuster successes, massive profit makers are what pays for all the many, many failures of drug development. There’s quite a bit of research on the economics of drug development but the thing that I find the most convincing is that the big drug companies aren’t exceptionally profitable. They’re pretty much in line with what you’d expect of multinationals of their size, 10% or so profit on revenue per year. Scientific publishers like the accursed Elsevier earn supernormal profits, 33%.

phonon 9y ago

> In the US, I guess they aren't so lucky - if I lived there, my Humira treatment would financially destroy me - and probably my entire family, too. What makes you say that? Either private insurance would cover it, or Medicaid (for low income people) or they essentially give it away to uninsured people through a non-profit foundation. (AbbVie Patient Assistance Foundation) https://www.humira.com/humira-complete/cost-and-copay https://www.humira.com/humira-complete/cost-and-copay

cnewey 9y ago
I'm not especially familiar with the structure of the US health insurance system, but I think that the lower costs mentioned on the page you linked largely depends on either receipt of considerable amounts of state aid, or having pretty high-quality insurance. Certainly, if you were to flick through various forums for those with Crohn's disease (e.g. [1]), you'd find many stories of people paying hundreds (or even thousands) of dollars for a month's Humira treatment. [1]: https://www.healingwell.com/community/default.aspx?f=38&m=2272681 https://www.healingwell.com/community/default.aspx?f=38&m=22...
- maxerickson 9y ago
  Under current law (the ACA), the maximum annual payment would be $7,350 (on top of monthly insurance premiums). That's for the lowest benefit, qualifying ACA plans and assuming the prescription is covered. The "cash" price is ~$4000 a month (https://www.goodrx.com/humira https://www.goodrx.com/humira ) so even the lowest benefit plans are kicking in quite a bit of support (but probably also negotiating the price down quite a bit).
pjc50 9y ago
How did this happen, then? https://www.snopes.com/shane-patrick-boyle-died-after-starting-a-gofundme-campaign-for-insulin/ https://www.snopes.com/shane-patrick-boyle-died-after-starti...
daturkel 9y ago
This is how the payment structure was explained to me when i started taking the drug. Ultimately i pay $5/mo, my insurance pays some amount, and Abbvie i guess pays the difference. I'm not sure what set of circumstances leads to people paying higher prices, given the info the commenter above linked to.

isolli 9y ago

Counterpoint: in the US my employer-based insurance paid for it, while in the UK the NHS refused to cover it. I was also covered in France and Germany, so the UK is the odd one here.

blibble 9y ago

the price the NHS will be able to negotiate will be a lot lower too a natural result of the having an organisation that represents 65 million, backed up by leading researchers, instead of each individual completely on their own

cnewey 9y ago
Actually, I don't think that's quite correct. The specialists that prescribed me the Humira treatment were quite keen to impress upon me the cost of the drug - i.e. that it "costs the NHS over £400 per pen" (and this was back in 2015). Of course, this is purely anecdotal but I'm inclined to believe the source as they've no motivation to mislead me.
DanBC 9y ago
https://www.mims.co.uk/drugs/skin/psoriasis-seborrhoea-ichthyosis/humira https://www.mims.co.uk/drugs/skin/psoriasis-seborrhoea-ichth... 40mg/0.8ml soln for inj in vial (for paediatric use), 2=£704.28. 40mg/0.4ml soln for inj in pre-filled syringe or pre-filled pen, 2=£704.28.

ddorian43 9y ago

I think your mortgage/rent should be lower instead of the drug. Why do people think giving $ to landlords is better than scientists/doctors/researchers/business ?

