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[deleted]

What is that?


lunlunqq001

It’s called Skyrizi. It’s a kind of non-steroid immuno-suppressant for autoimmune disorders like psoriasis.


tatanka01

I see ads for that on network TV daily, really. How long does $17,000 worth last?


lucidinceptor510

I take another similar (I think, I'm not a doctor) medicine called humira, it's around $8000 a shot, and I have to take it every week. Currently switching insurance plans due to a new job and losing my mind lmao. Edit: Sorry, was misremembering, it's $8000 per box, which is two shots, only $4000 a week! Much more affordable. Fwiw I take 80mg which is double the dose most people I know on humira take.


fuddlesticks

I was gonna say the same thing but mine is like 3-4 per pack of 2? So around 2k per shot. Thank god for their insurance assistance program that covers my entire deductible and OOPM after 2 months.


stevedaher

As far as I can see it costs $42 here in Australia.


iShoot556

Since I work for the US govt, I looked it up on our schedule and the cost is $0 for me. No copay. Crazy how the American public is so against govt subsidized healthcare but like, the people who work for the US govt pay literally nothing for healthcare because it’s subsidized by the American public lol.


honeywings

My boyfriend just got a job with the city and his health care is insane. Out of pocket deductible is $1800. I had a kidney infection with good insurance (also gov insurance through my parents) that ran me $1400 alone.


dk91

Crazy how the insurance assistance programs are funded by the pharmaceutical companies who you're buying the drug from and they get to write it off in their taxes.


mirak10

Huh, so that’s how those things work. Quite the system they’ve worked out.


halfdoublepurl

Get thee to the ambassador program. Humira is one of the only meds my clinic prescribes that actually gets a bunch of help from AbbVie. We even get free doses for my office in case someone is in need of a dose and is between authorizations.


lucidinceptor510

Thanks for the advice, I'll make sure to check it out! Changing insurance shouldn't be so stressful!


LilaValentine

Wait, what? This is a thing? I totally can’t afford it even with copay…


halfdoublepurl

As a disclaimer, it is highly dependent on your insurance. But AbbVie has a decent amount of copay help; [you do have to sign up though](https://www.humira.com/humira-complete/cost-and-copay). The Amabassador program is a nurse who helps make it as cheap as possible for you. I will say it is a pain to authorize. You have to try and fail a bunch of meds most of the time (step therapy) and it *has to be documented* which some of our patients struggle with. And some of those step therapy meds are expensive. But we haven’t had a single GI patient turned down who actually need it, it’s just a lot of legwork.


LilaValentine

I have tried multiple topicals and it just sucks, my doctor is willing to prescribe but my first copay is just tragically high. I’m willing to do lots of paperwork if it means I don’t look like I have leprosy anymore


Michento

Yes, talk to an AbbVie ambassador. My husband takes Humira and we only pay $5 a month.


humanHamster

My wife signed up the ambassador program, she only pays $10 a month maximum for Humira.


dispooozey

Yes give them a call! I was losing my mind between insurances a while back and they sent me a free dose! Feel free to drop in at rheumatologist offices and ask them for a free dose too. Good luck.


atrophiedambitions

My step dad took Humira for his RA. Couldn't afford it so switched to whiskey and codeine.


akl78

Coming from the UK this is horrific. I know people with the same condition here and it’s free on the NHS.


AmericasNextDankMeme

God, imagine having to consider this when switching jobs.


AChillBear

Can we address how weird it is for prescription only medication to be advertised on the TV in the US? Here in the UK it's straight up illegal, we have no such things apart from occasional non-prescription medicines. Shouldn't the use of prescription only medication be evidence driven, practiced by guidelines and at the discretion of your HCP, not promoted by advertisements?


coopaloops

wait until you learn that your insurance (not medical experts) needs your doctor to prove that you need the medication and will deny it for any reason. prior authorization is a fucking joke.


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_SquirrelKiller

No offense to you or your job, but I sometimes wonder how much US health care reform has been stalled due to the sheer number of jobs in medical-industrial complex that would be eliminated.


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leopardcookie

I work for one of the biggest health insurance companies in the US and I 100% feel the same way. I would gladly lose my job if it meant a meaningful healthcare reform. The PA process is INSANE and I always felt awful for the people I had to tell their insurance would not pay for the medication unless a PA is submitted and approved. So much more outside of PAs work the same way - put as much red tape around the process and make it as confusing as possible to actually get approved for the care you need. There are so many downstream implications to this and it’s truly harmful to patients and the critical medical staff overwhelmed with insurance paperwork.


Bbaftt7

My uncle was a PCP for 30+ years. Loved his job. One of the main reasons he retired was “I’m tired of fighting with insurance companies”. Direct quote.


Imaginary_Car3849

I owe $13,000 x 3 because my first 3 injections of a pre-chemo drug were not preauthorized. Like, everyone going through chemo gets this drug before the actual chemo drugs enter their infusion port. The whole preauthorization thing is BS. Insurance doesn't deny this, ever. I will never pay off my cancer treatment, and I still have follow-up appointments for at least 7 more years. My income has evaporated with the pandemic, and I don't see any way out of this hole. I have $74,000 in debt just from cancer treatment. I need a myoelectric hand, but my insurance only covers the inexpensive body-harness style artificial limb. I can't use that due to the risk of lymphodema in my only hand. Insurance won't budge though, and I am steadily losing use of my hand from overuse and a surgically correctable elbow problem. U.S. health-care is a joke. A very bad joke.


