If You Like Your Drugs...

You may not be able to afford them.

Simply put, many drugs may not be covered at all, and the costs patients incur by buying them with cash won’t count against out of pocket caps. This has repercussions for drug makers with big portfolios of specialty and primary care drugs (more on that later). But most of all, it has implications for patients.

This is what my mother-in-law is faced with:

Take, for example, the drug Copaxone for multiple sclerosis.

Someone on a bronze plan would be responsible for paying about 40% of the drug’s costs out of pocket, on average. That comes out to about $1,980 a month.

If you buy the highest cost platinum plan, the out of pocket costs drop to $792 a month. But you’re probably better off with the cheaper bronze plan anyway.

Since you’re going to hit your out of pocket cap regardless of your plan, you might as well save money on the premium (which doesn’t count against your deductible or out of pocket limits) and race to the $12,700 spending cap as quickly as your family can.

All brought to you by the "Affordable" Care Act. Nothing affordable or caring about it.

http://www.forbes.com/sites/scottgottli ... obamacare/

My wife switched to Copaxone last year. Thanks Obama! $4600 a month without insurance.

"Better living though chemicals!"

PERHAPS, it might force the pharmco POS to realign their price structure,so that it is looks like
OTHER countries price list (CANADA for instance....check mail order prices from REPUTABLE
sources and you will see a distinct problem.)

homeagain wrote: PERHAPS, it might force the pharmco POS to realign their price structure,so that it is looks like
OTHER countries price list (CANADA for instance....check mail order prices from REPUTABLE
sources and you will see a distinct problem.)

Agreed, I wish there had been an attempt to tackle the problem of drug costs FIRST, before this law was tossed together like a bad salad.

homeagain wrote: PERHAPS, it might force the pharmco POS to realign their price structure,so that it is looks like
OTHER countries price list (CANADA for instance....check mail order prices from REPUTABLE
sources and you will see a distinct problem.)

Or ever thought that the US market subsidizes the Canadian one? It takes a lot of money to develop new drugs. If the pharmaceutical companies see a future where they can only charge $20 a pill, what new research will have to be shut down?

We many never see that cure for cancer.

The drugs that are being R&Ded are VERY select....only the most LUCRATIVE pills are being
pathed within that field....PHARMCO,after all, is NOT into this field for your health,BUT RATHER,
for the money that the public will GLADLY give over.....we want MORE drugs,because THAT is
what the TV ad says we NEED....

Hint: Not Canada, Mexico. They need the jobs.....

That article in the original post really hit the nail on the head. And it covers what I've been posting about as well.

Most of the bronze and silver Obamacare policies are really crappy regarding prescription coverage. First many offer no coverage until you reach your deductible, then many still have you pay a 20-50% co-pay for higher tier drugs until you reach your max out of pocket amount. And that max out of pocket can run you up to $12,700 for a family policy.

Many have complained about the donut hole in Bush's Medicare part D. That can be pricey and run you up to $4750 (you pay 5% after). But a lot of Obamacare's policies can run you much higher for prescriptions.

Another good point made was that when many people see the large out of pocket expense they will be hit with for medical care or hospitalization, they will not pay it (may not be able to afford it) and stiff the hospital. So the rest of us will still have to pay higher prices to cover for that as well.

1. With any drug policy I have ever had, including Part D, I have had to pay a co-pay after meeting the deductible. For the higher tier drugs it is expensive. Part D is not free, for better coverage, lower deductible, more drug, you pay more.

2. We are already paying for people who stiff the hospitals, I would bet we pay more for goods so walk out on $100,000 bills than we will for those who don't pay their $12,000 out of pocket.