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645390 tn?1338558977

Copaxone price???

Shared Solutions called me today for all my info.  She said she will call me early next week to give me the cost. She then said they offer financial assistance. So, I asked "roughly" what does she think will be my cost with my insurance.  She said "typically" with my insurance, my part would be $2500.00-------PER MONTH!!

Does this sound right? That will be a problem, to say the least. Guess I shouldn't worry until I know for sure the cost, but at the moment, doesn't sound too promising for me.

Do other people pay this amount? More? Less? Just curious...

Thanks,

Michelle

Perhaps they could lower the cost if they didn't give out this HUGE fancy book with the DVD and CD's?!
68 Responses
1474224 tn?1287004626
WOW!   I had given up also because of cost for this drug.  My pharmacy told me it was going to cost almost $4,000.00 a month for THEM!  I didn't even think about being able to afford it after that.  I am so glad I found your conversation oline.  It gives me hope again, :)Thanks guys :)
1034549 tn?1255428213
Copaxone now charges my insurance $3997/month. My copay is $30 but Shared Solutions pays my copay. It is available for EVERYONE regardless of income. Just call SS and ask for the paperwork.
1545242 tn?1293556952
SO  THIS PASS MAY I WAS TOLD I HAVE M.S. I WAS SHOCKED! I DIDNT KNOW WHAT EXACTLY M.S. WAS...I HAD NO INSURANCE THRU MY WORK MY HUBBY HAD JUST LOST HIS JOB SO I QUALIFIED FOR MEDI-CAL...NOW THE WORKER IS TELLING ME I MAY NOT QUALIFY ANY LONGER CUZZ MY HUBBY GOT A JOB WHICH IM HAPPY CUZZ HE LOVES TO WORK AND FOR 10 YRS NEVER MISSED ONE DAY! MYSELF IM AN R.D.A, I BEEN HOME I HAD VISION PROBLEMS AND MY LEGS WOW! IT FEELS SOMETIMES LIKE I HAVE WEIGHTS ON THEM. I CALLED SHARED SOLUTIONS AND AFTER I GET THE NOTICE I NEED TO CALL THEM WITH THE INFO SHE TOLD ME ITS ROUGHLY $3000.00 FOR THE MEDS!! IM IN A PANIC! I CANT AFFORD THAT! I DONT WANT TO TELL MY HUSBAND CUZZ HE TO WILL PANIC...WHAT CAN I DO I WANT TO REMAIN HEALTHY FOR MY CHILDREN AND STAY AWAY FROM RELAPSING...PLEASE HELP ANYONE IF U HAVE AN ANSWER PLEASE!!
572651 tn?1531002957
Hi and welcome to the MS forum here.  First you have to stop and not allow yourself to panic about this situation. The insurance/money dilemma can be a nightmare and it does not help your health.

There are other drugs approved for treating MS - copaxone is not the only one available (I am on copaxone) and one, I believe it is Rebif, covers the copay for everyone who wants to take it. BUT The rules how they apply to people on government assistance (medicare/medicaid) are often different and I hate to speak out of line about it.  

You should contact your neurologist and the local NMSS chapter for advice, too.


Do me a huge favor, and please starrt a new discussion about yourself and the help you need.  This is a fairly old post and most people won't stop to read your comments.  Once you start something new, many of the folks here will be happy to help you brainstorm solutions.

welcome again,
Lulu
Avatar universal
with no insurance, copaxene is running about $45,000 a year in the US, have not researched out the plans yet.  
Avatar universal
We have an unopened month supply just got it in today. no scam. just have an extra box to sell. its in the fridge now. ***@****
Avatar universal
and That's with insurance - under the new health reform act Obama Plan.  I have a 50% copay.  My insurance will cost more come January and so will the copaxone.  I can't afford either and have been without copaxone for quite seometime.  Haven't been able to get any financial assistance through Shared Solutions - I was rejected.
429700 tn?1308011423
I will have to pay about $3000 for a 3 month supply with my Copaxone in October when my insurance coverage switches.  I opted for a lower level insurance which will actually be cheaper in the long-run.  I will reach out of pocket in October and then after that, everything is paid for in full.  

With my insurance, I have to reach the deductible and then I pay 20% of the drug cost.  Since the drug is $9000 for 3 months and the deductible is $1500, I pay the $1500, then something like $1500 for the drug, so $3000.  

So, it could be that your insurance coverage is something similar?  
429700 tn?1308011423
I just saw your post, so nevermind my question.  I'm happy you only pay $5.00.  That is wonderful!  Best wishes on this medicine.
1453990 tn?1329235026
The retail pharmacy cost for Copaxone is up to $10,700.00.  It went up in Jan.