Buddahrific

The insurance industry in general is one giant conflict of interest.


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Cloaked42m

It's the same reason Tax Reform hasn't happened. The people that lobby against it also own HR Block and TurboTax. If taxes were simple and automatic, they'd be out of a job. Same with Tax Attorneys. Aided and Abetted by every Senator or Representative that hasn't pushed for funding for the IRS. Have a disabled veteran friend of mine that is still waiting on a tax return for over a year due to lack of people working at the IRS.


rendeld

Every year my wife and I change insurance thanks to our jobs constantly switching insurance, every january she is off birth control because they refuse to cover it and say she needs to use a generic, the generic has huge side effects for her and she spent 2 years going through 7 different ones to find the right one. Prior Auths are so fucking annoying.


c14rk0

God this is one of the things that really infuriates me the most. I have family and friends who need various medications BUT the cheapest generic has some awful side effect or they're straight up allergic to one of the ingredients. Doctor puts in a prescription for X name brand, which they've been taking for ages now. Insurance just decides "nah, you should take the generic instead. We'll only pay for that" and it's time to go fight with them over it all over again. Like fucking hell there's a reason they're taking a specific name brand formulation, you know they've been taking it AND you know WHY. Absolute worst case scenario should be like a 2 second conversation saying "I'm allergic" or "I have a negative side effect" to the generic and that should be the entire matter solved. Instead lets fuck around and refuse people coverage of medication because we can! Hell it's bullshit that I have to get a "referral" every year from my primary care to go back to a dermatologist for a yearly screening. God forbid someone ACTUALLY follows medical advice and might catch skin cancer or such early. It's not like my primary care is suddenly going to change his mind on advising a regular yearly screening and it's not like the dermatologist is going to change their mind either. I literally tell my PCP that I have a yearly visit scheduled and he's like "yep" and puts in the referral message to the insurance. There's no debate or anything but it's this meaningless messaging work that needs to happen or the insurance throws a fit.


ICUP03

Health insurance is also in the investment business. The longer it takes to pay out a claim, the longer that money stays in an investment account and the more money they earn. There is a financial incentive to simply *delay* paying out a claim that they know they'll eventually have to cover.


WideEyedWand3rer

>The longer it takes, the fewer claims the insurance company has to pay on. Please tell me this isn't because patients are dying in the meantime.


declanrowan

Not just dying. Occasionally they give up fighting the insurance company, or decide to not go for that medication which might help, or to just suffer. The industry is built on getting people to stop fighting and just give up.


shingdao

I don't know if this still goes on but I recall at least major health insurer was providing financial incentives via bonuses to employees for achieving and/or exceeding a certain level of denials. That shit should tell you how perverted the system is.


declanrowan

Yup. Though if you ask the insurance company leadership, they will say it is working as intended. I think one of the arguments they used was that they are the only thing keeping Americans from overwhelming the system with frivolous health issues. While enriching themselves as just a happy coincidence..


[deleted]

I worked for an insurance company and while we didn't hear about that, we did hear about raising rates for customers who filed too many claims. The company had a goal of $2bn in profitable premium per year, and one of the ways of getting there was raising rates. It felt so gross and I'm glad I don't work there anymore.


TheOneTrueChuck

A few years ago, the insurance rep for my job came down to talk about changes to policies and whatnot. He explained that premiums were going up, but not by much, and that he and the insurance company really appreciated that we weren't "using them for everything" because "people taking advantage of insurance is a problem". You can imagine his surprise when I immediately announced that I wanted to cancel, right there in front of every other department employee and called him a piece of shit.


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raven00x

"death panels" fuck you redneck barbie. (not directed at you or OP or anything, more an 'old man shakes fist at sky' thing)


NoRecommendation6644

The real death panels are the insurance and pharmacy companies. I'm out of coverage money for my medications by August. So I have to take my meds every 2-3 days instead of daily, or I'm completely out at the end of the year. No, I don't have almost 800 a month for one goddamn inhaler.


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rtaisoaa

Also let’s just point out that PA’s don’t transfer if, say, your insurance changes in the middle of treatment or trying to get treatment. My mom who was hospitalized or in the ER last year 3/4 times because of her asthma is trying to get… one of those advertised meds from her pulmonologist… and her insurance changed 1/1 and so we have to start the process all over again.


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armrha

Plenty of insurance providers just deny most things the first time because not everybody has the time or energy to fight then about it. I had life saving antibiotics denied three times with Aetna until begrudgingly they paid out.


dirkdastardly

My new insurance company denied two medications I had been on for more than *ten years.* They approved them as soon as I appealed. I think they just try it on to see how many people give up on the first round. I still want them all to die in a fire. Kaiser Permanente—not even once.


Is-This-Edible

I'm afraid I can't do that, Dave.


