Copaxone does not have a free medicine program

[nurseMS]

Sad to say I don't see any solution to our problem nurseMS.

I have heard mention of bills in Congress that would disallow high co-pays (20% - 50%) on expensive biotech drugs like Copaxone but I don't think those have gone anywhere.

The ACA - Affordable Care Act - or healthcare reform act probably proposes some solution but I sure hope we MSers get caught up in the political kerfluffle about "free" care. I do not mind paying a moderate fee for my meds and my care because I am fortunate enough to be able to work, and because my husband has a good job. But like most people, I can't afford $10,000 per year for one medication co-pay.

If the price were still $985 per month, I could afford 25% of that, and if there were a cap on out-of-pocket expenses of $2,000 - $6,000 maximum per year, I could manage to pay that if I knew in advance and planned for it.

As it stands now the middle class is out of luck when it comes to affording these medications.

I could go on and on about meds and insurance..Ive been so frustrated with the ins co I could scream!! It almost doesnt pay to have a job and insurance and pay my bills as it bites me in the butt...cant afford high cost of MS meds and my insurance wont cover what I need..now Im switching to another med and if I get it covered Im looking at a high cost..so basically Im screwed.

[onlyairfare]

Actually, you may qualify for a program with Shared Solutions where they will pay your deductable. Do the math. If it costs $3000 per month, that's $36,000 per year. They will pay your $6000 deductable to get the other $30,000.

The problem is for people who don't have any drug coverage and are middle class. They can't get any copaxone.

No, I had no problem with the $6,000 co-pay, as it was taken out of my paycheck as $500 per month, pre-tax deduction to the equivalent of my medical savings account. All my expenses were covered 100% once I paid the first $6,000 and since my prescription drug bill ran over $50,000 a year, I considered myself lucky.

It was when my employer changed to a different plan that required 25% co-pay, or $800 per month after tax income, with no cap on the out-of-pocket cost that I got into trouble. That was $9,600 annually for Copaxone, with my premiums and co-pays for multiple other medications so the grand total was over $25,000 per year.

I couldn't afford that, and Shared Solutions was not allowed to assist with the co-pay as that would be "insurance fraud" according to the health plan and to our HR department. Nope, I had to pay the deductible personally or I wouldn't get Copaxone. I doubt Shared Solutions would have paid the co-pay anyway, as between my husband and myself we earn a good income, enough so we were not considered "needy."

So now I have a better job with better insurance but since I have done pretty well off Copaxone the past 4 years I am not going back to those daily shots. You are right, those who are middle class without pharmacy coverage are in bad shape, but so are the people with 25% co-pay requirements and insurance companies who say they have to pay it or else. They might as well not have insurance.

[its2much]

nursems

do both you and your husband have health insurance?

[nurseMS]

do both you and your husband have health insurance?

I do not, he does..

[its2much]

NurseMS

Were you able to get assistance for Copaxone?