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Author Topic: cost of meds  (Read 2002 times)

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Offline del9988

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cost of meds
« on: April 02, 2014, 09:20:15 AM »
hi
may 2013 / CD4--420   Vl--22000
dec  2013 / CD4--528   vl-- 19
taking 1 eviplera a day with food.
now only being pos for a short time, and i will be honest by saying i really dont know much about this , but on all the blogs and everywhere else i have looked i,m very curious about the price that people are paying for their meds . everybody seems to be talking about their insurance, doctors bills and stuff like that . i,m in Australia and everything is free , the meds , the doctor, everything. i allways thought that it was free for everyone ??? .

Offline zach

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Re: cost of meds
« Reply #1 on: April 02, 2014, 12:18:14 PM »
Welcome. I'll let somebody else do that whole rap. I'll hit you with some American numbers.

1 month supply of Atripla = 2100 USD

On a recent trip to the ER, I was passing blood, all they really did was give me IV fluids, only in for a night, then unceremoniously discharged. = 6000

Cost of care varies WIDELY around the world. Healthcare in the US is one of the hot political issues right now.

Offline AusShep

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Re: cost of meds
« Reply #2 on: April 02, 2014, 01:47:36 PM »
My insurance pays $2600 a month for Tivicay and Truvada.  My cost is $0, outside of paying for insurance. In your case the "insurance" is covered by taxes. 

The manufacturers have copay programs that will cover monthly copay amounts for those with insurance, and there are government programs and subsidies that can help most others.  I've never used any govt. program, so I don't have a clue how they work.

For example, your drug combo would cost $2100 a month here, but the manufacturer has a $400 a month copay program, so for most people with decent insurance or a program to help with costs on top of insurance, it wouldn't cost anything. 

I'm in the tech industry, so at least a basic level of health insurance has always been paid by my employers, at little or no cost to me.  Other industries may not contribute anything. 

Offline Miss Philicia

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Re: cost of meds
« Reply #3 on: April 02, 2014, 04:20:05 PM »
My drug costs average $100,000 a year. I pay about $65 out-of-pocket for that annually.

That's for 11 prescriptions used monthly, plus the odd-off item for something specific during the year.
"I’ve slept with enough men to know that I’m not gay"

Offline hope_for_a_cure

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Re: cost of meds
« Reply #4 on: April 02, 2014, 04:44:09 PM »
I have to find a better Medicare Part D plan for 2015. 

Offline mecch

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Re: cost of meds
« Reply #5 on: April 02, 2014, 04:45:33 PM »
i allways thought that it was free for everyone ??? .
Hello, welcome to the forum.

Wait, 1)
You were thinking everyone around the world, in their countries has free medical care for all their medical issues?

Or, 2)
You were thinking, everyone around the world who is HIV+ has some special magic deal, where their HIV treatment and drugs are free, even if other medical conditions are not?

Color me confused by your comment...

I pay close to 400 USD a month for general health insurance in Switzerland.  Everyone must buy a policy.  Then I pay about 350USD deductible each year, toward the total cost of medical visits.  Then I pay about 850 USD for a maximum deductible for my drug costs.  So if my drugs cost the insurance 30,000 a year, retail price, I pay 850 one time, plus my 400 a month insurance, of course.

There is a pricing index by the major drug companies. Rich countries, with big pharm industries, pay the top prices.  Then other rich countries.  Then a second tier (only sometimes), and then finally the developing and poorest countries have another price.  This is only for some drugs and by some companies.  The difference in price can be more than 10x. 

India manufactures drugs that are otherwise protected by patents, and other drugs that are off patent, and sells them at much lower prices. I believe some of this is condoned by the big pharma drug companies.  Anyway, after the Indians refused to stop, and other developing countries threatened to do the same, I think this helped the big pharma companies to introduce the radical tiers pricing.  Otherwise they were being shamed, and were never going to sell their drugs in so many countries!

Finally, rich governments who buy and supply drugs to poor countries directly, may or may not be paying the top price, or the lower prices.  Its very complicated.

This is my own inexact summary, mind you.  Just related to give you an idea.

You realise NO TREATMENT IS FREE ANYWAY.  Someone is paying for it.  Australian taxpayers are paying for your treatment.  It is NOT free.