Bob
Avatar universal
hi dear. My mother really needs to be on copaxon but we cant afford it. we need to get her an insurance plan. I was wondering what insurance plan you have!
thanks
bronika
572651 tn?1531002957
All of the manufacturers have patient assistance programs.  Please call or have your mom call Shared Solutions and discuss all the options for help to cover this cost.  They make enough money off everyone else, they have surplus to help others.

My insurqance is now being billed $3,700 per month for my copaxone - but of course they don't actually pay that much.  Cobob may have been talking about a 90 day supply at that price, but I may be wrong.

good luck,
Lulu
1337734 tn?1336238191
Hi ! I have been on Copaxone for 10 months. I get  it sent to my home every month from a specialty pharmacy through Shared Solutions. Everyone has been very helpful and cooperative :) I am blessed to have a good insurance policy with BC/ BS so I have a copayment of only $35 a month. I truly hope everyone who needs this drug will find an affordable way to get it.
Xxxx Deb
Avatar universal
the price of copaxone is about $3700 per month - my copay for prescription drugs is 50% so the cost to me is $1850 - I know the price will go up January 1st - it always has - when I started the drug in 2006 the monthly cost was about $1470.  I cant afford the drug - the maximum shared solutions will give for copay assistance is $500 per month (which is alot of money but it still leaves me with a monthly cost of over $1300 - and that's just for copaxone!)
359574 tn?1328364024
I am in a QHDHP (Qualified High Deductible Healthcare Plan), and have a health savings account.  My deductible is $5,000.  Prescriptions are covered, but there is no co-pay.  It's just one of the things that can be applied to the deductible.

I am not on a DMD, and I haven't been diagnosed with MS.  However, I have researched the cost.  This year I hit my deductible in the summer.  I went to my plan's pharmacy site and priced copaxone and avonex.  Both would be free.  I signed on as my husband, who has not met his deductible this year, and they would cost him over $2,000 for a 30-day supply.  So the first couple of months would be horrendous, and then it would be free for the rest of the year for me.  As it is, I'll be paying about $400/mo for my other prescriptions for several months, anyway.
Avatar universal
what state do you live?  I have BCBS and live in NJ.  
Avatar universal
I live in NJ also.  Do you purchase your own insurance privately - unfortunately, That's what I have to do....
Avatar universal
You commented that the insurance companies don't pay $3700 per month for Copaxone.  I agree they probably don't but where could someone get information about that?  My insurance company wouldn't even give me the cost of the drug unless I ordered (and paid for) it.
572651 tn?1531002957
Like2no, now is the time to be talking to your local NMSS chapter or the MSAA office there in NJ and ask what they know about assistance programs.  There is no reason why anyone in this country is without a DMD because of the cost.  There are asisstance programs available but it takes a very determined person to sometimes find it.  Specifically ask the Shared Solutions people about the help through NORD - national organization for rare disease.  SS/TEVA fund NORD heavily to help people who can't afford their drug.  

Also, your share of the copay should be based on what your insurance actually pays.  It should bethis less amount  instead of 50% of the retail price.  My insurance paid substantially less than that $3,700 and then if I had to pay a percentage it would be based on that new amount.  

Please, please do not give up on finding a way to start your therapy.

Also, talk to your doctor about this problem.  They may have other resources for you or a suggestion of a different drug with a lesser cost.





Avatar universal
Thanks for your comments.  I've even contacted the state insurance department over this (and was told I was getting a good deal!.....)  They did tell me that the insurance company paid less than $3700 per month (which the insurance company claims the cost is.)  Are there any guidelines as to what percentage of one's income is suppose to be used for medical expenses?  I am suppose to be taking several drugs.
Happy New Year!
572651 tn?1531002957
I wish there were such guidelines for aid in this country.  It sure would make sense to me - but I don't know of any particular ones.  A lot of what I see are based on federal poverty levels times a certain multiplier.  My med center has those guidelines printed on their billing statements.

That $3700 sounds about right but definitely not what any insurance company is paying - that is the retail list price.  

All those drug bills by themselves may not sound like much but if you are taking multiple drugs with high copays you can rack up a bill pretty darn fast.  

To find out about the cost, go back to your specialty pharmacy and ask for an itemized statemnt of your account.  That should show what the insurance company has paid - that is how I know about the contribution mine makes.

