Getting help with prescription costs is very common in the United States. This is because prescription drugs and medication prices in the US are one of the highest in the world.
According to the National Health Interview Survey in 2011, everyday Americans have spent over $45 billion in total on out-of-pocket cost for retail prescription drugs.
Individuals with rare diseases, in need of ongoing and regular medication and individuals accessing newer drug treatments can spend over $100,000 annually on prescription drugs.
The high cost for prescription drugs and medication can have adverse effects on the patient’s ability to access life-saving medication.
The National health expenditure data 2012 found that individuals were twice as likely to not take medication in order to save money. Adults deliberately choose to skip medication or delay filling prescriptions due to the high cost associated with them. A study in 2007 also found that many patients practice these cost-reduction strategies in order to reduce the cost of their prescriptions.
However, patients can have poorer health and have greater chances of needing emergency care. This can increase the total medical cost to thousands of dollars due to further hospitalization and treatment, which could be easily prevented if patients were able to access prescription drugs at a low cost.
10 Most Expensive Prescription Costs In The US
Soliris, sold by Alexion Pharmaceuticals is used to treat patients with a rare disease called paroxysmal nocturnal hemoglobinuria (PNH) is used among 8000 Americans. PNH is a rare disease that breaks down the red blood cells in the body. Being a rare disease, little is known about it, making options for treatments limited. The annual cost for treatment of Soliris for these patients is $440,000.
Individuals with hunter syndrome, which accounts for 500 Americans across the US can expect to pay $375,000 to $657,000 annually for their prescription drug called Elaprase. Sadly for patients with hunter syndrome, an inherited condition, it is incurable, meaning patients will be forced to pay these prescription costs for life.
Patients living with hunter syndrome can experience difficulties in growth and damaging of joints, vision and hearing. Elaprase, a drug that is produced by Shire, provides individuals with improvement in their ability to walk and overall health in dealing with hunter syndrome.
An annual cost of $365,000 for Neglazyme is what many patients with Maroteaux-Lamy syndrome require. This rare genetic disorder that affects tissue growth and heart disease. Neglazyme assist to break down glycosaminoglycans and as a result, can dramatically help patients with mobility and growth.
Patients with rare genetic disorder called hereditary angioedema (HAE) are expected to pay $350,000 each year in order to receive prescription medication called Cinryze. This treatment helps the deficiency of a blood protein.
Over 8000 Americans have been treated with a drug called Cinryze. This drug treats patients diagnosed with hereditary angioedema. Hereditary angioedema is a rare genetic condition that can cause life-threatening swelling all over the body. This includes the patient’s hands, feet, face, genitals, abdomen and throat.
Typically, patients will require two vials of the drug Cinryze each time, which can cost more than $4,600 in the U.S.
With a monthly cost of $30,000, the annual cost of Folotyn can easily amount to $360,000 each year. This drug treatment is a short-course (six weeks) treatment for patients diagnosed with a rear form of cancer. Patients with peripheral T-cell lymphoma who have not responded well with other forms of treatments will often resort to using Folotyn for better results.
Peripheral T-cell lymphoma is an aggressive form of cancer that spreads throughout the body rapidly. Patients with this rare form of cancer may use Folotyn in order to prolong or stop the cancer from spreading.
Treating infantile spasms or otherwise known as seizures is a common problem for patients who are under the age of 2 years. Acthar has been used in order to help infants with seizures. The annual cost is $300,000, with a cost of $30,000 per treatment when required.
This is one of the most expensive drugs on the market for patients in the United States but is also a non FDA approved drug. This means, health insurance companies often do not provide any coverage for this medication. The cost remains predominately, if not all out of pocket.
Myozyme prescribed to patients with pompe, a rare and sometimes life threatening disease can cost $300,000 per year for adults. There are 40,000 newborns daignosied with pompe. Children with pompe can expect to pay $100,000 each year for Myozyme.
Individuals with pompe have a disorder where an enzyme called acid alpha-glucosidase is missing. As a result, this creates build-up of glycogen (a type of sugar) in the blood. This can overtime cause problems with the heart and skeletal muscles.
