Cost of Medication / Generic Drugs

[jamaicam]

For those who have followed my saga, I am currently importing medicines for my MS directly from India. (all prices are in US$)



For reference, only 2 medications are available for MS here - an interferon beta which is about $12k for the year and an infusion which is over $50k for a year. I am a fairly senior government employee and my health insurance offers less than $1k per annum towards these drugs.



After a lot of research, I have managed to access a generic version of one of the interferons from India whcih I (legally!) import myself. This works out to $5k per annum. However, obviously this is still out of the range for most peopel with MS and hence most people here with MS suffer with no medications.



My dream has been able to move to one of the tablets for MS - they are more effective, they dont require refrigeration (which can be an issue when you live in a poor country which gets hurricanes), and obviously, it would be nice not to inject myself. However, these tablets are about $20K per annum in the US. I recently saw an article where one of the manufacturers is in court defending their drug against a generic so I decided to start researching again. A generic version of this $20k per annum tablet is now available in India for approx $500 per annum.



I spoke to my consultant and he is thrilled. He is about to go away to do more training in MS as there are no MS specialists in the country (due primarily to the myth that MS is a white person disease) but he was beaming when I showed him my research. it will be a complete game changer for so many people here! He is very happy for me to change to one of the tablets once my current supply of injections runs out (i have to get annually as shipping and importing from India isn't cheap).



And it just hit me again as to how ridiculous the whole pharmaceutical industry is.

[fuckyourcouch]

That’s great, I hope it works out for you.
I just wanted to bring up the manufacturer copay programs in case you haven’t looked into them? I don’t know if they differ by country. I only bring it up because my monthly infusions are over $20k billed, then between my (also govt employee) insurance and the copay program I very luckily pay nothing out of pocket.
Anyway, great job advocating for your own needs!

[shauni27]

the pharmaceutical industry is INSANE. I am glad you found a solution that will hopefully work for you! Nice work on the research

[jamaicam]

May 19, 2022 14:16:52 GMT -5 fuckyourcouch said:

That’s great, I hope it works out for you.
I just wanted to bring up the manufacturer copay programs in case you haven’t looked into them? I don’t know if they differ by country. I only bring it up because my monthly infusions are over $20k billed, then between my (also govt employee) insurance and the copay program I very luckily pay nothing out of pocket.
Anyway, great job advocating for your own needs!

Thanks but those don't work here unfortunately!

[curbsideprophet]

Add in the insurance industry and I agree it is all insane. I also have MS so I am familiar with some of the issues.

I was taking a name brand medication. I was on the company co-pay program. Everything went crazy for me when they lost their court case and generics became available. My insurance starting charging a brand fee ( I don’t remember the exact term). In the short term the company picked up the extra cost. I then got a letter from my insurance saying they would not be covering the brand name the next year, even though they had just processed my prior authorization and said it was good for a year. The company also was eliminating their copay program for that drug. They have a new drug which is slightly different that I think has a co-pay program. I think they wanted to get people to switch to that drug so they could continue to get money from the insurance companies.

I could have potentially tried that brand name drug but was pretty happy with my current drug so decided against that.

I ended up switching my insurance in part because of potential drug prices/copays/approved medications. I tried to get my new insurance to approve the brand name medication. They refused and said I had to try a generic version first.

I got mixed messages on co-pay programs for generics but eventually found a manufacturer’s program that works for me.

In the process of switching I had a couple different brands of generic but have it noted on my file that they are to only send me the one through the co-pay program.

Thankfully I have handled the switch okay and have not really noticed any impacts. Things are good right now medication wise. However at times I have spent a large amount of time/effort/phone calls to figure out exactly what was going on. It should not be this complicated to get a medication (especially one that has been shown to be working for me).

I am now paying $20 more for a 30 day supply but that is not a deal breaker for me. I know I am very fortunate to have the means to pay that and that I had the time to put into getting to this point. The whole process was quite frustrating and I can see how others would end up with less ideal results.

When I was last quoted prices, the cost for a 30 day supply was over 8K for the brand name and over 5K for generic. My doctor thought those prices might come down over time as the existence of generics can help push the price down. However those prices are still not realistic to anyone without insurance. My doctor did warn me that depending on my insurance copay prices still could be quite high with a generic.


Hopefully the option of a generic helps get the medication to people who need it. Glad you found a new option to try. I hope your transition to the new medicine goes well!