When it comes to talking to shared solutions, call over and over.  Each person you talk to will havea different take on your coverage and what they can do to help.  Sooner or later you will connect with a person who will really be able to help.  Be sure to ask them if they can't help with the copay costs, what organizations you can contact.  

happy new year to you as well - here's to getting this straightened out for you!
L

Avatar universal
Insurance claims to have paid half, which is $1759.00.  I've spoken to numerous people, all of whom have told me they've never seem a 50% copay for drugs.....As to income levels. All I keep hearing about is the federal poverty income levels as well.  Soon the cost of my insurance premiums and my copays will equal my income after taxes!
Avatar universal
just learned what copaxone will cost me in 2012 - the price now is $4307.78 - my copay is 50% - so it will now cost $2153.89 per month
Avatar universal
Can you offer any suggestions where I can get help:
just learned what copaxone will cost me in 2012 - the price now is $4307.78 - my copay is 50% - so it will now cost $2153.89 per month
198419 tn?1360245956
Hi Likeno,

Sorry I'm chiming in so late. Have you priced out the other DMD options? I'm in NJ too and am going to try to see if I can put my fingers on some of the info you are looking for.  Just wondering too if the price of another med would be less costly in the end.

Shahlahelectra -

Thanks for posting your cost of supplements working for your MS. Copax is not an oral peptide, and therefore not comparable to those supplements you mention. However, if you have links to studies of MSers using oral peptides vs. sub Q or intra M disease modifiers, would love to read them.

We always interested in learning more of what's working for people.

Avatar universal
Through my pharmacy company the cost without insurance or shared solutions is almost $4000.  However with my insurance and the shared solutions program I only pay $30 per month.  Doesn't Copaxone have a payment assistance program other than shared solutions which is for uninsured under insured individuals.
429700 tn?1308011423
Copaxone does have a payment assistance program with Shared Solutions and they helped me out big time.  It does help people with insurance.  

Here's how Shared Solutions helped me--and they did big time.  

This year, instead of paying an extra $300 cost differential between level 1 and level 2, I decided to go with the lower level, reach my out-of-pocket to pay zero (out-of-pocket is $1200 after paying deductible & co-insurance).   Since Copaxone is so expensive, I met this deductible right away.

Here's the bottom line--Shared Solutions kicked in $1500 this last time.  I paid only $1200 (a far cry from the $2700 I was going to have to pay).  I am DONE with any more health care costs and medication costs for the year.  I will be saving a lot more money this year than last going to a lower level (less expensive) plan that covers less, and thanks to Shared Solution's program, I am having to pay $1500 less than I thought I would have to pay, AND I'm saving much more money going to a cheaper plan.

Shared Solutions is awesome for having these programs to help people.  I hate having to have expensive medicines for my disease, but they sure did take the sting out getting these shots (pardon the pun). Talk with them about your insurance coverage, etc.  They may be able to help you out . . .

Deb
Avatar universal
How can I get it for this price. I had to stop taking it because my copay is now $100 and I can't afford it.
2063887 tn?1337833346
Get in touch with Shared Solutions.  The called me about helping me with my copay when I started on Copaxone in February.  They have a patient assistance program.

Best Wishes
Chris
Avatar universal
if you tell SS you can't afford to continue, I wonder what they would say?

I take Tysabri and told them right out front, I could not afford their drug and they now pay for it 100%.  All I pay is $25 to the infusion center for administering it.  

Copax has an ad that you pay no more than $25 I think.  Check out their website if you have not done so, although am sure you have already been there.
1045086 tn?1332130022
Call Shared Solutions and talk to their financial assistance team.  They will help if possible.  The program that limits the monthly co-pay to $35 requires you to get the drug through specific discount pharmacies.  My insurance wouldn't agree to that but many do.

They offer other assistance programs based on the limits of your income.  Be prepared to share general financial information with them about yearly earnings and yearly medical out-of-pocket costs.

