Managing the costs of your prescription drugs (here in America)

As most of the readers of these blog posts will be all too well aware, the costs of prescriptions drugs for the treatment of prostate cancer have been rising significantly in recent years, and even when you have good insurance coverage, you may find that you have to pay a significant copay or even a percentage of the costs (co-insurance) for treatment with newer drugs like sipuleucel-T (Provenge), abiraterone acetate (Zytiga), enzaluatamide (Xtandi), radium-223 (Xofigo), etc. These costs can be considerable, many of us need help to pay such costs if we are to be able to access the high quality care that we need and want.

It would be impossible here to get into all of the details about all of the patient assistance programs designed to help to cover the costs of all the drugs that any one patient might need. However, there is some helpful and general information on the Janssen Access web site that gives insight into the range of options that may be available to individual patients and their families.

First, there is a detailed brochure on “Affordability options for prescription drugs” which gets into the details of the different programs that might be available for individual patients based on their insurance coverage and other factors. (Note that although this brochure is dated 2014, Janssen has assured The “New” Prostate Cancer InfoLink that the content of this brochure is still accurate for 2015.)

Second, there is a summary “flashcard” with a shorted version of the same content as the above-mentioned brochure.

Third, there is a glossary of terms relevant to insurance coverage and being able to seek patient support from third-party patient assistance providers.

On another page of the site there is a brochure dealing with Medicare Part D prescription drug coverage for the standard benefit and the low-income subsidy benefit, along with options for assistance programs. Another brochure deals with the low-income subsidy for Medicare Part D prescription drug coverage.

As a quite separate opportunity, the Partnership for Patient Assistance is designed to help patients access the individual patient assistance programs run by the US pharmaceutical companies that manufacture and market individual, specific drugs, including all of those mentioned above (and many others too). Do understand, however, that there are eligibility requirements that patients must meet in order to be able to get help with the financial costs of any form of treatment for any disorder, including income and related criteria.

6 Responses

  1. It amazes me that there is no groundswell of opposition from the American public against the conspiratorial activity between Big Pharma and the US Congress to keep prescription drug costs sky high. We, the public, just roll over and take it. For example, my wife must have a biologic injectable to survive. In Europe, South Africa, South America this drug went generic years ago. But, in the USA, Congress does not permit such drugs to go generic because Big Pharma essentially pays congressional members not to allow it. Big expose in the New York Times proving this to be true.

  2. I know you stated it would be impossible to state all the programs but in addition to the pharma companies that do co-pay assistance another org is the Patient Access Network. Spoke to them at PCRI and they can help too.

  3. I had no idea what these drugs cost and looked at Provenge: 93 large for a treatment regimen. I read this would extend one’s life for 25 months vs. 22 months for a placebo, or $31K a month which sounds insane. One doesn’t know what one will do until confronted by such an eventuality, but with those numbers I hope I would opt out. I guess a lot of other people did, as the maker, Dendreon, is in bankruptcy with no buyers, and the stock is down from $55 in 2010 to a few pennies.

  4. With the present (and worsening) political and drug cost climate, the real question boils down to whether you are going to leave your widow and children destitute, or are you going to sequester enough morphine or other items so that you can schedule your personal tenure termination as a budgetary consideration. …

  5. As we have noted multiple time before on this web site (and elsewhere), the historical model for drug pricing in America has become hard to justify — even for the most ardent of “free market” advocates. On the other hand, we are about to see the first “biosimilar” form of a biologic agent approved in America, and I expect to see a stream of such approvals over the next 5 years. Hopefully this will include the product needed by Dave’s wife.

  6. If you missed the 60 Minutes segment Sunday with a Steve Brill interview you may want to look for it on the ‘net. He wrote the investigative report “Bitter Pill” last year, and now has a book out with the same name. We are paying billions of dollars of profits for Big Pharma, Big Hospitals, and the insurance industry only because our political system lacks the courage to change the system. Our population health doesn’t even rank in the top ten in the world anymore and countries with single payers and cost controls are doing much better than we are. Wake up America.

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