Without the medication of Myozyme, children can die at the age of one.
Yervoy, a drug commonly used for patients with advanced stages of melanoma cancer, can cost $117,648 for one course of treatment. This is currently the most expensive cancer drug in the United States. Produced by Bristol-Myers Squibb Co., this drug has a proven track record in helping melanoma cancer patients have longer survival rates.
Avastin which aims to slow down the growth of new blood vessels has helped patients with cancer for years. This prescribed medication treats a number of cancers, where patients are expected to pay $100,000 per year. One of the biggest benefits of using Avastin is the ability to prolong death for patients by several months.
Patients diagnosed chronic myeloid leukemia, a type of cancer can benefit from the new drug called Iclusig. With a $115,000 price tag each year for the drug treatment, patients resort to this form of treatment when other treatment and therapies have not helped.
8 Ways To Get Help With Prescription Costs
1. Speaking With Your Doctor
Having a discussion with your doctor can help with prescription costs. If you are unable to afford your medications, a doctor may be able to help by providing free sample medication for a length of time. This is often only a few doses of medication and is a short term solution to an ongoing problem.
Patients can also find it beneficial to speak with your doctor in order to receive recommendations of possible generic form medication compared to expensive brand-named medication. By switching the medication brands, you will be able to save more money. This can significantly cut the cost of your prescription cost without jeopardizing your health and well-being.
2. National and community-based programs
There are a range of national and community-based programs available to help patients with the cost of prescription medication. These programs can help you reduce the cost of your medication.
The National Organization for Rare Disorders is one example, which aims to help patients with rare disorders access medication. The National Organization for Rare Disorders runs a program called NORD Patient Assistance Programs, which assists patients in receiving life-saving or life-sustaining medication they could not otherwise afford.
They also have a list of medication assistance programs in collaboration with pharmaceutical companies to offer certain drugs for cheaper or for free.
Being disease-specific, programs such as these can often restrict patients who do not have rare diseases and who are in need of medication. With all programs provided by non-profit organizations, individuals must read the terms and conditions in order to check their eligibility for each program. Patients with higher incomes of $26,000 per year can find it difficult to receive assistance as they are most likely deemed high-income earners.
3. State Pharmaceutical Assistance Programs (SPAPs)
State Pharmaceutical Assistance Programs (SPAPs) can help with prescription costs by paying drug plan premiums as well as other drug costs. SPAPs is available in 21 states. Typical assistance from SPAPs include help with paying drug plan premiums and offering options of cost sharing methods to reduce the cost of your prescription costs.
4. Pharmaceutical Assistance Programs
Pharmaceutical companies also offer assistance programs targeted to help patients with prescription costs. These programs are often known as Patient Assistance Programs (PAPs).
Patients can receive medication at a low cost, offer co-pay plans or provide free medication for a period of time. The availability of the type of medication and prescription drugs are dependent on the manufacturers and pharmaceutical companies, which can be a limitation of these forms of programs.
5. Extra Help
Extra Help is a government program that assist individuals who are already on Medicare. Extra Help can provide up to $4,000 per year to pay for prescription medicine costs. To qualify, individuals must be already be on Medicare, reside in the US and have assets totaling $26,860 for couples, or $13,440 for single individuals.
With an average cost of medication totaling $10,000 per month for some patients, Extra Help can provide a small amount of financial assistance to cover the overall cost for their prescription medication. For patients with long-term chronic illnesses or patients who require years of treatment, this is a short term solution in an ongoing problem.
6. Medicare And Other Government Healthcare Programs
Getting help with prescription costs through the Medicare system is one of the most common options for patients. Medicare is a government-run healthcare program, where patients are able to access what is called Prescription Drug Coverage. Prescription Drug Coverage allows patients to pay a monthly premium in order to lower prescription drug costs and help protect against higher costs in the future. Medicare is only open to patients who are 65 years or older, or who are living with a disability.
