Medication prices continue to be a major concern for many Americans.  Recent months have seen a deluge of stories of drugs with $100,000+ price tags.  A 2015 poll found that a third of patients saw a price increase in their medications last year.  The problem is that these price increases have different causes, making it difficult to solve all the issues.

With advances in science we have seen development of new, highly successful drugs sometimes costing as much as $1000 per pill.  These prices are often seen as justified when researchers look at the benefits of a curative versus the potential long-term cost of living with a condition and less effective treatments.  This is frequently called “value pricing.” The companies that develop these drugs reap profits for the medications patent life (typically 7-12 years) until generic medications are able to enter the market at more affordable prices. The question that remains is whether these exceedingly high prices and several years of wait are worth some patients not being able to afford a medication that could cure them.

The problems of expensive effective brand-name drugs

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Drug prices continue to be a major concern for Americans.  According to a Kaiser Family Foundation Health Tracking Poll published today, 77% of those surveyed said medication costs were their number one health concern, reflecting recent headline-making increases.  Furthermore, 63% support government action to lower prescription drug costs as a top priority. Compared to a study by the same organization from August, the results are largely the same with notably increased support of government intervention.

The United States is the only developed nation that allows drug makers to set their own prices. Throughout Europe, Canada, and Australia, governments negotiate the price of drugs with pharmaceutical companies in the name of public interest.  The United Kingdom, for example, negotiates through the National Institute of Clinical Evaluation (NICE). NICE researches and analyzes new drugs, procedures, and devices and tells the manufacturers the price the UK is willing to pay. These practices make life-saving healthcare affordable to all those who need it in their countries.

In the US, pharmaceutical companies set the price

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This post was written by Sandy Hope, Funding Specialist, and Justine Dolorfino, Social Media Specialist & Communications at Diplomat.

Did you know that foundations and grants exist that may help patients afford their important specialty and limited-distribution medications?

Getting started with co-pay assistance

Each foundation has designated disease states or medical conditions that they support. Some diagnoses can be covered by several foundations. Others are only supported by one or two foundations. This can make it more difficult to find funding for some medical conditions because of a lack of funds available or because there is not enough funding for certain diagnoses.

In addition, some foundations are diagnosis and drug specific. This means that in order to qualify for funding, the diagnosis and drug prescribed must both be supported by the foundation. As part of the application process, the prescribing physician is required to complete and sign a section of the foundation’s application verifying the diagnosis and drug(s) prescribed.

What are some other factors that are considered?

Most foundations will consider the household

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By Brenda Hawkes, Patient Advocacy Manager, and Justine Dolorfino, Social Media Specialist & Communications at Diplomat Specialty Pharmacy

If you have a prescription to treat a serious disease or condition such as HIV, psoriasis, or cancer, chances are that you get your medications through a specialty pharmacy. You may have wondered what the ‘specialty’ in the title means and why that makes a difference.  We can help explain that here.

What Is A Specialty Pharmacy?

Specialty pharmacy is a branch of pharmacy care that helps people with special and often long-term needs. These people include those with conditions like cancer, multiple sclerosis or HIV, as well as people with fertility issues or who’ve received a transplant. Specialty pharmacy care allows people to continue leading lives outside a hospital, with better outcomes and lower overall costs.

To treat these diseases and conditions, specialty pharmacies focus on specialty and limited-distribution drugs, which require special handling, storage, and dosing.  These treatments are often expensive, and typically, they’re offered only at specialty

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by Richard J. Sagall, MD, President of NeedyMeds

Everywhere you look you see claims of savings from drug discount cards. You may be skeptical when cards promise huge savings. And you should be because not all the claims are real.

Too Good to Be True

The old saying “If it seems too good to be true then it probably is” applies to drug discount cards. Drug discount cards have the potential of saving you a lot of money, but you have to understand how they work.

It’s important to remember that they all work basically the same way. Here’s the scoop.

First, a company called a “pharmacy benefits manager” (PBM) or an adjudicator sets up a network of participating pharmacies that agree to accept the cards. Then the PBM negotiates with each pharmacy chain and all the participating local pharmacies offer a discount on the drugs they dispense. The discount is usually a percentage of the cash price of the drug. The percentage may vary from drug to drug.

Next, the PBM finds companies or organizations to market their card. These groups, called marketers, may be for-profit companies or non-profit organizations.

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