Cost of DMD's 2014

[its2much]

I know it's only January 9th but has anyone had their DMD prescription filled in 2014? I just checked pricing for Copaxone under my new coverage. Last year it was around $4600 per month - it is now about $5100 - a 10% increase.
Also my new coverage does NOT cover any of the oral or IV drugs, just the basic four CRAB...
Anyone heard back from the Assistance Fund For 2014 assistance?

[ru4cats]

its2much,
My Tysabri (just the drug) went from $4800 to $5800 in one month. I called the infusion center, and they said the price jump was "across the board" (all suppliers). I had heard from my local pharmacist that the ACA has limits on price increases, and so suppliers were jacking up the price before the new limits went into effect (Jan.1). My Tysabri is still covered under my plan, but then I stayed with my old employer's insurance when I retired; I will probably stay with them when I reach medicaid age for the supplemental.

[marybenes]

I would call Shared Solutions to see if they can help you with the co-payment.

[its2much]

I think the increase

was even more in past years. My prior insurance has been cancelled but the new one has a 40% co-pay for just about everything . The maximum out of pocket, however, is now $6350 - prior policy was the sky's the limit. Don't know how I'll afford the new maximum... Not too please about insurer's restrictions on choice of drugs either.

[akafearless]

Outrageous

I'm covered under my husbands insurance this year, so i logged on to check on my Avonex. For a 90 day supply (13 pens) the cost is over $61,000. I swear it was only $7k in 2009. That is almost a quarter of a million per year.

I'm so agast for want of a better word

[Mable]

I think the trick is to get the pharma company to use their assistance programs (not all of them are need based) to pay that $6300 out of pocket maximum for you. That way, you actually get by cheaper than someone who doesn't have a horribly expensive medication. It's all about timing.

My strategy would be to get my refill right after the first of the year, before I go back for my MRI or annual Neuro visit.

[its2much]

Shared Solutions

assistance program has never been helpful to me. They advertise they have a $35 co-pay but very few people, who really need assistance, qualify for that $35 co-pay. They wouldn't help when I have a 50% co-pay - now it's 40% (meaning they'd have to help with 60% of the cost).

[PhiSiggyro]

When I was looking for insurance plans on the ACA, out of the four companies that offered plans in my area only one covered tecfidera

[its2much]

How did the premiums

and benefits (e.g. co-pay, deductible, etc) compare between the plans? I'm also concerned that mid-year insurance companies can change their formularies.

[macarolina]

Its2much, now that you have insurance that has a max out of pocket, the shared solutions assistance should work for you. I have a similar out of pocket max, and I only have to pay $35, while Shared Solutions pays the remaining (40 percent in your case). The amount that Shared Solutions pays counts towards my out of pocket/as if I paid it myself, so between your monthly $35 and Shared solutions' payments, you soon will hit your max out of pocket and no longer even pay the $35, or any other med expenses for the rest of the year. I have never been asked for income info, either. The likely reason shared solutions will cover under this type of max out of pocket insurance plan is that they only have to pay the max out of pocket, less a few of your $35 payments- a quantifiable contribution for them...

[its2much]

macarolina

Please remember I have cognitive impairments.... Are you saying that Shared Solutions will assist me with my $6350 out of pocket max? Guess it would take less than three months to reach it.