You might be able to get other assistance from sources outside Shared Solutions.  Check with your prescribing doctor (does he know you can't afford to take what he prescribed?) and/or the MS societies.
Avatar universal
I, however, was on Avonex for 12 years and when my husband retired, our retirement insurance would not pay anything.  Since, I did not have any other insurance I had to go off my shots.  My cost would be $3300.00 per month and that was two years ago.  I had no choice but to go off the shots then and have been shot free and I pray every day that I have no major problems. I was exhausted trying to find a way to pay but nothing came through.  I  can not get on our state insurance because we have a policy even though they do not pay for MS medication.  Good luck finding somewhere to pay for this rich mans disease.  Disabled in Oregon
Avatar universal
I had the same problem which continues my saga....I will start on MediCare on 8/01/12...and cannot find a Prescription D provider to cover the Copaxone.  I have been on Copaxone since 1998, and do not want to deviate from it.   Because it works!!!  So, when I call all the pharmacies...Walgreen's wants $103,000+ per month.  Yes, that is right...with no insurance.  When I had BC/BS provided by my employer, my deductible was $40/mo.  Now, no insurance, I had to get the grant for one year.  Now, I can't find any one to assist with my questions...including Shared Solutions.  What happened with all these people.  They never did this before.  It was such a good program...and called all the time.  Haven't heard from anyone in ages, and I agree with you on how expensive this is.  If we aren't working, have MS...how do they expect us to come up with $2,000+ and $100,000+ per month?  That is rediculous.  Who can pay any of this?
2194295 tn?1338398759
Coincidentally, I'm starting Medicare on August 1, 2012 also. I'm trying to find a way to continue taking Copaxone. I agree, it seems to work pretty well but I just can't afford the enormous costs. Have you had any luck finding a way to pay for it once you start Medicare?

Thanks!

Mackenja
Avatar universal
How much does copaxone cost under medicare?
Also, has anyone been able to get assistance through Shared Solutions or anyone they recommend. e.g. AssistRX?
398059 tn?1447949233
Depends on what drug program you choose under Medicare.  Typically one pays at most $30 copay for approved medications.  Normal pharmaceuticals are either $5 or $10 copays.
398059 tn?1447949233
Please, understand that you might need to shop for a good drug program even on Medicare.
Avatar universal
But look how much the insurance pays.  My insurance (Thank god I live in Oregon and we have what the rest of the country turns down due to morons stressing about nonsense) through the Oregon Health Plan pays the entire thing but even they pay $4,500 a month.

I'm not a drug user and have no clue what drugs go for but isn't crack and heroin cost more than 30 shots at $4,500?  What exactly am I injecting as even the price of gold is less than this drug for the amount that I get for that price.
Avatar universal
I pay nothing for Copaxone, 20mg per  day.

My insurance, First Health, does pay some but I am receiving other financial assistance. Don't ask me who it is, I do not know.

When my doctor put me on the drug, I mentioned cost, copays etc and his reaction to me was...Don't worry about it, it will happen.

My doctor is with OSU Medical Center in Columbus Ohio.

There is no way you should be paying that much.


Avatar universal
MY INSURANCE BASES CHARGE AT $4000 PER MONTH. AFTER DONUT HOLE COST IS $220.00 PER MONTH. THIS IS THE BIGGEST RIP OFF BY DRUG COMPANIES. THIS DRUG HAS BEEN OUT OVER TEN YEARS AND THERE IS NO REASON FOR THES HIGH COSTS. ASKING FOR FINANCIAL HELP IS LIKE BEGGING. WILL NO LONGER DONATE TO ANY GROUP TO FIND CURES, AS ONCE THEY DO THEY SCREW THE PUBLIC THEY ARE SUPPOSED TO HELP
Avatar universal
My husband has been on Copaxone for 1 year and had assistance. We were very blessed for that because my insurance company UNITED HEALTH EXCLUDES this medication and wont pay a dime. Copaxone has kept him out of the hospital this year. Unfortunatley when it came time to renew the assistance he was turned down. Not to sure why...we've lost our home, our car...and I now make less money. So last week he had to stop taking it. Just cant afford it. We were going through AssistRX which works with Shared Solutions. DOes anyone have any suggestions. He was doing so well. Being off the Copaxone really scares me....and him. Thank you
Avatar universal
copaxone now costs $4600/mo according to my insurance.  they pay it all and i pay $85/mo copay but with financial assistance from shared solutions/cvs it goes down to $35/mo
1307298 tn?1305950451
The cost you have quoted is not unusual.  I started Copaxone 3 years ago (2009) and at that time the total cost of the drug was $4000/mo and I had to pay $2000 of that.  

However, Shared Solutions has a program where you only have to pay $35 per month.  I called and did not have to give any financial information.  The call literally took 5 minutes.  Call!

Here are the details on their drug site.

http://copaxone.com/StartingCOPAXONE/COPAXONE-Co-pay-Solutions-aspx-1.aspx
Avatar universal
Hello, I am sorry that imam saying this, i do not have ms I was somewhat diagnosed with ms about a year ago, my doc prescribed copaxone. I have been taking it for the past year. Recently a different doc confirmed i do not have ms. Yes i feel fortunate but I do have almost three months of copaxone that paid for.

I really hate throwing it away

Can you help....can anyone
1045086 tn?1332130022
No need to apologize for your good news!  I just hope you're able to look forward to a healthy future now and don't have to re-enter diagnostic hell.or adjust to some new disease process.

