4 ms·

Not sure how widely known or common this is for medications but I take PrEP (Truvada) and the maker has a free "co-pay" card on their website that basically cov

Not sure how widely known or common this is for medications but I take PrEP (Truvada) and the maker has a free "co-pay" card on their website that basically covers $4800/year in copayments (well above the $50/month I would ever pay). I'm sure there's some shady big pharma economics behind why these exist in the first place, but at the very least I'm getting a very expensive drug for free.

amaccuish 8y ago
We're about to get Truvada free on the NHS here in the UK and I'm interested on going on it. Have you had any side effects?
- dawhizkid 8y ago
  No side effects, no.
bradleyjg 8y ago
> I'm sure there's some shady big pharma economics behind why these exist in the first place The co-pay is designed to make you share in the pain of the sky-high costs the drug manufacturer charges the insurance company. This has two benefits—1) you are only going to get it if you really need it 2) maybe you’ll lobby your congressperson to rein in monopolist pricing. By giving you a coupon there’s no pain sharing and those benefits are lost. Sure you’ll pay higher premiums, either directly or in reduced wage gains, but that’s defuse and indirect, so far less likely to drive behavior.
- dawhizkid 8y ago
  Makes sense
- zdragnar 8y ago
  Biologic drugs are grown, not manufactured. Mine should be around 4k / dose; insurance won't cover it, so the drug company only charges me I think a $25 copay. Fwiw, the insurance would have covered older alternatives, but the potential side effects on those are worse than the cure.
  - bradleyjg 8y ago
    Should be in what sense? Is that the marginal cost to manufacturer a dose?
    - zdragnar 8y ago
      Should be in the sense that I don't recall the specific number, only that it was around $4k. Given the decreased consistency in the process (living things vs. mixing chemicals), I imagine a fairly good chunk of that 4k is also marginal cost to the manufacturer. Everything from research, to scaling up production, to storage and shipping (spoils at room temp) becomes more expensive.
reaperducer 8y ago
Not sure how widely known or common this is for medications but I take PrEP (Truvada) and the maker has a free "co-pay" card on their website that basically covers $4800/year in copayments (well above the $50/month I would ever pay). I see drug commercials all the time that say something like "Visit our web site, or call this number to find out how you can get ___ for little or no money." Perhaps this is the same thing.
gnicholas 8y ago
They are taking advantage of misaligned interests. You get to choose what drug to get (in consultation with your doctor), and you and your insurance pay for it together. The drug company sets a super high price, gives you a rebate to cover your share, and then charges your insurance company an arm and a leg. By doing this, they can net more money than if they had a lower price and got money from both you and your insurance company. This practice also happens in auto repairs, where shops will "waive your deductible" and then charge your insurance company an inflated price. See discussion toward the end of this article: https://www.4autoinsurancequote.com/blog/when-is-deductible-waived/ https://www.4autoinsurancequote.com/blog/when-is-deductible-...
- yborg 8y ago
  Just had this discussion with a co-worker that is taking brand-name Humira - and AbbVie does exactly this, they coupon his out of pocket to his deductible limit and then he pays nothing. The rest of us in the risk pool of course then carry the ~$4K/month cost and nobody in the food chain pushes back, because they are incented to do the opposite. The result is 2017 sales for Humira of $18.43 billion dollars, 2/3rds of which was US. This is just one drug that the US healthcare insurance participant is carrying pharmaceutical profits for.
zifnab06 8y ago
Interestingly the cash price is around $1800/30 day supply. Absolute insanity.

amaccuish 8y ago

We're about to get Truvada free on the NHS here in the UK and I'm interested on going on it. Have you had any side effects?

dawhizkid 8y ago
No side effects, no.

bradleyjg 8y ago

> I'm sure there's some shady big pharma economics behind why these exist in the first place The co-pay is designed to make you share in the pain of the sky-high costs the drug manufacturer charges the insurance company. This has two benefits—1) you are only going to get it if you really need it 2) maybe you’ll lobby your congressperson to rein in monopolist pricing. By giving you a coupon there’s no pain sharing and those benefits are lost. Sure you’ll pay higher premiums, either directly or in reduced wage gains, but that’s defuse and indirect, so far less likely to drive behavior.

dawhizkid 8y ago
Makes sense
zdragnar 8y ago
Biologic drugs are grown, not manufactured. Mine should be around 4k / dose; insurance won't cover it, so the drug company only charges me I think a $25 copay. Fwiw, the insurance would have covered older alternatives, but the potential side effects on those are worse than the cure.
- bradleyjg 8y ago
  Should be in what sense? Is that the marginal cost to manufacturer a dose?
  - zdragnar 8y ago
    Should be in the sense that I don't recall the specific number, only that it was around $4k. Given the decreased consistency in the process (living things vs. mixing chemicals), I imagine a fairly good chunk of that 4k is also marginal cost to the manufacturer. Everything from research, to scaling up production, to storage and shipping (spoils at room temp) becomes more expensive.

reaperducer 8y ago

Not sure how widely known or common this is for medications but I take PrEP (Truvada) and the maker has a free "co-pay" card on their website that basically covers $4800/year in copayments (well above the $50/month I would ever pay). I see drug commercials all the time that say something like "Visit our web site, or call this number to find out how you can get ___ for little or no money." Perhaps this is the same thing.

gnicholas 8y ago

They are taking advantage of misaligned interests. You get to choose what drug to get (in consultation with your doctor), and you and your insurance pay for it together. The drug company sets a super high price, gives you a rebate to cover your share, and then charges your insurance company an arm and a leg. By doing this, they can net more money than if they had a lower price and got money from both you and your insurance company. This practice also happens in auto repairs, where shops will "waive your deductible" and then charge your insurance company an inflated price. See discussion toward the end of this article: https://www.4autoinsurancequote.com/blog/when-is-deductible-waived/ https://www.4autoinsurancequote.com/blog/when-is-deductible-...

yborg 8y ago
Just had this discussion with a co-worker that is taking brand-name Humira - and AbbVie does exactly this, they coupon his out of pocket to his deductible limit and then he pays nothing. The rest of us in the risk pool of course then carry the ~$4K/month cost and nobody in the food chain pushes back, because they are incented to do the opposite. The result is 2017 sales for Humira of $18.43 billion dollars, 2/3rds of which was US. This is just one drug that the US healthcare insurance participant is carrying pharmaceutical profits for.

zifnab06 8y ago

Interestingly the cash price is around $1800/30 day supply. Absolute insanity.