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What does your MS drug cost you?
Jorge from Costa Rica was curious as to our drug costs and we were looking at an old thread on the topic. This is a good time to ask again - What does your MS disease modifying treatment (DMT or DMD) cost?
I am on Tysabri and I looked at the numbers - My insurance company, Blue Cross/Blue Shield, was charged $5,829.48 for my monthly infusion in December 2013.
At the beginning of 2013, that cost was 'only' $3,901.90 .
That is a crazy price increase in just 12 months.
Fortunately there is a generous patient assistance program for Tysabri and I paid $0 for my drugs and my insurance covers 100% of the infusion center costs.
Surprisingly, in January 2014 my drug price came down a bit to $4,433.55. That is still over $53,000 a year just for the drug. There is another $430/month for the infusion site charge, which makes that another $5,000+ a year.
How about the rest of you? If you don't mind sharing - what do your drugs cost?
Laura
I am on Tysabri and I looked at the numbers - My insurance company, Blue Cross/Blue Shield, was charged $5,829.48 for my monthly infusion in December 2013.
At the beginning of 2013, that cost was 'only' $3,901.90 .
That is a crazy price increase in just 12 months.
Fortunately there is a generous patient assistance program for Tysabri and I paid $0 for my drugs and my insurance covers 100% of the infusion center costs.
Surprisingly, in January 2014 my drug price came down a bit to $4,433.55. That is still over $53,000 a year just for the drug. There is another $430/month for the infusion site charge, which makes that another $5,000+ a year.
How about the rest of you? If you don't mind sharing - what do your drugs cost?
Laura
I'm on Tecfidera, in the UK.
We pay 12% gross salary up to £42k per year then 2% extra above that into National Insurance (National Health Service). Medical prescription charges on top of that in England are around £9 per item (free in Scotland). Private medical cover is optional but usually just allows quicker access to specialists rather than meds payment.
Tecfidera is part funded NHS and the manufacturer in a Govt deal - where they think too expensive to pick up all the tab! It's approx £1k for a month. Due to this anomaly though, patients can't be charged even the prescription fee as it isn't an NHS prescription (bit of a weird one).
So, I pay NI contributions into the big pot, but nothing specifically for my MS meds. I also have a pre-payment card as a one off annual fee to let me have all prescriptions all year without exceeding that cost - great for me as I have Asthma and dodgy back discs needing inhalers/meds etc too - plus high dose Vit D.
Feels like a simple system when you're in it, but isn't really!!
We pay 12% gross salary up to £42k per year then 2% extra above that into National Insurance (National Health Service). Medical prescription charges on top of that in England are around £9 per item (free in Scotland). Private medical cover is optional but usually just allows quicker access to specialists rather than meds payment.
Tecfidera is part funded NHS and the manufacturer in a Govt deal - where they think too expensive to pick up all the tab! It's approx £1k for a month. Due to this anomaly though, patients can't be charged even the prescription fee as it isn't an NHS prescription (bit of a weird one).
So, I pay NI contributions into the big pot, but nothing specifically for my MS meds. I also have a pre-payment card as a one off annual fee to let me have all prescriptions all year without exceeding that cost - great for me as I have Asthma and dodgy back discs needing inhalers/meds etc too - plus high dose Vit D.
Feels like a simple system when you're in it, but isn't really!!
My husband now has secondary progressive MS. We live in Rhode Island, US.
The fee for the Tysabri alone is $6000 A MONTH. Honest.
We get help through a fund or we would be without this (or any other) MS drug.
Pretty sad, huh?
The fee for the Tysabri alone is $6000 A MONTH. Honest.
We get help through a fund or we would be without this (or any other) MS drug.
Pretty sad, huh?
I am just starting in the next few weeks with Avonex, $1800.00 per month, but with my works extended health,Bio Gen assistance and then Pharmacare i will have to pay a miminal amout..under $100.00 per month for about the first 2 months,then it will be no cost to me, Bio Gen also said they do this every year for the patients until they reach their pharmacare limit
PD - I like your thinking. Now if only the insurance company would agree and send us via First Class. :-)
I am on Gilenya
I do not qualify for our provincial plan
My blue cross denied coverage bc I did not try 2 injectable treatments which were unsuited to me as per the neuro .. I only failed at 1
So the drug company Novartis is paying 100% of the cost until blue cross gets with the program
It is a cost of $30 000/ year
I do not qualify for our provincial plan
My blue cross denied coverage bc I did not try 2 injectable treatments which were unsuited to me as per the neuro .. I only failed at 1
So the drug company Novartis is paying 100% of the cost until blue cross gets with the program
It is a cost of $30 000/ year
LauraLu, I checked this morning; our dollar is reportedly worth $1.17 in NZ. Maybe you've looked into this already, but it seems to me it would make sense for BC/BS to fly you and a friend to NZ once a month for your Tysabri infusion. If your hubby is busy (or bored) I am sure that you could find someone here to help you navigate the airports once in a while. Just a thought. ;-)
I live in Canada and take Rebif. Currently I pay $50 per year for our provincial health plan and they pay $800 per month and my insurance at work pays the other $1200 per month.
The irony is that our provincial health plan is changing in 2015 and because I earn higher than they will allow starting at that time, I will no longer qualify so my insurance at work will have to cover it. They will charge me up to $60 per month.