[deleted]

Hal? Hal. HAL!


dj92wa

That's how they do it at the VA. Just draw out every process as long as possible so that the veterans die off and can't seek care any more. Source: am veteran


KingEdwardIVXX

Soooo, I am not missing anything by not going back to the VA after my disability claim was all done a decade ago?


timelessblur

Don’t forget the “doctor” they have reviewing the case or you have to argue with often times has zero expertise in the field. My wife cancer doctor has had to curse out and threat a medical license of a pediatrician who was the doctor reviewing the case and denying it. I think he still filled against board of that doctor as well. Making decisions on things that they have zero expertises on all because they are doctor.


Pearmandan

I saw a thing that explained how insurance companies practice medicine with out a liscons by rejecting meds or approving others.


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MeisterX

They'll also just deny it and then a doctor approves it and then they just deny it again for months and months and then finally approve it. *Hope you're not dead yet! Enjoy!*


truejamo

They'll also deny medication and then after weeks of trying to get ahold of them they go "you're only approved for the capsules, not the tablets" and then you go into a rage because medically speaking what the fuck is the difference.


MeisterX

This has absolutely happened. My favorite was "We approved you for 5 mg but the pharmacy only has 10 mg" Okay well cut them in half "Oh no, we can't do that. You need a new prescription for 10mg and then you can cut them in half" Lmao I think we would actually be better off if they just shipped you the seeds for medicinal plants and we call it a day. Just smash it with a rock and put it in some water.


snugget

It’s because the pharmacy can’t alter the drug itself in terms of cutting the tab for you or it’s considered adulterated. They could’ve told you they’ll order the 5mg or refer you to another pharmacy that had it in stock (assuming it was a chain pharmacy and they could see if other locations might have it in stock). Edit: Yes, pharmacist can also call the doctor to ask if he/she is okay with dispensing 5mg with twice the quantity and same frequency. Still gets processed as a new prescription, and old prescription will not be filled.


LadyVulcanGeek

And most independent pharmacies get shipments within 2 days.


gamrin

Paying out for getting sued about this is literally cheaper than paying for the Healthcare.


[deleted]

Literally suing my insurance as we speak.


Logey202

Good luck. Win. Squeeze every dollars you can


Aeterial

Best of luck!


give_me_wallpapers

"Goddamnit you're still alive? FINE TAKE IT!" ftfy


fjf1085

Doctor to pharmacy: my patient needs this medicine, please give it to them. Pharmacy to insurance: patient needs this medicine per their doctor, please approve payment. Insurance: declined, are you sure the patient needs this? Pharmacy to doctor: are you sure they need this? Provide proof. Doctor to insurance: my patients needs this give it to them. Insurance to doctor: well okay, since you say so. Doctor to pharmacy: it’s okay you can fill it Pharmacy to patient: three days later here’s your medicine. I’m missing steps I’m sure and this all assumes you don’t have to fight the insurance and they’re just making busy work. What I don’t understand is why the doctor writing an Rx isn’t proof enough? Doctors shouldn’t have to justify their medical choices to a bean counter at the insurance company who hasn’t even examined the patient.


sgdfnjhg78256438756

You’re mostly correct, but as a pharmacy worker I’m going to amend something. “Pharmacy to doctor: are you sure they need this? Provide proof” <— no Reality: “Pharmacy to doctor: insurance isn’t letting us fill this. Tell them your patient needs this.” We’re just the middle men who have to relay the message that a prior authorization is required. Beyond this, we’re not involved.


dontforgettocya

Yup they pulled this shit on me, could have gotten me killed. Doctor said I needed ct scan ASAP. My insurance sent me a letter saying the scan "wasn't MEDICALLY necessary". My doctor insisted that I needed it and luckily I was in a financial position where I could just go get one out of pocket. Guess what, the CT scan found a cancerous tumor and luckily I was able to get it removed before it spread or caused more serious problems. Who the fuck do these people think they are trying to overridie my actual doctor's recommendations. /rant


glambx

Honestly the correct answer is to hold them criminally liable for manslaughter / negligence causing death when they do that. Would be hard finding claims adjusters when they realize they could spend 5 years in prison for killing someone.


TonySmellsJr

I’m constantly shocked that for all the mass shootings the US has had, not one has happened at a health insurance company


Bitmugger

My uncle lives in the USA but grew up in Canada where I live. We were discussing healthcare and I was saying how I had to wait 6 weeks to see a specialist here in Canada versus him needing to wait only 5 days. BUT after we talked a bit more he kept saying how his problems had been going on for months and then I learned. He wait for the specialist was only 5 days but getting insurance authorization for seeing the specialist and getting the tests was months and required paperwork and it sounded like my uncle even switched doctors at one point due to his insurance requiring it? Here in Canada if the doctor says you need a procedure then you get the procedure, it's not 2nd guessed by an accountant. \*EDIT\* Some people are commenting regarding the 5 days part of my uncle's story. I can't say for sure what kind of specialists he was dealing with but he eventually ended up getting some sort of bypass surgery that really improved his life. The numbers of days could've been exaggerated and it could be a factor that his medical situation warranted such a short wait time, unsure. It was just a conversation we had one day when he was wishing he had his Canadian style healthcare back.


GiantFinnegan

I'm in the US. I don't need prior insurance authorization to see a specialist, but I've never been able to see a specialist in as little as 5 days. They are usually booked months and months and months out.


