Drug Prices Leave Even Insured, Affluent Struggling

I'm counting my blessings, I guess. So far most of my meds have been covered. And my family's too.

At WSJ, "Patients Struggle With High Drug Prices":

BELLEVILLE, Ill.— Jacqueline Racener ’s doctor prescribed a new leukemia drug for her last winter that promised to roll back the cancer in her blood with only moderate side effects.

Then she found out how much it would cost her: nearly $8,000 for a full year, even after Medicare picked up most of the tab.

“There’s no way I could do that,” Ms. Racener says. “It was just prohibitive.” Worried about depleting her limited savings, Ms. Racener, a 76-year-old legal secretary, decided to take the risk and not fill her prescription.

The pharmaceutical industry, after a long drought, has begun to produce more innovative treatments for serious diseases that can extend life and often have fewer side effects than older treatments. Last year, the Food and Drug Administration approved 41 new drugs, the most in nearly two decades.

The catch is their cost. Recent treatments for hepatitis C, cancer and multiple sclerosis that cost from $50,000 annually to well over $100,000 helped drive up total U.S. prescription-drug spending 12.2% in 2014, five times the prior year’s growth rate, according to the Centers for Medicare and Medicaid Services. High drug prices can translate to patient costs of thousands of dollars a year. Out-of-pocket prescription-drug costs rose 2.7% in 2014, according to CMS.

For many of the poorest Americans, medicines are covered by government programs or financial-assistance funds paid for by drug companies.

For those in the middle class, it is a different story. Though many patients can get their out-of-pocket costs paid by drug companies or drug-company-funded foundations, some patients make too much money to qualify for assistance. Others are unaware the programs exist. Medicare patients, who represent nearly a third of U.S. retail drug spending, can’t receive direct aid from drug companies.

The upshot is even patients with insurance and comfortable incomes are sometimes forced to make hard choices—tapping savings, taking on new debt or even forgoing treatment.

“Drugs are so expensive that once they flow through our ragtag insurance system, we have patients who can’t afford them, or they can barely afford them, so they’re not getting therapies,” said Peter Bach, a physician and health-policy researcher at Memorial Sloan Kettering Cancer Center in New York.

A quarter of U.S. prescription-drug users said it was difficult to afford them, in an August survey by the Kaiser Family Foundation. In another survey, published in the journal Lancet Haematology in September, 10% of insured U.S. patients with the blood cancer multiple myeloma said they had stopped taking a cancer drug because of its cost.

A look at how patients are coping with the cost of the medicine prescribed for Ms. Racener, called Imbruvica, illustrates the issues...

Not sure how to solve this problem, but it's obviously lame that Medicare prohibits recipients from receiving prescription help from drug manufacturers. Seems like government always makes these problems worse.

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