« Last Edit: April 02, 2014, 04:52:14 PM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mecch

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Re: cost of meds
« Reply #6 on: April 02, 2014, 05:06:27 PM »
del9988 - if you are curious to know how much your drugs cost, the pharmacy that supplies them may be able to tell you the retail price that your country's health service is paying.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline del9988

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Re: cost of meds
« Reply #7 on: April 03, 2014, 12:38:27 AM »
hey thanks for all the reply's.
1/ yes i really did think HIV meds were free or close to being free, pretty silly of me really , how else can the big company's make more money.
2/ and yes the Australian taxpayer does pay for our free or near free health system, its pretty simple really everybody pays 1% of their wage, that's it , sure i can get private health care. all that does is get me treated asap if not, i go on a waiting list and i get surgery at a public hospital instead of a private hospital, . i can rock up too any hospital in Australia 24/7 and get treated with or without health cover, i have read so many times how in the USA that people without health cover cannot get treated in hospitals and just die there or go home and die , if that happened here the doctors would go to jail for not treating you , Australia the lucky country.

Offline buginme2

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Re: cost of meds
« Reply #8 on: April 03, 2014, 02:30:57 AM »
i have read so many times how in the USA that people without health cover cannot get treated in hospitals and just die there or go home and die , if that happened here the doctors would go to jail for not treating you , Australia the lucky country.

Well your two for two
Don't be fancy, just get dancey

Offline mecch

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Re: cost of meds
« Reply #9 on: April 03, 2014, 09:54:13 AM »
I still don't quite understand your thinking process.
You believe that in the USA, people are dying on the sidewalks for lack of medical care, but you also used to believe that all HIV medical care was free around the world?

Anyway, if you are interested to know a bit about the history and present circumstance of the HIV epidemic.

For example, 10s of millions of people died between 2000-2010 in Africa because treatment access was only starting to be ramped up.  The treatment was in place, but nobody could figure out how to pay for it! Some countries even denied the (EXPENSIVE) treatments were effective.  In South Africa, it is estimated more than 300,000 people died needlessly when their government denied the need for HIV medicine.

Now, for example, there are huge problems in Russia, Eastern Europe, and Central Asia with the HIV epidemic. 
http://www.avert.org/hiv-aids-russia-eastern-europe-central-asia.htm
 There might be 1,300,000 living with HIV there, and the numbers are rising.  It is estimated only 25% of those in need of HIV treatment are receiving it.

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline BT65

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Re: cost of meds
« Reply #10 on: April 03, 2014, 01:48:56 PM »
In the US, if someone goes to an emergency room, they cannot be turned away.  They have to be treated.  Whatever the cost to the person depends on what kind of insurance they have.  Government insurance, such as Medicare and Medicaid, often pay most of the cost.  It's pretty complicated.

With the new Affordable Care Act, we really don't know how this will go since it's so new.  But something was needed.  People have been filing for bankruptcy for years due to high medical bills.

I am on Medicare and Medicaid, though the Medicaid I am on is for working disabled people, so I pay a premium for it every month, and it picks up what Medicare doesn't cover.  And because of being on Medicaid, I qualify for "extra help" which pays for almost everything med wise. 

It's kind of a (excuse my language) cluster fuck.  I never know from year to year what is going to change.  Like my premium for my Medicare Part D (medication coverage) has gone up since last year.  But it's pretty good. 

As you can see, healthcare in the US is complicated.  But, if someone goes to the ER, they have to be treated, that's the law.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline justpoz

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Re: cost of meds
« Reply #11 on: April 04, 2014, 11:38:46 AM »
Houston we have a problem and its not going away...

  You can see my stats below, Sadly the results are in on ACA and it is a big Fail.

First understand that Congress failed to provide oversight on how insurance companies could play with policies in regard to providing essential coverages for HIV patients.

As a result of this my Co-pay two years ago was $55.00 last year it went up to $120.00 this year its 33 percent of the retail cost.

$970.00 per month, (medicare) BCBS, until you reach your plan threshold, around $2600.00 Then the cost is 50 percent of the retail cost of the drugs until you reach an out of pocket cost of $4600.00

This is insidious, now with ACA, you now have a much more difficult time reaching the out of pocket costs unless you have an income that is substantial enough to allow you to purchase the medications.