Other programs such as Medicaid offer eligible patients with low cost health insurance which can help offset the cost of expensive prescription drugs. Financial eligibility is one of the biggest requirements. Families and patients must provide proof that they are from low-income households.
7. Compare Pharmaceutical Drug Prices
Pharmacies big and small all have varied prices for prescription drugs. You can easily compare these prices and be able to get the best price, saving you hundreds of dollars per year. Mail-order pharmacies for example can provide cheaper prices for prescriptions as they tend to have lower overhead costs to run their business. Since they run online, they do not have high rent, electricity bills and staff costs found in local pharmacies. GoodRx can assist in comparing prices in your local area.
8. Medical Fundraising
Medical fundraising online can be very helpful in paying for prescription drugs. Patients can create a fundraiser online for free and seeking financial assistance from family and friends to help pay for life-saving treatment and medications.
One example of where you can start your fundraiser is through a website called PeoplePledge. This website offers patients across the United States, the ability to raise thousands of dollars within a short period of time. There are no cost to start and run a fundraiser from PeoplePledge. Patients however, will need to cover the bank transactions fees, which are generally deducted from the donation. Therefore, fundraisers will not have any out of pocket costs.
1) Extra Help with Medicare Prescription Drug Plan Costs: http://www.ssa.gov/medicare/prescriptionhelp/
2) Affordable Care Act of 2010 Expands Medicaid Eligibility in 2014: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Eligibility.html
3) Prescription Drug Patient Assistance Programs: http://www.nami.org/Content/ContentGroups/Helpline1/Prescription_Drug_Patient_Assistance_Programs.htm
4) NORD’s Patient Assistance Programs: https://www.rarediseases.org/patients-and-families/patient-assistance
5) The Most Expensive Prescription Drugs in the U.S: http://www.takepart.com/photos/most-expensive-prescription-drugs-us/next-gallery
6) The 7 Most Expensive Prescription Drugs: http://pharma.about.com/od/SalesandMarketing/tp/The-7-Most-Expensive-Prescription-Drugs.htm
7) $4.2 Billion Deal Highlights Drug Profits From Rare Diseases: http://www.forbes.com/2010/02/19/expensive-drugs-cost-business-healthcare-rare-diseases.html
9) Strategies Used by Adults to Reduce Their Prescription Drug Costs: http://www.cdc.gov/nchs/data/databriefs/db119.htm
10) 4 Ways to Help Lower Your Medicare Prescription Drug Costs: https://www.medicare.gov/Pubs/pdf/11417.pdf
11) High cost of cancer drugs forces many to stop treatment: http://www.tennessean.com/story/money/2014/05/06/high-cost-cancer-drugs-forces-many-stop-treatment/8745043/
More Prescription Costs Financial Help Resources
- Even generic drug costs can take you by a surprise In the US, about $1,000 is spent towards prescription drugs per person each year. To get an insight into this figure, one may look at the prescription drug spending in other countries. It is 40% higher than that spent by Canada and twice as much as that spent by Germany and France. It is a multifactorial ... Read more
- 4 programs for patients who need help paying for medication According to many different studies it has been determined that approximately there are about 52 million American adults who are in a state of medical debts. Many of these individuals often will require ongoing treatment and medication. As a result, with all the limited financial assistance options that are available, many different programs for many medical ... Read more
- Where To Find Help When You Can’t Afford Medication? If you are finding it hard to pay for your medications, they are ways by which you may receive help. This article outlines some of the agencies/programs that provide assistance towards prescription drugs. 1. Seek Medication Help From Your Doctor Ask your doctor if there is a possibility of switching to lower-cost drugs. Explore the possibility of ... Read more
- Top 10 cancer prescription assistance programs for free or low cost medication Cancer is undoubtedly a costly illness that not only takes a toll on health but also your finances. Even with best insurance policies at hand, often the treatment costs become exceedingly overwhelming for patients and their families. During the treatment there will always be several unexpected and unforeseen charges involved that can make it hard ... Read more