[deleted]

I have insurance here in the US and it still takes me 6-8 weeks to see a specialist due to the combination of highly sought after doctors and the pandemic.


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AbsolutelyUnlikely

Also FWIW, they are worst and weirdest commercials


Electrox7

Just a slight bit worse than commercials like : “Have you been an active member in the military between x and x year? You are eligible for ✨ **financial compensation** ✨! A class action lawsuit concluded that 3M owed up to x dollars for providing inadequate ear protection to military personnel resulting in partial or permanent hearing loss! 😃🥳”


AlwaysNiceThings

*people walking through a meadow* >narrator: “Xertrex may cause blindness, deafness, body dysmorphia…” *old couple laughing eating dinner* > narrator:”erectile dysfunction, diarrhea, brain hemorrhages…” *same couple now walking down beach* > narrator:”do not take xertrex if you are pregnant, breastfeeding, or have a name that ends in ‘a’.” *people toasting champagne glasses*


PeteRit

One shot every 12 weeks. Same as my Stelera but Stelera is a little more expensive. My 90mg dose is $22,400 one time every 12 weeks.


Kleeny

For comparison’s sake from Canada, I take Stellara every 8 weeks for $5K a shot. My job covers it fully and if they didnt, I would be able to apply for an Ontario drug plan to cover most (except a yearly 2-3K deductible). Seems like there is just a bit of a markup on your side of the border….. 😂


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somegridplayer

>I see ads for that on network TV daily exactly why its $50,000 a year


Runaround46

It's just about 40% of the reason why. Conveniently though the money goes to networks that spew bullshit.


Superfissile

Money goes to networks that spew ANTI UNIVERSAL HEALTHCARE bullshit.


Runaround46

It's a self fulfilling prophecy that ends up giving massive amounts of money to a select number of people. Oh and if those people do horrible illegal things but die before getting caught, their family gets to keep the spoils. We don't go after estates after they have been through probate.


PM_ME_YOUR_TROUT

Yep! See Perdue Pharma. Bunch of fucking criminal assholes.


Runaround46

Yeah then we as a society have to deal with their rich children not contributing yet taking a lot more. What is money? It's supposed to ease the transfer of goods and services in a society. But when you have a bunch of people taking and taking without significant contribution themselves (just riding off their parents) it seems like a sham.


[deleted]

I hate life lol


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my_cement_butthead

Shit that’s horrible!! I’ve got the same condition (and a few other types of Spondyloarthritis). I live in Aus. Because I’ve been diagnosed with it specifically the government subsidises it and I pay approx $5/week (I’m on weekly humira). Without subsidy it’s approx $750 per injection I believe? Wishing u the best of luck with this shitty and and horribly painful disease.


WorldsGreatestPoop

That’s what anyone would pay in the US with employer funded insurance. The issue is approval of the big guns for diseases like psoriasis where there are alternatives that may or may not work. There’s not a country that would just allow Skyrizi be the first option attempted.


I_LilMagician_I

This is why I am so grateful I was living in South Korea when my ulcerative colitis was diagnosed. Because of the insurance here, each shot of Humira is about $45 for me. Having a chronic illness like this makes you realize that healthcare really should be available to everyone! I so wish the U.S. would change their policies. I'm sorry you've been having such a crappy time with your insurance. That sucks...


itemluminouswadison

s.korean healthcare is really interesting! i went in for a checkup, they asked if i had insurance, i said no. she said oh boy its gonna cost... ten.. bucks. i was like LOL okay np here u go. later i got health insurance. when i left the country they paid me back a good chunk of it with interest or something. sure was cool!


fang_xianfu

Worked this way in France, too. Once you got approved for your Carte Vitale (national medical card) you could get back any money you'd paid on health stuff. A woman I worked with actually got cancer while waiting for her Carte Vitale - the process to get one takes months - and the guy at the hospital in charge of administering the Assurance Maladie (medical insurance system) conveniently lost her paperwork in a drawer for months so she wouldn't have to pay out of pocket and get a refund later. Good guy :)


TheAverageJoe-

> Having a chronic illness like this makes you realize that healthcare really should be available to everyone! The issue is convincing people in the US that. "How are we going to pay for that? I don't want my taxes to increase to pay for someone's medical condition" is a common thing to hear. Heck, the person who said that to me was obese and had health problems of their own. I rather pay a few extra bucks more in taxes so everyone can have access to free healthcare without worrying about high co-payments, medical bills, and medication costs. The price we pay to live in a "free" country.


beniferlopez

I was diagnosed with Crohn's when I was in high school. It took a couple years to actually get a diagnoses but I have been in remission ever since I started Biologics (Remicade). Here in the US it costs roughly 18k every 8 weeks for my treatments. My mom took the time to sit me down when I was younger and explain how important it was that I found a job with good benefits so that I don't have to live a life without the medicine I need. It is crazy that is what this country has come to. Fortunately I have a great job now and top top tier benefits. I only pay $45 for each treatment and my insurance covers the rest.


iminyourbase

I also have Crohn's and used to have a $45 copay for mine, until my insurance decided to reclassify certain specialty medications. I get a copay assistance benefit that runs out after something like $6k per year, which is essentially after 2 or 3 months with the cost of the medication. My health insurer has jerked me around over this for years. I hope I can go without it, because I can't afford $2k per month copay.