I know I quickly racked up a big credit card bill until I realized that I could not possibly pay this credit card off and had to stop.

Another disturbing trend is that due to the ACA, patient assistance is no longer accepting applications where you have not yet met the required $4600.00 in out of pocket expenses.

Last year I qualified for patient assistance, this year there is a problem and that problem is directly related to the ACA.

If you have an income over 23,000 you will not qualify for Ryan White.

If you make less than that amount you will have a much easier time getting some help, the one thing none of us can afford to do is to remain silent.

diag 08  vl 60,000 cd4 360
started atripla, 708
could not afford cost of meds.
stopped atripla 808 started atripla 109  vl 90,000 cd4 250 | 209 vl undect, cd4 275

Changed meds Truvada 200-300
Isentress 400 | 0312  vl und  cd4 550
snip
1212  vl und  cd4 625
0113  vl und  cd4 675
12/13 vl und  cd4 720

Feb 2014, insurance blue cross blue shield, increases co-pay from 120.00 to 970.00, tier 5, 33 percent of retail prices.

Cannot obtain any patient assistance, the AFA is a serious threat to patients with HIV. 

Unable to afford to purchase medications.
tired of fighting to stay alive.

March 4, 2014, VL, 161,000 cd4 400
Terrified but helpless to do anything about it.

Offline GoForIt

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  • Posts: 126
Re: cost of meds
« Reply #12 on: April 04, 2014, 12:37:50 PM »
Houston we have a problem and its not going away...

  You can see my stats below, Sadly the results are in on ACA and it is a big Fail.

First understand that Congress failed to provide oversight on how insurance companies could play with policies in regard to providing essential coverages for HIV patients.

As a result of this my Co-pay two years ago was $55.00 last year it went up to $120.00 this year its 33 percent of the retail cost.

$970.00 per month, (medicare) BCBS, until you reach your plan threshold, around $2600.00 Then the cost is 50 percent of the retail cost of the drugs until you reach an out of pocket cost of $4600.00

This is insidious, now with ACA, you now have a much more difficult time reaching the out of pocket costs unless you have an income that is substantial enough to allow you to purchase the medications.

I know I quickly racked up a big credit card bill until I realized that I could not possibly pay this credit card off and had to stop.

Another disturbing trend is that due to the ACA, patient assistance is no longer accepting applications where you have not yet met the required $4600.00 in out of pocket expenses.

Last year I qualified for patient assistance, this year there is a problem and that problem is directly related to the ACA.

If you have an income over 23,000 you will not qualify for Ryan White.

If you make less than that amount you will have a much easier time getting some help, the one thing none of us can afford to do is to remain silent.

Not exactly sure how you can sum up the ACA as a fail when I think its the best thing to ever happen for me.  Without it, there would be no insurance for pre-existing conditions.

I found a good BCBS plan that had 0 deductable for around $350 a month.

I make around 30k a yr and qualified for Ryan White and my insurance premium is now being paid for along with my meds using ADAP.   

So at this point I am getting meds and monthly premium covered as long as I don't make much more money at my job. 

I think this is very helpful and the ACA is a blessing for me in this terrible time.

You might have picked a bad plan?
« Last Edit: April 04, 2014, 12:40:10 PM by GoForIt »
08/09/2013   Diagnosed WB positive
08/20/2013   CD4-506(28%)  VL-10,800
09/12/2013   CD4-391(28%)  VL-14,900
09/17/2013   Start ART (Truvada & Tivicay)
10/11/2013   CD4-377(26%)  VL-UD
12/20/2013   CD4-590(??%)  VL-UD
03/18/2014   CD4-660(29%)  VL-UD
07/22/2014   CD4-613(29%)  VL-UD
08/01/2014    Start Phase 3 TAF Clinical Trial
10/09/2014   CD4-498(29.5%) VL-UD
11/06/2014   CD4-600(30.2%) VL-UD

Offline AusShep

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Re: cost of meds
« Reply #13 on: April 04, 2014, 09:06:36 PM »
Justpoz,

There are ACA plans which do not require a drug deductible, or copay%, they use a straight copay $ amt like most corporate policies.  I suppose this could vary by state, but did you fully evaluate your options?

