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645390 tn?1338555377

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
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667078 tn?1316000935
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

Helpful - 0
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
Helpful - 0
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?
Helpful - 0
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
Helpful - 0
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!  
Helpful - 0
1045086 tn?1332126422
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!!!
Helpful - 0
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
Helpful - 0
1307298 tn?1305946851
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
Helpful - 0
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
Helpful - 0
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
Helpful - 0
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
Helpful - 0
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.


Helpful - 0
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.
Helpful - 0
398059 tn?1447945633
Please, understand that you might need to shop for a good drug program even on Medicare.
Helpful - 0
398059 tn?1447945633
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.
Helpful - 0
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?
Helpful - 0
2194295 tn?1338395159
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
Helpful - 0
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?
Helpful - 0
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
Helpful - 0
1045086 tn?1332126422
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.
Helpful - 0
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.
Helpful - 0
2063887 tn?1337829746
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
Helpful - 0
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.
Helpful - 0
429700 tn?1308007823
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
Helpful - 0
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