The irony is that our provincial health plan is changing in 2015 and because I earn higher than they will allow starting at that time, I will no longer qualify so my insurance at work will have to cover it. They will charge me up to $60 per month.
Since my insurer requires use/failure with Gilyena first; I'm qualified for Biogen's financial assistance. Hopefully by the time my year rolls around, my insurer will approve with no contengencies. I love Tecfidera and do not want to change............
I pay $22 a month for my tecfidera. My insurance covers the majority of my fees. I don't think its a bad price.
Isn't this an interesting look at the vagaries of health care? It so much depends on luck, location and insurance. Is it too simplistic to think that no matter where we are we should all be afforded the same treatment at basically the same price?
Copaxone $1455 per month (about $17K/yr) covered 100% between the Alberta government and my employer drug plan. It's gone up about $50 per month in the past six years.
I am on Tecfidera. The contracted price between the specialty pharmacy and my insurance company is $4,995 of which I pay $10 (this included Biogen's co-pay assistance). I never inquired about the co-pay assistance it was just applied since day one. When my new insurance plan begins on 4/1 my responsibility will increase to $99.99 because of co-insurance. I am not sure what the final cost will be after Biogen's co-pay assistance program but I imagine somewhere between $10 and $100. I will gladly pay $1,200 annually for treatment that costs $60K.
If I were on a MS drug it would be $125 a month. I do not know about Tysabri. My Insurance has paid over $100,000 for my Cancer Clinical Trial . I owe about $4,000 so far this year. I have to pay $70 every time I go in which is 5 times at least every month. That does not count towards the $4,000 I owe. I qualify for no assistance from anyone. I spent over $10,000 on medical last year not counting my insurance premiums. I am glad to have insurance or I would be dead right now. My total yearly deductible is $10,000. and my premiums are $12,000. Then the thousands in Copay and medication.
Alex
Alex
My Tysabri is $49,000/year. I qualify for $10 co-pays on the Tysabri, and Biogen-Idec is chipping in $120/infusion. My insurance company picks up all but the $4500 max out-of-pocket, so I'm still stuck for that. It's hard to squeeze that into my budget, but the Tysabri is working so well for me, I can't see stopping it, now. *sigh*
When I was on Tysabri my insurance company was being billed $6,900/month,, of which I paid some nominal amount. This calculates to $82,800/year.
For Rituxan the insurance company was billed $22,500 for the two infusions. I had them late in the year so my deductible and out of pocket max had been reached, so I paid nothing.
Kyle
For Rituxan the insurance company was billed $22,500 for the two infusions. I had them late in the year so my deductible and out of pocket max had been reached, so I paid nothing.
Kyle
Nothing. I'm on a drug study, so the pharmaceutical company picks up the tab.
However, in Ireland, MS is one of the diseases whose treatment drugs are covered (as well as relevant medical appliances) by the long-term illness scheme.
People in Ireland with MS are covered. We pay nothing.
"If you qualify, you will get a long-term illness book. This book lists the drugs and medicines for the treatment of your condition, which will be provided to you free of charge through your pharmacist. You do not have to pay a prescription charge for drugs covered by your long-term illness book. Other drugs and medicines not related to the specified condition must be paid for in the normal way.
If your doctor or occupational therapist prescribes a medical or surgical appliance, it will be supplied to you from your Local Health Office."
Source: http://www.citizensinformation.ie/en/health/health_related_benefits_and_entitlements/long_term_illness_scheme.html
However, in Ireland, MS is one of the diseases whose treatment drugs are covered (as well as relevant medical appliances) by the long-term illness scheme.
People in Ireland with MS are covered. We pay nothing.
"If you qualify, you will get a long-term illness book. This book lists the drugs and medicines for the treatment of your condition, which will be provided to you free of charge through your pharmacist. You do not have to pay a prescription charge for drugs covered by your long-term illness book. Other drugs and medicines not related to the specified condition must be paid for in the normal way.
If your doctor or occupational therapist prescribes a medical or surgical appliance, it will be supplied to you from your Local Health Office."
Source: http://www.citizensinformation.ie/en/health/health_related_benefits_and_entitlements/long_term_illness_scheme.html
I am in Australia & I don't have to pay anything for my Rituximab. When I started it over 6 years ago I was told for 4 infusions a year it was AU$28'000 but that was a long time ago. I am getting this covered due to my Rheumatoid Arthritis otherwise I would have to pay the amount in full. This is only because it is not available as yet for MS.
I don't have to pay for my hospital stay with my private health insurance but if there were any tests that came up in the process I would be hit with co pays on all of those. I avoid a lot of costs by having blood tests done as an out patient before admission where there is no charge. I can of course go through the public health system over here but the wait list to get just into the neurology dept is about 2 years I was told. I'm sure all of this is as clear as mud to people outside of Australia lol.
Karry.
I don't have to pay for my hospital stay with my private health insurance but if there were any tests that came up in the process I would be hit with co pays on all of those. I avoid a lot of costs by having blood tests done as an out patient before admission where there is no charge. I can of course go through the public health system over here but the wait list to get just into the neurology dept is about 2 years I was told. I'm sure all of this is as clear as mud to people outside of Australia lol.
Karry.
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