copaxone price increase

[meg321]

Has anyone else had an increase for their copaxone?

Mine just went from $50.00 to $158.81....it is funded by teva pharm..

hugs, meg

[Jan47542]

My husband's insurance has changed. We will now pay a 50% co-pay or about $1100 a month. Can't find assistance since we are both working. Shared Solutions said we do not qualify for assistance as most of the other websites I have searched. Any other avenues to search?

[meg321]

Smart aleck !!!

[JemmAus]

*glad to be australian*

[HVAC]

My insurance for state workers has charged $100 a month for DMDs for years. Lyrica and my asthma medications are $50 a month. I think Amprya is $100 as well. I am now taking medicine which are generics which do not work as well. I have halfed dosed anything to survive. I used to get samples from my Doctor for my asthma and migraine medications but they have dried up.  A forth of our income at least goes to my medical. I think hard before I buy anything including groceries. I do not qualify for any assistance. I am glad I am no longer on a DMD. I owe $4000 the first month of the fiscal year in copays. It will take us over a year to pay that off.

Alex

[lovemy6monkeys]

I just got an email a couple days ago from my local NMSS chapter. It said that many insurance companies are no longer putting DMDs on the prescription tiered co-pay. For example, for someone who "needs" Viagra, they might pay the highest tier co-pay for it, usually around $35 a month. But, for the DMDs more insurances are making you pay a percentage of the cost. Even 10% of the monthly cost is an insane amount!

The email from my local NMSS was asking me to sign a petition of protest. As of right now, my state (NY) does not allow them to change the policy to charge a % if the rest of the policy is a tiered co-pay.

On a bit of a side note: we have a state insurance (not medicaid, but it is for those who make too much for medicaid and not enough to buy into employer offered insurances...but it does use medicaid for prescription coverage). From the time SS sent my prescription to the pharmacy it took about 2 weeks for insurance approval. I do not know the actual cost of my Copaxone, I have no co-pay. I wish more states offered insurance for those like us. My DH is paid bi-weekly, and if we used the insurance offered by his employer it would cost us one of his monthly paychecks. The *entire* check! And, the state run insurance has MUCH better coverage. You pay a monthly premium based on income. (ok, I'll stop before I start a state vs. employer insurance debate LOL)
~Jess

[meg321]

I must say its all very confusing, but i really have a hard time understanding many things.  I am having to concentrate very hard on this.

I am still talking with them, they don't quite inderstand my insurance.  So it goes on and on, they need to know what slot to put me in.

What happens to some of us who do not have insurance?

meg

[twopack]

I suspect SS got your insurance information from the prescribing physician, Imeiser.  At least I hope our health care system isn't so out of control that my insurance pays $8684 a quarter while yours pays nothing.

Shared Solutions' program covers or waives the co-pay (I think up to $50 a month), not the basic cost of the Copaxone.  Otherwise there wouldn't be US citizens here who can't afford to take this DMD.  I'd love to know how SS benefits from patients using 'their' specially designated pharmacies.

I don't have the option to participate in the SS offer because my insurance doesn't let me choose their preferred pharmacy.  I have to satisfy myself with free meals and a cloth tote (that smells of tobacco smoke) from them when I attend their presentations locally.

Still, I'm glad you benefit and can apply the savings to other meds you need for treatment.

Mary

[lmeiser45]

I would call Shared Solutions again.  I told them I had insurance and that I'm a teacher, so I know I won't qualify.  She said we don't even need to know what insurance you have.  All they wanted was for me to fill out the form.  I've never paid a cent for any of my meds. I had to agree to use their online pharmacy where they mail the meds to me in a huge box with ice containers to keep it cold.  For as many other bills for prescriptions we all have to take I wouldn't hesitate to see if we qualify.  I am not low-income...maybe middle of the row, but still... Our pain with this disease deserves free coverage.  When they told me it wouldn't cost, I started to cry with a little bit of happiness. All I could think about is...what am I going to do and how am going to pay for this.  Now, I don't have to think about it.  They also call you every three months to refill the prescription.  It's nice.  

[meg321]

Well, Lulu, that article took me right back to SS.   That is the problem now that you mention it, it was because of the Aetna pharmacy..

They did call back today to correct misinformation they had in my file.  They will call tomorrow.  I may see if my MS doc can do something too.  UCSF has a bit of power..

will let you know what comes of it..

meg

[twopack]

Oh, and I'm in the same boat as you Lulu.  My insurance says I must get refilled from one specific pharmacy and Shared Solutions only offers to wave the co-pay when you use one of their designated discount pharmacies.  Sounds like something not quite kosher to me.  I didn't even think service providers were allowed to wave co-pay amounts after insurance payment.  That's how the so-called 'professional discount' disappeared.

On the other hand, I did have a very helpful conversation with one of the SS nurses on a routine call last week.  Not at all scripted.  They sent me a letter today that stated now that it's been six months, I won't hear from them so often.  I'll survive.

Mary

[twopack]

I just got my refill for three months.  The cost to my insurance company is the same as three months ago.  The plan paid $8684.08 and I paid $150.  I sure hope I don't need coverage for any other conditions along the way.

Mary

[meg321]

Thanks Lu..i will check it out..I didnt mind $50.  but i have a call into SS..we will see..they couldnt help me before..

hugs, meg

[Lulu54]

I got distracted over on MSF's site and found this interesting piece about the cost of MS treatment - it has tips on how to approach keeping your drugs affordable, including people who are on govt. insurance assistance.

http://www.msfocus.org/article-details.aspx?articleID=353

[Lulu54]

this is my ongoing debate with SS and my insurance company.  

I don't qualify for the program because the pharmacy I am required by Anthem to use is not a particpating pharmacy in the SS plan.  So I am responsible for the monthly $50 copay.  I try to tell myself that it could be so much worse.  But still, that adds up to $600 per year.

[HVAC]

There are two copay assistance programs with Shared Solutions one is for most folks ( except when it does not work with your insurance or pharmacy) need or not and one is needs based. The needs based you have to send your Tax forms etc.

[momma2abcd]

Yes, copaxone went up in price. the insurance side use to be a little over $2000 a month and I noticed it went up to $3000 a month now, it didnt affect my co-pay but that is what happend. a big jump in price for sure!!

[meg321]

Great, i did find the form online...will check it out today.

Thanks, meg

[lmeiser45]

I would call Shared Solutions as well.  I don't pay a thing and I have never even had to show them my insurance card.  As long as I didn't live in a certain state (I don't remember which one) and as long as I wasn't receiving medicare, you qualify.  I would call them.  All I had to do was fill out a really easy form that they faxed to me.  I had my paperwork that I qualified within a couple of days. My medicine gets sent to me from Walgreens Medmark in the mail.  A paper inside says I owe a $25 copay, but we don't have to pay it.  It's 100% free.  

Good luck!

[meg321]

Last time it happened I talked to Shared Solutions and they told me that they didnt work with my insurance..but i also have Aetna.   But not all insurance is the same even within the same company.

I couldnt get them to cover me...

But on Monday I will call them again...

thanks, meg

ps..why don't we have happy faces on here...

[twopack]

Last time I ordered my three month supply the base price went up about $800.  My co-pay stayed the same at $150 for the 90 day supply.  I've been interested to see what insurance is charged when I refill again the first week of September.

Mary

[jensequitur]

Ouch!

Have you talked to Shared Solutions about their patient assistance program?  I'm currently on 100% financing for Copaxone.  If I didn't have that, it would cost me $90 from Aetna per month.