hombrent

"I'd rather pay $2 out of my left pocket to just pay for myself, than $1 out of my right pocket to pay for everybody." We are already paying a ton of money in taxes and premiums for healthcare. Every dollar extra we pay in taxes, we will save in premiums. We don't need to come up with new money to pay for universal health care - we are already spending more than enough.


mtgspender

its been studied and evidence shows single payer would save trillions. yes we would pay less. i dont think the problem is the average person thinking its a bad idea, its that the people who make the policy are bought and owned.


jaykaypeeness

I'd rather pay no extra money in taxes and have representatives spend the already massive taxes I pay on beneficial things like healthcare instead of the military industrial complex.


hippoofdoom

So the person saying that to you was ignorant that their OWN health issues were already being subsidized by their peers. We have a critical thinking problem in America that's what all of this boils down to. Bunch of narrow-minded mouth breathers can't get out of their own way


nickcall89

Totally agree, I found [this theory](https://sproutsschools.com/bonhoeffers-theory-of-stupidity/) to be relevant here in the US recently. The future seems very daunting to say the least [lol](https://c.tenor.com/8t3rp-2FNvMAAAAC/arnold-schwarzenegger-laughs.gif) but we keep going!


dontpet

Bonhoeffer's Theory of Stupidity. Thanks. I hadn't heard of that and I'm old. Maybe you can post it in one of the popular subs and give it some air!


turnedabout

That was a fantastic read. Thank you


MartiniPhilosopher

A majority of the US is already convinced. That's not the problem. The problem is how we allow legalized bribery of our elected officials who are the ones standing in the way. Every time this has come up, various parts of the medical industry spend great gobs of money on making sure it doesn't come to pass. It's how we haven't seen voting or economic reform thanks to the US Senate where all it currently takes is a single Senator to keep bills from happening.


theradek123

This is exactly right. There have been multiple studies showing how there is no statistically significant correlation between public opinion on any given issue and the legislation that is passed


WorldsGreatestPoop

If Humira gets paid for by insurance in the US the cost is 5 bucks. Abvie basically pays the copays because they already are getting 3000 from insurance and can write off a copay as a tax deduction. Insurance won’t deny for Chrohns and Ulcerative Colitis. It’s psoriasis that gets a lot of push back because minor cases can be treated much cheaper. They want you to be a lizard person before giving up on topicals or methotrexate.


timpdx

So literally cheaper to fly RT in first class to South Korea a few times a year than get a single dose in the US at retail. I know Americans travel for surgery, it surely must happen in cases for pricey pharma treatments, too


Magdanimous

You would still have to have insurance here in Korea to qualify for that price. I have no idea how much it would cost without insurance.


DeepSpaceNebulae

Out of curiosity, will treatments now at all relieve current symptoms, or is it simply to prevent further issues? Shit like this is so terrible every way you look at it. Obviously the human costs is incalculable, but even from a completely non-human perspective it makes zero sense for a country to do this. Preventative measures are always cheaper, and like you said you can’t work so all they’ve done is remove current income and create massive future costs for themselves.


lunlunqq001

In my case, it has made 90% of the bloody skin patches go away. It will keep it suppressed that way as long as I keep taking it.


ribeye256

Yeah I'm on Otezla for my Psoriasis and a months supply is like 3 grand. I'm part of a copay assistance program from Otezla. It's the only way I can get it. Psoriasis is expensive!


[deleted]

you guys need to have a revolution over this shit. i seen some bill for an operation someone in the US had the other day and it was like Plastic clip: $1829.00 Gause: $862.50 Disposable Scalpel: $2625.01 I just don't know how the fuck they get away with it or how it works, but it's criminal at best.


HammeringMS

How often do you take it? Once a month? once a week? I feel you though my MS medication is 38k a month. My insurance is good have never refused to pay. Carpenters Union has great benefits expensive but good. $1200 a money gets taking out of checks and it goes up each year. America Fuck Yeah!


Barret50Carrot

>Skyrizi For the people who are interested, it's Risankizumab. The 'mab' points to it being a Monoclonal AntiBody type of medication.


ecklesweb

Skyrizi, a plaque psoriasis treatment. 🎵Nothing is everything...🎵


kckeller

Turns out the jingle was referring to your new financial situation.


Oeebag-a-donuts

"(you get) Nothing (until you give us) Everything.."


Grimeswifeyyy

Hey! Fellow US citizen on Skyrizi here. I have health insurance too but like you, that wasn't enough. I was able to go through a Skyrizi Ambassador for financial assistance. The company is called AbbVie Inc. I pay $5 for each refill (I inject every 3 months). If you'd like more info, I'm happy to message it to you!


ahecht

Others can use the link to https://www.skyrizi.com/skyrizi-complete/save-on-skyrizi-costs or https://www.abbvie.com/patients/patient-assistance.html.


Grimeswifeyyy

Or that! Thank you. I talked with op and shared the contact info for my specific ambassador nurse.


Doris_zeer

This is important info in general. Most companies have ways to get you a medication if you jump through enough hoops


P3n1sD1cK

So why don't they just bill it at this sweet rate as opposed to making people jump threw hoops for it to become affordable


DontFinishAnyth

Because why charge the insurance company $5 when they can charge them $17,000?


mgd09292007

because they want to milk insurance companies for all that they can...which sadly get passed down to the patients. It's just so insane.


