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Multiple Sclerosis Community
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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
1012981 tn?1322606893
Do you think that maybe she misunderstood you? I'm on Copaxone and it cost about the same price. My copay is $15.00/month, my insurance covers the rest. I would call your insurance company and ask them how much it will be. If your insurance doesn't deal with shared solutions try calling Pression RX.

Best of Luck,

Bob  
572651 tn?1531002957
Michelle,
That price sounds like the total cost of the copaxone - about $2,500 a month is the cost of the drug.  Your insurance should cover it under your prescription plan.  

I have a $50 copay on this drug because it is not in the formulary - normally my copay is $10/generic and $25/name brand drugs.  

My drugs come through Precision RX in Indianapolis - they are a specialty company connected through blue cross/blue shield's pharmacy network.  

I am sure that there was confusion on this question - please do not panic about this.  You won't have to choose between your meds and shoes for the boys :-)

Also, Teva has pharmaceutical cost assistance for people without insurance.
later,
L

620048 tn?1358021835
I get mine thru Teva also and i was paying $50.00 and it just went up to $137.00, will check with my dr when I see her.

Maybe $2500.00 is what is covered....that sounds better.

meg
505094 tn?1240321031
I'm on Copaxone and have a $30.00 co-pay.  Shared Solutions called me and wanted me to know that they would pay the co-pay for me.  I'm still waiting for the application.  Also, the drug company that Copaxone comes from also has a plan to cover the co-pay.  The price of Copaxone is 2500.00/mo that my insurance covers.  Charley
667078 tn?1316004535
Shared Solutions has a needs based discount program. You have to ask for the needs based discount. You need to apply asap because it takes a week and they will not cover Copaxone retroactively.

For example they o.k.ed mine the day after my prescription was filled so I had to pay my whole copay which was $300 for three months. They do have a lifetime cap on there assistance.

There non need discount has many loopholes. They keep saying I am o.k.ed but at the last minute I am not. They used to call once a week to say I was accepted and then say Iwas not. I told them they were sadistic. SS no longer calls now they send letters. I have to get Copaxone through Medco Accredo.  SS does not work with Medco Accredo. They do not work with many other pharmacies.

Otherwise the MS Society may offer help you.

Teva makes more money on the Copaxone in the U.S. market than you can imagine.3.4 billion a quarter. Go to their web page for Stockholders. They say no other MS drug in history has made the money Copaxone has. Ironically if you are on any generic in this country Teva probably makes it to.

I like Copaxone do not get me wrong and will stay on it. Teva is a business and like the Medical Insurance Companies the stockholders are the bottom line.

Alex

755322 tn?1330272714
My quoted price for Copaxone was $2880.00 month... After finding an insurance company to cover some of it my out of pocket was $484.00. I am actually glad I had a bad reaction to it and had to stop after 10 days. That was just totally unacceptable price. I am so glad some of you or rather most, can get a decent copay. $484 was more than my monthly house payment!
620048 tn?1358021835
I know I really didnt have to do anything, UCSF did it all for me, got my financing thru Teva....I LOVE THAT HOSPITAL !!!

But my co-pay went up and I don't why....

hugs, meg
Avatar universal
Michelle, as others have mentioned, this just doesn't sound right. Insurance companies foul things up all the time, so don't get worried yet.

For me, after 14 months on Avonex delivered in 90 supplies, I suddently needed 'prior authorization.' which apparently I was just supposed to intuit. That caused a huge runaround and a delay in shipment, meaning I was 4 days late in doing one dose. I'm still angry over that, angry at the way I was treated during this process, and angry that they used the opportunity to more than double my co-pay (though it's still amazingly reasonable).

The lesson for me from this is that there are a lot of incompetents handling insurance work, along with many who know what they're doing. So if something sounds wrong it probably is. Make sure you investigate this again, and make sure your doctor knows if you still have trouble, also, of course, Shared Solutions. My neuro's secretary told me she spends way too much time straightening out insurance messes, and I'm beginning to think she's right.

ess
195469 tn?1388326488
I agree with the others.  You were given a price that is the total cost for one months' supply.  This will not be what you have to pay, if you have insurance.  You will have a co-pay.

I am one of the fortunate ones.  I am on Social Security Disability and also on government or State insurance, because I am single and unable to work.  I actually get a check called SSI.  It's a supplemental income of $674.00 a month, with free medical care with no deductibles.  I am extremely grateful for what I receive, of course, I have had others tell me that I earned the assistance, after working all my life.  Nevertheless, I am grateful.

