MS Drugs Offer Hope, But Can You Afford Them?

Mandy Crest Health Guide
  • If you have multiple sclerosis, or are married to someone with multiple sclerosis, what is your single biggest source of stress?

    Without a moment's hesitation, I can answer for myself and my husband. Health Insurance. Capital H, Capital I. It is that big an issue. More specifically, it is the soaring cost of prescription medications for MS, which, even if you have a solid group health plan, are becoming frightfully out of reach for a great many people.

    A recent article in the New York Times  has finally brought this issue to the attention of the general public. Finally, what MS bloggers around the country have been shouting from the rooftops, has gotten some mainstream press. The true picture is even more complicated than the article implies.

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    MS is a lifelong condition. There is no cure, but recent years have hailed the arrival of several prescription injectable drugs which have the potential to stave off relapses and permanent disability. At this point, our best chance for a decent quality of life rests in these drugs. The price? $1,900.00 per month.

    We all have a story. I can't speak for all MS patients. Some have wonderful health coverage; some do not. Some apply for and receive assistance of one kind or another; some, for a variety of reasons, are not eligible. Some choose to forgo these medications because they have not been convinced of their effectiveness, or because their particular case of MS seems to be benign. Some people have no choice; they simply cannot afford the exorbitant price.

    My story is, I suspect, fairly common to MS patients. Upon diagnosis, I had a full-time job with group health coverage. Before long, the MS robbed me of my ability to work full-time. COBRA allowed me to continue with my group coverage, but now the premiums were 100% out-of-pocket. COBRA protects you for only 18 months due to loss of job and 36 months due to divorce or death. After that, you are on your own if you still cannot get group coverage.

     

    These days, I work part-time and my husband is self-employed. With no access to group coverage, we were forced to take out an individual policy for me, which has a monthly out-of-pocket of $500.00 per script. All together, I have $20,000 per year in various deductibles and a premium of $520.00 per month. You don't have to be a math major to figure out that this is a problem.

    We actually consider ourselves lucky to live in Virginia, a state which mandates that this insurance company must offer me some type of policy, even though there is no cap on the premiums they may charge. Shockingly, in many states across our nation, there is no such provision, and insurance companies are free to deny you ANY coverage because of a pre-existing health condition. That is a sobering thought.

    These are important issues which must be considered, especially in this election year. Is it acceptable that health insurance is tied to the workplace? Should we be allowed to comparison shop health care coverage across state lines? Do we want some kind of safety net for people who have chronic health conditions? Do we want to continue allowing insurance companies to have the last word with our health care decisions?


  • If you and other members of your family are healthy, how secure are you in your coverage? You are only a job away... a diagnosis away... a small twist of fate away from joining us in the sinking boat. We must urge our representatives in congress to act. No, we must insist. Make your voice heard.

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    Share your story about the cost of MS prescription drugs and health insurance. 

Published On: April 16, 2008