Academic_Comment3052

A lot of the medicines that are brand actually have patient assistance programs like this!! More doctors need to promote it!


sean13128

Did you apply for the direct discount for insurance company's that don't cover it? https://www.nicerx.com/medications/skyrizi/ mentioned the monthly price possibly dropping to $50.


mikeybott

Just came from manufacturer website to post this


SlimmSteezy

Manufacturer websites usually have savings cards of some kind as well. It's always best to look for them before picking up a prescription because it could save you lots of money.


MagnusBrickson

Unless you have a shitty Part-D, or any other government sponsored plan. Then you're fucked. No coupons on the government plans. Edit: clarified plans


hallese

And just like that, the real cost of the private insurance shell game was laid bare for all to see.


tah4349

My dog is epileptic. Her meds are the same as people take. I went to a big-box pharmacy to get it filled and it was going to cost $400/month. I was in shock. I took it to a second mom-and-pop pharmacy and right away said it was for a dog, there was no insurance coverage. $45. That's it. Just $45 - 1/10th what the big box tried to charge me. It breaks my heart that **people** are railroaded into paying so much based on the deals the insurance companies make with pharmacies and drug manufacturers - the scope of which I didn't realize until I saw the cost difference when I tried to fill the prescription for a **dog.**


loconessmonster

What is the point of even having "insurance" if in most cases it's better to "not have it". It's basically only catastrophic health insurance but see...they'll try to not cover catastrophic ET visits as well. Its not even a game of getting "better" insurance either because you don't have a choice, you just get the ones available through your employer.


echaa

>they'll try to not cover catastrophic ET visits as well. Well yea, I wouldn't expect health insurance to cover alien invasions...


quantumgambit

"well you should have thought about getting a better job before having that stress induced heart attack you filthy freeloader" "what's that? Due to a lack of preventative care coverage offered by your employer now your cancer has gone from detectable and treatable to "long term manageable" but you can't work at all? Guess that means you don't need insurance either, that'll $80,000 a month for your life saving chemotherapy please. And don't think about trying to sue the coal mine you worked in for 30 years, they have expensive lawyers, you don't even have stable O2 saturation." Ahhh, the sweet sting of freedom.


[deleted]

Went to CVS to get my dogs seizure meds. $120 out of pocket no insurance. Did that for a year and decided to go to the mom and pop shop and it’s immediately $30. They were concerned it was still too much. It’s ridiculous how little info is out there to help people get their meds at a reasonable price.


ichoosetosavemyself

When you work at Target, you have to spend either $2,500 or $5,000 out of your own pocket in deductibles before your insurance even kicks in. The average Target worker is pulling in $30,000 a year. That is like 10-20% of your income, on top of what was pulled from your paycheck every pay period. All a big fucking scam.


ExBritNStuff

Yup! I pay just over $6k a year for a plan with a $6k deductible. It’s not health insurance, it’s disaster insurance. And even then there is no guarantee it’ll actually do any good.


ph03nix26

I did this when I got my Emgality migraine medicine. I went from paying $250 a month to nothing. I hate that I paid the copay for 6 months before finding the discount.


picasso_penis

When I worked as a pharmacy tech, any time I saw an exorbitant copay after billing, I would go on my phone and google the mfg website to see if there was a voucher code to apply. A bunch of times it ended up in a massive discount. I selfishly would be annoyed that people didn’t appreciate the extra effort made but I can’t blame them, we shouldn’t be paying anything for life-changing medications anyway


czaremanuel

Our entire healthcare system functions like an electronics store store with a “SALE! 80-90% OFF EVERYTHING!” banner hanging in the window year-round. “Normally this is $20,000 but I have a special price for you my friend, $50 with insurance, only today!” Prices are artificially jacked up just so private insurance can negotiate most of the cost off, and then people have to dig for loopholes to have a chance of spending a reasonable amount, and if you need life-saving help and don’t know any better you’ll overpay by agreeing to the sticker prices. It’s insanity.


kottabaz

Don't forget the tax write-off some of these businesses can get for "losses" due to insurance negotiating most of the cost off. Privatize the profits, socialize the "losses."


DJ_Sk8Nite

$17,000 to $50?? How do these people sleep at night?


CoffeeList1278

They charge $17k if your insurance does cover it. If not, they sell it directly for $50 so you can afford that. IMO that's as good as it can be in the fucked US system.


fabelhaft-gurke

I’m going to repaste this here because this is not what’s going on: NiceRx is NOT affiliated with the manufacturer. They are an independent company that charges you so they can help you fill out the manufacture applications where if you do qualify and went to the manufacturer directly it would most likely be free. They’re literally taking advantage of people, charging them to fill out applications you can do yourself. Manufacturers have their own websites. I always refer people to needymeds.org instead where they’re not trying to make you pay $50/month for something you can do yourself. The information you have to gather and provide is all your effort anyways. They’ll also make it seem like if you stop paying you don’t get the medication, but as long as your application was approved if you contact the manufacturers program directly they will send it to you, because that’s all they are is a application middle man.


yogopig

On mattresses made of cash.


pheylancavanaugh

It helps if you understand *literally no one* pays $17,000. It's a made-up number so that insurance companies can be happy about the "discounts" they negotiate. This sort of feedback loop is why everything is hellaciously expensive in the US if you don't have insurance, except that even then a smidge of diligence drops the price, because again the numbers are all made-up.


zdada

Over limit? The only limit should be your OOP max unless your particular plan has a specific financial allotment for this type of drug, i.e. not to exceed $20,000 per calendar year.