I hope they can get your insurance straightened out soon, so you will know exactly what your deductible will be.  When I was on Copaxone, I had to get re-authorization for the drug every six months.  I was only shipped one month supply at a time, by their chosen mail-order pharmacy.

Good luck,
Heather
198419 tn?1360245956
Hey Michelle - lending more weight to her being totally off.

Like Ess says, they foul it up all the time - as do pharms.  You typically should not pay more than what your prescription plan pays for name brand. Unless, like Lu's issue where it's considered formulatory - only way around that is if an exception is made on your behalf.  And, that is done all the time.

If you are in this situation - please ask your physician to submit for one for you - there is a good chance it will be approved due to the limited drug options available to us MSers.

Please hollar if you need more info and we can dig for the criteria for this for your insurance company...

ttsy,
shell
1012981 tn?1322606893
If you can work this out with your insurance company, and it's affordable. I would highly recommend Copaxone, it's been a miracle drug to me and to the majority of the people who have been on it.

Bob
1034549 tn?1255428213
Michelle,


I hope that possibly you misheard them, because it doesn't sound right. My co-pays for meds are either $10, $30, and $50. When I was on Rebif my co-pay was $50/month and my insurance covered $2,190. Now I will be starting Copaxone and my copay for that is $30 and my insurance covers the remaining $2525.00.

Also if the quote they gave you IS true, contanct Shared Solutions and see if you can get into a *study* for some they will give FREE meds for the first year if you participate!

Hope this helps and you find a resolution.... In this economy NO ONE can afford that

~Scottie
382218 tn?1341185087
The cost of Copaxone in Alberta, Canada is somewhere between $1400-$1600 month.  This is mostly covered for all Albertans with RRMS through a provincial MS drug program.  (the other first line DMD's are covered too).  The program is not income/needs-based.

To get this coverage, one needs Blue Cross non-group insurance which is about $30 per month for premiums.  The co-pay is a max of $30 per month.  I am lucky to also have drug coverage with my employer plan; the two plans are linked so I pay zero co-pay for Copaxone; actually, for all my meds.

The most someone in Alberta without employer coverage would pay for Copaxone would be $60 month ($30 premium for the plan, which covers other meds and services too), and $30 for co-pay.

I've wondered why the cost of this med is so much lower here, in some cases half of what it costs in parts of the U.S.  
667078 tn?1316004535
It is cheaper in Canada because the Government negotiates with the drug companies which the U.S. does not even do with Medicare the government run health program. In the U.S. drug companies spend millions of dollars on individual lawmaker's campaigns and on lobbyists. The Drug companies and Health Insurance Companies practically own the U.S. government. Teva make more money on Copaxone in the U.S. then any other place in the World. Novartis has filed for a generic patent and Teva is fighting it in the U.S. Courts on the other hand they make generics of most of the generics in the U.S.

The argument has been the U.S. pays higher prices because of Research and Development. Teva is in Israel.

Also the advertising is expensive only the U.S. and New Zealand allows direct advertising to patients. Some Drs. are paid $5000 to use a drug. Pharmacies even tell drug companies how many times a Dr. prescribes a certain drug and then the Dr. is rewarded. Medical Journals are subsidized by pharmaceutical ads, the same journals which publish drug studies.

I have one Doctor who will not have anything to do with representatives from the drug companies selling or as they like to say educating him on drugs. BCBS will not allow him to be a provider for this reason.

Alex
645390 tn?1338558977
Got a call from the specialty pharmacy tonight regarding Copaxone and when do I want it shipped.

I asked the dreaded question about the price.  I feel very blessed and HUGELY relieved. It is a $5.00 copay for a 3 month supply. I hope I heard that right. I am pretty sure I did, and asked him to repeat it.

We will see, but for now I definitely like that price SO much better.

hugs to all,
Michelle
1012981 tn?1322606893
Michelle - Thats great news, and i hope that the Copaxone works well for you.

Bob :)
Avatar universal
I have been on copaxone for almost three years.  When I started I had a $50 per month copay.  My health insurance provider signed with Acredo and when they did, the copay went up to $100 per month.  Just this past fiscal year, they jumped the copay to 150/month.  Who knows where it will go.
When it gets up to 250 per month, I think I will just take a short ride in a fast airplane.
Avatar universal
we were on NORD assistance and when hubby got on ss disability we were kicked off we cant afford medicare insurance and so we do have medicare rx but they wont cover hardly anything of copaxone. I have tried everywhere and most insurance companies rates are way too expensive for us. we are just barely above poverty level. I havent tried the teva maybe they can help. Our cost right now will be$1750 per month then medicare will only cover the 750.its so frustrating
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. ***@****
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