I believe the yearly raw billed price on Copaxone now tops $50,000 so there are, no doubt, many people who would consider themselves fortunate to be the recipient of the generous gift of three months of disease modifying treatment.  You'll probably run into difficulty though since Copaxone is a prescription drug subject to specific dispensing regulations.  Your best hope is probably if you met someone else in your time 'with MS' who feels comfortable with 'disposing of your excess'.

Good luck and
CONGRATULATIONS!!!
Avatar universal
My husband has been on for 3 weeks.  We are paying $35 a month thru Shared Solutions.  I just found out that his employer is being charged $4800 per month for the insurance share.  Jeez!  
Avatar universal
Hello.  I was Diagnosed with MS in June and I panicked as well!  My employer does not offer insurance AND I am single so I was able to qualify for State Assistance.  Do some research..and there is A LOT, but there are a lot of programs that are willing to help.  I have a friend who also has it and she gets help through MS Foundation because her insurance plan does not cover her meds.  She is not on Copaxone....it begins with a B....Betaseron.  Like I said, do your research.  Yes, it's a lot to take in, but so worth it!  Good Luck
Avatar universal
All of you people should count yourselves lucky. I live here in the US but on a limited visa as my husbands company really needed him here. I don't qualify for any form of local insurance and my insurance from the home country wont cover the medicine here because of its ridiculous cost. I was diagnosed with MS a month ago. I chose copaxone as my treatment. As usual I applied to TEVA for help, got the info and all the phone calls. That's where it all falls down. They flat out said they couldn't help me and hung up. I am not a permanent resident so apparently its ok for me to suffer without treatment.

I know the price in my home country is WAY less than here. In Australia the current retail cost is $1056 per month rather than $6000 that is listed here. I qualify for my national prescription program too which means I can get it for 38 a month. So several times a year I am going to have to use my family's holiday money to fly home and see another neurologist, waste a week of my life on bloody planes and wait in pharmacies for them to find a supply of it for me to travel back here with.

Do any of you people here realise how badly you are all being deceived by the drug companies? In my country you could be paying less than a fifth of the ridiculous costs here regardless of who you are or where you live. 1056 is the maximum over the counter (with a prescription obviously) price paid in the entire country.

Also for a country that welcomes people from everywhere, how can you all sit there Knowing how expensive it is and allow these companies to play god and decide which segments of the population deserve help to get the drug and who they cast aside without ANY regard at all?
Avatar universal
Hi there. I understand why you're angry. The American health care system could be argued ad infinitem, and already has been, so I don't see a point in getting into all that here.

What I wanted to say, though, is that yes, the retail price of the MS drugs is outrageous. However, I've never met or heard of anyone who actually pays these prices, so basically they're just numbers. Most of us have insurance that covers the vast majority of the expense, and the insurance companies negotiate the amounts with the various drug manufacturers, What they pay is a lot, but it's far from $6000, for instance. We do have copays, which vary considerably. Mine is extremely low, much less than I pay out of pocket for prescription eye drops, I'll never understand these things, but am just glad to have the insurance (for which I also pay a premium, as does everyone else).

Those who don't have insurance or otherwise qualify do get a big break from the drug companies, and some pay nothing. It's unfortunate that this possibility is not available to you (thus far), but since they more or less give away the drugs, they get to make the rules.

I suggest you try for a prescription for another MS drug. Copaxone has lots of competitors which have pretty much the same effectiveness profile.

I'm also wondering why you need to return to Australia each time you need a refill. In the US we don't have to see our neuros for a prescription, all other things being equal, and many go once a year or so. This varies with the individual and the doctor, so there is no rule about it.

But if that's a requirement for you, why not set up a working relationship with a neuro here, in conjunction with your home doctor? Not someone to do tests, etc., but someone to communicate with your home doctor, who then could verify the script and order it. You might make arrangements to receive it by mail from overseas. Even if you paid the US neuro out of pocket, that still would be cheaper than several round trips to Oz each year. But maybe your husband's insurance would even cover the neuro visits, even if they won't pay for the drug.

Finally, what plans do you have in case you have a bad relapse while here? And whom will you be seeing for symptom drugs? You do need someone local in any case.

Good luck with this.

ess
667078 tn?1316004535
I am sorry for your situation. It is not fair.

On the other hand Americans can't get Visas to work or for an extended stay in Australia if they have MS or any serious illness because of the universal medical system. We also can't repatriate there or to other countries that have universal health care. I have seen this first hand.

Alex

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