5 ms·
Woah is that a typo? $108,000 a year for psoriasis? Would it be cheaper to fly somewhere?
by switch007 2y ago
Woah is that a typo? $108,000 a year for psoriasis?
Would it be cheaper to fly somewhere?
- ceejayoz 2y agoThat's why I have the health insurance. I pay a $5 copay on it. I don't think it's sustainable on the national scale much longer; the insurance premium costs me twice my mortgage each month.
- switch007 2y agoOh the wording was ambiguous. Sounded like that was what you paid. $5 is more reasonable!
- s1artibartfast 2y agoI assume this is sarcasm. Either way, it highlights the fundamental challenge with how healthcare incentives are set up in the US
- switch007 2y agoI'm lost. Just a confused European trying to understand US healthcare
- s1artibartfast 2y agoOh, in that case your comment highlights the difference between the obvious and direct cost to the patient $5, and the less direct cost of $100k/yr which the patients are also paying. In the US you might have the copay $5, but you also pay for your insurance plan, which might be like $30k/year for a good family plan.
- ceejayoz 2y agoDon't worry, Americans don't understand US healthcare either. One of the biggest challenges to reform here is the costs are all hidden away from most people. People think their health insurance costs $100/month because their employer chips in the other $1900/month towards the premium.
- s1artibartfast 2y agoThe other challenge is the decision maker for what is covered is separate from the payer. People choose different plans, but my understanding is that they dont differ much at all in healthcare access. Instead, they differ in the average percentage of healthcare expenses that will be paid by the plan.
- jasonjayr 2y agoI'm on a similar deal for my Psoriasis medication, Cosentyx. The Insurance company is billed some ungodly amount, and my copay is small or $0. There has to be some financial shenanigans going on: someone is marking up the price, and writing it off to some reasonable level for some benefit. It's not sustainable to the insurer or the insured to be paying these kinds of prices for what amounts to a 'forever' medication. The stress of maintaining the discount programs, induces quite a bit of anxiety.
- s1artibartfast 2y agoNovartis revenue from Cosentyx is 3 billion for the first 6 months of 2024, and up 20% YoY. There is absolutely some shenanigans going on, but most of that goes on with the Pharmacy benefits manager.
- jasonjayr 2y agoRight, so, My insurer is United, the Pharmacy is OptumRX, the PBM is OptumRX, and the discount program is from Novartis. All these parties (ultimately 2?) are doing something to their balance sheets.
- ceejayoz 2y agoYes. For example: https://www.propublica.org/article/when-buying-prescription-drugs-some-pay-more-with-insurance-than-without-it https://www.propublica.org/article/when-buying-prescription-... https://www.propublica.org/article/take-the-generic-drug-patients-are-told-unless-insurers-say-no https://www.propublica.org/article/take-the-generic-drug-pat... https://www.nytimes.com/2024/04/07/us/health-insurance-medical-bills-takeaways.html https://www.nytimes.com/2024/04/07/us/health-insurance-medic...
- s1artibartfast 2y agoRight. PBMs and insurance make large profits, and that is additive to that of the manufacturers. I wonder what the total cost to patients of the drug is.
- 2y ago