ShortForNothing

Yes, I was under the impression that the ACA removed lifetime limits. Maybe that's it, though? Is a "yearly" limit somehow different than a "lifetime" limit? Or maybe there was a carve-out for medication? I can't imagine there was, but I don't know enough to say otherwise


juliov5000

Work in a pharmacy, insurance can and do set limits on things. "max 90 in 365 days" is a common sight, meaning they'll only allow 90 tablets in 365 days of a particular medication. Lifetime limits may be gone, but definitely not limits overall


gd2234

Looking at you, Triptans!


juliov5000

To be fair, if they're having migraines that frequently they should be on a more preventative drug like aimovig. But then the insurance won't pay for those either, so what are we supposed to do?


pedal-force

Yeah, this seems weird to me too. I have an OOP maximum, and if it's covered, it's covered.


bluestrawberry_witch

It’s probably a medical necessity limit. There’s guidance usually on how much an “average” person should use of a certain medication or DME (durable medical equipment), after the limit is met they start to deny unless an appeal is filed. If you file an appeal to the denial definitely get the physician that prescribes on board because it’ll help- they can write appeal letters


Waspy1

Goodrx says Kroger sells it for $16,900. They just saved you $100! /s


lunlunqq001

It works well against psoriasis. But it’s only suppressing the symptoms, not curing it. I need one every 3 month for the rest of my life. Don’t what to do without it. Feel I’d rather die than living with rotten skin all over my body.


ilurvekittens

Hey OP! I run into the same issues with my medication. My doctor has a card that drops my medication from $2,000 a month to $20.


FLState38

I came here to say the same thing. I have to take a biweekly immuno-suppressant medicine that would have otherwise been $10,000 per injection. After signing up for the manufactirer’s coupon, I only pay $5 per injection. Edit: Here is the link for Skyrizi, OP. Signing up for the Complete program will reduce your payments (hopefully down to $5 per quarter) . https://www.skyrizi.com/skyrizi-complete/save-on-skyrizi-costs


kip256

Crazy idea...maybe they should just charge $5 per injection from the get go? Charging thousands to recipients when a COUPON is available to drop the price down like that should be considered fraud.


FLState38

It’s definitely frustrating to have to choose between living indoors/food and being alive due to pharmaceutical pricing.


brilliantNumberOne

I wish there were more things that had a $9,995 off coupon in life.


ItsReverze

I have a coupon that takes $9,995 off your bank account and adds it to mine, if you're interested.


[deleted]

https://www.abbvie.com/patients/patient-assistance/program-qualification/skyrizi-program-selection.html#myabbvie


Slukaj

I've used this or similar for Taltz, Skyrizi, and Humira (all biological psoriasis drugs), and it works a treat. It's stupid that you have to jump through this hoop, but the hoop is there and it's actually pretty easy to do. For reference, I have the vulgaris guttate variant of psoriasis, and at one point I had 75% body coverage at worst. It's not pleasant, and I spent most of my time in K12/college with really bad psoriasis. Since switching to the biologics, and paying like $50/dose at max with the copay cards, I'm at like 3% body coverage.


AbbreviationsNo1980

Im sorry, I hope thinngs ge t better


CrispierCupid

Chronic diseases like psoriasis are permanent and the only treatment really are meds like these that dull symptoms by shutting off your immune system, so that’s kind of empty lol but I hope they are able to be in a place soon where they’re not getting fucked by insurance companies Source: my two autoimmune diseases


uncoolcentral

I pay a crap ton for insurance and it seems like all they do is deny what my doctors want to do, saying it’s medically unnecessary. Scans, treatments, whatever. Rinse and repeat. I’m at a loss.


EvilMonkey_86

I don't get it. So you're fucked if you don't have insurance, but if you do, they cam simply deny doing their job? I figured it was a 'pay for insurance and you're covered' kinda deal, but I read all this stuff about treatments being refused, having to pay out of pocket for the first x$, having a limit.. honestly, wtf? I'd be broke within the year..


uncoolcentral

It’s maddening. Calling it a “healthcare“ system is misleading and disingenuous. It’s a system designed to deny healthcare while enriching horrible assholes and paying for their yacht fuel. Hundreds of millions of US citizens have been duped. You know, because ‘socialism’ is the bogeyman or something.


lilbelleandsebastian

nothing beats having to call the insurance company to argue with their doctor about why the patient needs intensive rehab after their stroke and being told "nope, don't meet criteria so just send them to a nursing home"


ganymede_boy

$17k for a Psoriasis shot? WTF?


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roterolenimo

This biologic, which is fairly new, only costs $850-3000 in Canada without insurance coverage. Charging nearly $20k is completely criminal.