cnewey 9y ago
Bearing in mind that accommodation is quite frequently the single largest outgoing in many people's finances (i.e. commonly approx. 30% of income), do you really think that the cost of medical treatment should exceed this? Do you really think that medical treatment should be an individual's single largest outgoing cost? As for giving money to scientists/doctors/researchers, that isn't really the case either. See [1] - the cost of prescription medication appears to be largely determined by "what the market will bear", rather than how much a drug costs to research and develop. [1]: https://jamanetwork.com/journals/jama/article-abstract/2545691 https://jamanetwork.com/journals/jama/article-abstract/25456...
- ddorian43 9y ago
  I think medical treatment SHOULD be the largest cost. Do you really think something else is more important ? At least non-sick people will have money this way. I understand, what the market will bear. But that's for everything ? (market bearing rents in sf) Still, drug companies are more prone to invest their $$ in drugs compared to landlords, don't you agree ? Of course I'm not ok with spending 30% on rent + 30% on meds. But it's more insane that we do on rent, I think (or move house and commute 2 hours, waisting your life)
  - cnewey 9y ago
    I'm trying to fathom your point. Regardless of how much rent or mortgages cost, do you think it's acceptable or fair for individuals with chronic illnesses to bear the cost of a treatment which would cost them more than their rent (i.e. an additional cost which healthy people wouldn't have to pay?). That sounds like a pretty bad deal if you ask me - not only would one have to deal with a chronic disease, one would also have to budget for a (very considerable) additional expenditure which healthy individuals wouldn't have. At the end of the day, that is what makes the price of Humira unfair and immoral - its ability to severely financially disadvantage its patients (by being priced disproportionately compared to the cost of R&D / production). Now, if you're talking about spreading the cost of all medical care across the entirety of the working-age population (essentially, national insurance) - that's a more sensible proposition. In fact, that's (broadly speaking, of course) what the NHS does in the UK - and the system works quite well.

walshemj 9y ago

Yes as a chronic kidney disease patient I am glad I am in the UK id quite possibly be dead if I lived in the US. BTW before my transplant a single one of my meds (phosphate binder) was around £500 a month god only knows what serverlamer costs in the states - let alone the cost of my transplant.

cuckcuckspruce 9y ago
Some perspective from the US. My girlfriend has lupus - diagnosed at eight. The lupus destroyed her kidney by her fourteenth birthday. She got a transplant at sixteen. Her transplant was covered by her mom's insurance with the rest of the costs falling onto our state's medicaid because she was a minor and her mom, an RN, was not well to do. Her medications were also covered by her mom's health insurance and picked up by our state's medicaid program. She and her mom moved to another state when my girlfriend turned seventeen, so from that point it was her mom's insurance picking up the medication. She and I started dating when she turned eighteen. At that time, all of her drugs, including anti-rejection medications, were $5 per 90 day supply at the local pharmacy under her mom's insurance. Her mom lost her job when she was 21, so my girlfriend lost her insurance and was unable to afford COBRA. My girlfriend did not qualify for medicaid in this new state because she was not a minor, pregnant, or considered disabled by the federal government despite not being able to work with the lupus. At this time, our best option for her medications were discount mail order pharmacies, which cost $1000 per 30 day supply, which we could barely afford with my computer programmer salary, as I could not add her to my insurance due to us not being married. For awhile, she was on PCIP and then a plan made available on the ACA exchange. Her premiums were $400 per month, and that made her prescriptions $20 per 90 day supply. So it brought the costs from $1000 per 30 day supply to about $450 per month, counting insurance. We managed to make this work for a few months before I was laid off from my programming gig and lost my insurance. We moved back to the state she moved from due to a job offer. She still did not qualify for medicaid, but my new job allowed me to add someone to my insurance if we were married or domestic partners. So we got a domestic partnership, and her drugs now again cost $5 per 90 day supply. So I've been with someone on both sides in America - good insurance, no insurance, basic insurance, and then good insurance again. We really need to find a better system. We've survived by luck and really tight financial planning.

manyxcxi 9y ago

I take Remicaid, which has technically been on the market longer than Humira and still requires me to go in to an Infusion Center to get hooked up to an IV for 2hrs every 8 weeks. The ‘full price’ cost of my treatment: $16,000 just for the Remicaid. They have a co-payment plan that, for the most needy, would effectively make the drug free. For me, my insurance gets billed a few thousand and I would have a $250 copay, which they pay. It makes me wonder though, has anyone ever paid the full price, or is it just astronomically high to maximize the ‘charitable’ deduction side of their business?

cnewey 9y ago
I can't speak for the US, but I've been told by the clinical specialists at my local hospital that Humira cost £400+ per pen (this was back in 2015). I don't think that AbbVie can offset any of that price as a charitable donation, so I guess that price must be what they actually charge.
- kgwgk 9y ago
  Note that the list price in the US is way higher than that (over $2000). But list prices are not actual prices (the average discount may be around 25% for Humira).
blonky 9y ago
I haven't had to pay full price. But, last year I had to pay 20% of the cost. It gets out of control fast since I have to take Remicade every 4 weeks. I was on the hook for about $6000. My bill was cut down because I qualified for charitable funds from my hospital. It's shocking to see the bill before insurance pays it's share. I was getting bills for $25k. !!!