ACA has also capped out of pocket expenses below what some individual plans had before.  No limitations on pre existing conditions, etc.

Overall much better I think than what was available several years ago.

The cost of healthcare and insurance has been outpacing inflation for many years, so unfortunately some price increases are to be expected.  I'm not saying $55 to nearly a grand is an example of this BTW.





Offline mecch

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Re: cost of meds
« Reply #14 on: April 04, 2014, 09:08:34 PM »
I am keen to understand why some people are winning and some are losing with ACA.
Does it depend what state you live in?
Is it up to the state to make ACA affordable and add in the extras to cover HIV care?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline AusShep

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Re: cost of meds
« Reply #15 on: April 04, 2014, 09:24:29 PM »
I am keen to understand why some people are winning and some are losing with ACA.
Does it depend what state you live in?
Is it up to the state to make ACA affordable and add in the extras to cover HIV care?

I'm in Texas now, so it's part of the national exchange (with plans specifically offered in TX).  Every plan I looked at, even the very cheapest, highest deductible plans, covered all HIV medications at the preferred brand name pricing tier.  I don't recall any of them having pre authorization requirements except for injectables.

But on the lower priced plans there generally was a drug deductible, something I had never even heard of in the corporate world.  You had to choose higher priced plans to get lower deductibles and strict $ copays without having a separate drug deductible.

Edit: just checked my plac Rx docs again, there a couple of older non preferred brand drugs, but they're still covered.
« Last Edit: April 04, 2014, 09:53:39 PM by AusShep »

Offline mecch

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Re: cost of meds
« Reply #16 on: April 04, 2014, 09:27:56 PM »
Justpoz, what state are you in? No ways to fill the gap between your ACA plan and the cost of HIV treatment?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline zach

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Re: cost of meds
« Reply #17 on: April 04, 2014, 09:30:02 PM »
Implementation is at the state level. That was a mistake. Some historically red states are doing everything they can to oppose ACA

Offline mecch

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Re: cost of meds
« Reply #18 on: April 04, 2014, 09:45:02 PM »
Yes but do people in these states realise its their own state government that is fucking them royally? 
I dont understand why the Dems are predicted to lose everything in Nov.  Don't people see who is fucking them?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Online Jeff G

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Re: cost of meds
« Reply #19 on: April 04, 2014, 09:54:15 PM »
Politicians and Pundits are allowed to lie and spin with impunity ... so nope, most of the red state voters tend to support conservative candidates because they relate to them more than us commie left wing liberal types .     

Offline AusShep

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Re: cost of meds
« Reply #20 on: April 04, 2014, 09:56:47 PM »
I bet they don't know unless they frequent places like this or have friends in other states.  I guess TX hating "Obamacare" so much that they didn't do their own exchange and defaulted to the Federal rules may have actually helped (other than the lack of Medicaid expansion)

Offline zach

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Re: cost of meds
« Reply #21 on: April 04, 2014, 10:01:49 PM »
Republicans are well known for voting against their own self interests

Online Jeff G

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Re: cost of meds
« Reply #22 on: April 04, 2014, 10:13:28 PM »
I have asked questions of some of my rural Alabama relatives and asked them why they vote the way they do and after listening closely to what they have to say its clear that they haven't really researched the issues or completely understand them for that matter .

Its true that elections have consequences .   

Offline Miss Philicia

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Re: cost of meds
« Reply #23 on: April 04, 2014, 11:07:17 PM »
I have asked questions of some of my rural Alabama relatives and asked them why they vote the way they do and after listening closely to what they have to say its clear that they haven't really researched the issues or completely understand them for that matter .

Its true that elections have consequences .   

They're all on disability anyway.
"I’ve slept with enough men to know that I’m not gay"

Online Jeff G

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Re: cost of meds
« Reply #24 on: April 05, 2014, 08:54:01 AM »
They're all on disability anyway.


That's a great chart to break it all down . Looking at those numbers and seeing how so many red state governors have a high rate of medicaid recipients I can see why they are fearful of expanding medicaid even if the federal government is going to pick up the majority of the tab . I do not agree with it but I see it .

Its not going to change anyway as long as we have a for profit system .   

 


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