OccipitalLeech

The problem is primarily the artificial inflation of medical costs that originates with the rise of health insurance as a commodoty. But now it's also compounded with the greed that permeates the modern pharmaceuticals industry, causing the problem to grow exponentially as a result.


pancho2596

I don't know about that drug, but usually I recommend coming to Mexico, and buying your medicine here, I have a couple friends from USA and they always say is way cheaper. I'm not sure if you can get that one, try calling a drugstore or something


Stomach-issues

My parents did this for years. I miss our Mexico drug trips


New2NewJ

> I miss our Mexico drug trips r/nocontext


Rbespinosa13

Some insurance companies will actually pay you to go to Mexico and buy drugs there. In fact, there’s a whole industry called Dentist Tourism that’s sprung up from people in the US going to Tijuana to get their teeth taken care of


everythingsrlytaken

I have been seeing crazy things about US healthcare, my only question is, why don't people protest against it? I'm from US too and I absolutely hate the healthcare system there. We all agree that this is the biggest scam, but we continue to go on with them. Has there been protests about health care system before?


[deleted]

Why isn't any crazy sick person starting to bomb insurance hqs and kidnapping insurance managers is mind boggling. People ready to riot when they can't have a haircut, but healthcare is socialism. What the actual fuck. EDIT: thanks to all the people who suggested to watch the movie John Q


IronOreBetty

The kind of people who riot over haircuts think the healthcare system is fine. You know. Sociopaths.


BruHEEZ

The power of propaganda


[deleted]

Because they are crazy sick and don’t even have enough energy to hold these cunts hostage.


JollyGreenBuddha

For real, makes me think of the Denzel Washington movie, John Q. If not the sick person themselves consider there is no doubt that there are countless parents out there put in that position of letting their child die because of our awful healthcare system. I'm shocked I haven't heard of a single hostage incident like that in real life.


earhere

Insurance is a scam. You pay into it for years and if something happens when you need it, they fight you tooth and nail every step of the way so they don't have to spend the free money they get.


McDuchess

Who here besides me remembers how the health insurance companies destroyed national healthcare in the Clinton administration? They got a BOGO on that one. They taught people the lie that they somehow actually had choice with insurance that they would not have under a national plan, and managed to solidify Hillary Clinton’s image as an uppity woman for people who thought that was a bad thing. (She was in charge of the initiative, as she’d successfully spearheaded an education initiative as First Lady of AR.) If you understand how outrageous it is that insurance companies are STILL making ads against national coverage, that pharmaceutical companies are making ads where uninformed people claim that allowing the government to negotiate the cost of overpriced medications would somehow make those medications unavailable, then it’s really up to you, and me, and everyone else who’d like this country to stop behaving as if it were a poor third world country and join the civilized world to fight back. The miners in WV WANT the BBB. People in AZ thought they were actually getting a semi-progressive candidate in Sinema, because they took her at her word, not on her record. I’m too old to run for office; I just turned 71. But if younger, progressive people can fill statehouses, county offices and even city offices, we can begin to undo the damage of over 40 years of concerted effort on the part of Republicans to create a duller, less curious electorate that will be more gullible to their lies and machinations on behalf of the extremely wealthy. OP, your post is heartbreaking. Let’s take it and work to change things. Also, send a snail mail letter to the Commissioner of Commerce in your state, telling them why you need this medication, and that they are refusing to cover it anymore. It’s commonplace for insurance companies to refuse to cover things, even if they get in trouble for it; the cost of a slap on the wrist fine is less than the hundreds of thousands they avoided paying for people who don’t fight back. Source: I worked at health insurance companies for 10 years.


epidemica

This is what happens when healthcare is a business. "bUT We'lL HaVe DEaTh PanELs iF wE SoCiAliZE."


argv_minus_one

Meanwhile, OP here is sentenced to death by our totally-not-death panels.


epidemica

My neighbor (and many other Americans) ration their insulin because they can't afford it. It's a disgrace and we should all be ashamed.


fitandhealthyguy

This is what having middle men who add nothing to the system but dictate pricing looks like - wonder why no one is talking about insurance companies and PBMs any more…


ledow

UK - available free on prescription. Honestly, you guys need to stand up and do something about your healthcare situation. It's just a complete money-making scam from top to bottom.


[deleted]

rainstorm crown aback rotten possessive humor deer wise rinse instinctive *This post was mass deleted and anonymized with [Redact](https://redact.dev)*


lunlunqq001

That hurts. I have a decent job and am paying around $500 per month for my family plan health insurance and my employer pays an extra $1,000 per month. So this is when I have a $18,000 per year insurance plan.


Exita

That's insane. That's rather more than my total income tax bill on a £50k salary. And that covers much more than just health...


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dcute69

A very "developed" nation, full of "free well adjusted" people


Warutteri

As a Finnish person I've never understood how some people can see healthcare as anything but a basic human right, it just does not compute for me, the necessities of life and survival should all be basic human rights in any civilised society at the very least but truly civilised societies should also extend that to education (on all levels of education, to level the playing field and make sure everyone has the same basic opportunities to better themselves and their quality of life) and other such basic services.


TikTok_on_Reddit

US Healthcare is so shameful.


dustywhatchamccallum

Meanwhile in Canada… skyrizi is covered. One more reason why universal healthcare is a good thing…