Question of the Week: Can You Afford Your Osteoporosis Medications?

Pam Flores @phflores Health Guide
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    Many of us are uninsured or underinsured, having to choose between vital necessities like paying for rent, utilities, or getting prescriptions medications filled. With the rise in unemployment, "the number of uninsured today is probably close to 50 million," said Ron Pollack, the executive director of Families USA, which says it "advocates for high-quality, affordable health coverage for everyone (CNN Newswire September 10, 2009)."

     

    On our web site's Question and Answer forum we hear from members about this problem.

     

    Charlotte asked: "I don't have insurance and have gotten the Reclast from Novartis under the patient assistance program. However the cost of infusion is prohibitive. Is there any way to get this infused as well? If I pay for the infusion I can't pay rent."

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    Mrs. Beezer asked: "Without insurance coverage, how much does Reclast cost?"

     

    A second problem could be a high co-pay price for those with insurance. What can we do to resolve this situation?

     

    Eileen asked: "I am enrolled in Humana Gold Plan. My Doctor has arranged for me to receive an injection of Reclast. My co-payment is $232.96. I cannot afford the co- payment. Where can I get help so I can get Reclast? Who manufactures Reclast?"


    Most Medicare Part D plans pay for generics and not brand name drugs, so those with this type of insurance have to choose the generic form that's available, and they could have pre-existing problems with this particular drug. If they want to take a drug that isn't covered, then they have to pay the retail price.


    We are also seeing changes in insurance prescription formularies (companies' covered drugs) due to the high cost of prescription medications.  Now that one of the osteoporosis treatments (Alendronate/Fosamax) is available in generic, this is prompting the insurance companies to push the cheaper medication and not cover the brand names.


    Barbara Pandolfo asked: "I have recently switched from Actonel to generic Fosamax because of cost. What will be the effect? I had been taking Actonel for 6+ years; I have gone from osteoporosis to osteopenia. Medicare no longer covers Actonel and the cost is $75.00."

     

    Questions:

     

    • Have you found patient assistance programs to help with the cost of your   medications?
    • Have you been able to get help from the drug companies?
    • Have you found any other solutions to this catastrophic situation?
    • Is your insurance only covering generic osteoporosis medications, and what will you do if you can't take that particular medication?
    • Is your insurance co-pay price too expensive?

     

    We would like to hear from members that are dealing with these problems. If any of you have found solutions to these, please let us know.  Together we should be able to find some help for those who need it, to get their needed medications.

     

     

     

     

Published On: November 09, 2009