Medication Costs on the Rise

Last month, we posted a blog about how many Americans are spending more than $50,000 or even $100,000 a year on medications—more  people than ever before. The information included insured Americans and found that insurance covered an average of 97% of prescription costs for those spending at least $50,000. At NeedyMeds, there are many assistance programs for those who are in need.  However, even with new laws and regulations there are those stuck in between.

There are patients in America that make too much money to qualify for assistance but still not enough to pay all their medical bills.  Patient Assistance Programs (PAPs) and non-profit organizations often have limits to how much income a person or family makes in a year to be eligible for their services.  Good jobs and good insurance can still leave patients paying huge amounts for prescribed medications.

Some medications for serious or chronic diseases such as lupus can cost $2500 per dose. Even with insurance that pays 80% of the drug price there is a $450 out-of-pocket payment, which does not include monthly insurance premiums or other medical costs.  One hepatitis C drug costs $84,000 for a 12-week course. While some patients end up taking on massive amounts of debt, others opt out of taking their medication at the risk of more serious health problems in the future.

According to Truveris, a drug pricing research firm, the price of prescription drugs rose 10.9% in 2014 compared to 2013. Pharmaceutical companies often blame insurance companies who in turn blame the pharmaceutical industry; experts see both sides to blame, with government regulations exacerbating an already losing situation.

Despite recent Supreme Court rulings upholding Affordable Care Act (ACA) subsidies and that patients with pre-existing conditions can continue to get insurance, medication costs are becoming a top concern for many Americans.  According to one poll, 76% of Americans agree that making high-cost drugs for chronic conditions affordable should be a top priority of the president and Congress.

While the uninsured rate in America continues to steadily fall, the amount of money being spent on medical care is increasing dramatically. There are resources available at Needymeds.org for those that meet unique eligibility criteria for each program listed as well as access to drug discount cards and coupons for uninsured or underinsured patients. For those simply trying to make ends meet between being employed, insured, and unable to afford medical care there are options such as crowdfunding, an example being NeedyMeds’ platform HEALfundr.  There are new regulations expected from the Department of Health on discrimination in the ACA in the coming months, which could impact some of these new concerns. Call our toll-free helpline (800-503-6897) if you are looking for any information.