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Higher Co-Pays For Expensive Drugs Continue To Hurt Those In Need

Posted Apr 22nd, 2008 by Patient Assistance Team
It's no secret that the prices of prescription medication have been increasing over the past few years. The uninsured have been faced with much higher unsubsidized prices reflecting the full impact of these actions, but now they aren't the only ones feeling the sting in their bank accounts. A system called Tier 4, which started out only effecting Medicare prescription plan patients, has made it's way into the lives of the insured as well, drastically increasing their co-payments for prescription medication.

The Tier 4 system works on a percentage scale, charging a patient between 20% - 33% of the total cost of high priced prescription medications. Nearly 90% of all Medicare programs and at least 10% of all private prescription coverage plans follow this system to date and more seem to be considering it. The concept is behind the system is simple: The individual in need of the high priced prescription medication incurs the brunt of the cost while the rest of the individuals on that insurance policy and the employer who offers it pay lower premiums overall, as the cost of the high priced prescription medication isn't dispersed. Essentially, reversing the entire purpose of having a communal prescription insurance plans.

From an employers point of view, it does make sense to want to lower the overall cost of insurance premiums that they and their insured incur. Prescription insurance plans claim to have made this system to do specifically that. So without the proper information available to an employer as to how they can better satisfy the needs of all their employees, this seems like the most viable solution available. The truth is this isn't the only solution that an employer has.

In 2003, President George W. Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act which allowed for the creation of Health Savings Accounts. This programs, a vast improvement on it's predecessor, the Medical Savings Account, allows for an employer of any size to issue a form Health Savings Account which will allow them to determine how their insurance money is spent. Coupled with a free prescription discount card like CountyRxCard, those insured in this manner save more and pay less out of pocket than any other form of insurance. This method also cuts out a significant amount of administration fees that can now go towards providing employees with the proper prescription coverage plans to fit their specific needs.

Another method to help alleviate the burned of the rising costs associated with prescription medications is by looking into the patient assistance programs offered by the pharmaceutical companies. The report done by Avalere Health in 2008 for the New York Times lists the following medications as “The Top 12 drugs in Tier 4”: Procrit, Neupogen, Actimmune, Cerezyme, Fabrazyme, Intron-A, Intron-A with Diluent, Avonex, Betaseron, Copaxone, Humira, and Remicade. These medications treat conditions from Multiple Sclerosis to Cancer and as such, cost a significant amount of money. The advantage is that each of these prescription medications do in fact have a patient assistance program available.

If you're paying for any Tier 4 medications out of pocket, please do yourself a favor and apply to the specific patient assistance programs for your medication. PatientAssistance provides the most comprehensive list of prescription assistance programs available at no cost whatsoever, so please take advantage of that. Below are links to the specific programs available for those medications listed above.

Procrit Patient Assistance Program

Neupogen Patient Assistance Program

Actimmune Patient Assistance Program

Cerezyme Patient Assistance Program

Fabrazyme Patient Assistance Program

Itron-A Patient Assistance Program

Intron-A with Diluent Patient Assistance Program

Avonex Patient Assistance Program

Betaseron Patient Assistance Program

Copaxone Patient Assistance Program

Humira Patient Assistance Program

Remicade Patient Assistance Program