Tuesday, January 10, 2012

Tough pill to swallow

This is a tough post for me because yesterday I was hit with a reality check that I didn't want. Part of yesterdays stress was my own doing but on the other hand I wish I would have received a reminder letter, or something just to confirm I was going to have to deal with a deductible. For the most part when people have a disability and have to take medication there are alot of costs that come into play. Depending on your income and what type of medication you go on will make or break you. I feel like it at first is all so confusing trying to figure out the process of drug approval and then who is going to cover the huge costs. Lets see I work full time but I don't make a ton of money. I have to live, pay rent, eat, commute...it all adds up. There is insurance, and medical insurance, also physical therapy. In the end it all adds up. What I have a hard time with is that I need a good quality of life and in order for me to have that I need to be taking the best treatments that work well with my body. In my case we tried all the pill form of medication before we realized they were not working, also I had to then take other pills to help with the side effects of that pill..so on and so on. We finally decided to do the humira. Not knowing much about the costs I was pretty shocked when I saw how much it was. I was lucky to have two forms of extended health and one would cover most of it but the process to figure all of it out was overwhelming. I started my humira in may of 2011 and I assumed since it requires government approval per calender year that my anniversary date would be May. When you register for Pharmacare it is dependent on the amount of income you make to determine what they will assist you with.  You also have a deductible that must be paid every year. Once you have reached paying that deductible you can then expect them to pay 50-70 per cent of your medication. I am not sure if me typing this makes it easier to understand but it costs a far bit. In general with out coverage it can cost from $15,000.00 to $20,000.00 per year mine is $18,132.00 depending on if you have coverage. The drug company does offer an assistance program but only if you qualify. Abbott drug company claims they have given $80 million dollars worth of humira from the time it became available.......ummm I didn't get any...???? Anyway back to yesterday. I went to pick up my humira and BAMN guess what a delectable was due.....I do not want disclose how much but enough to make my stomach sink and me to feel nauseous. I actually had to leave the pharmacy and figure out how to pay. The thing is I assumed that may was my renewal date for the deductable, and the re-approval. The government runs January to January which means January is when you MUST pay the large deductible. I had no letter to remind me, which I guess is alot for them to do because they are to busy taking my money..........This was only my first year on this medication so I still am learning the ins and outs. Just would have been nice to have the heads up. Most people do not ever ask me about the financial end of it but I fully understand why I feel so stressed out when it comes to money. Thankfully for me I have some insurance coverage that allows me to get most of it back. I unfortunately must pay for everything upfront then wait for the re-payment....it sucks!! I honestly was not expecting yesterday to happen so  I was caught off guard. For anyone taking these medications it can be hard to find all the ins and outs and it is truly through having theses things happen that I learn how it works.

I am very grateful to my dad yesterday for being able to help me in my time of need. I was in a total finacial jam that determined if I would take my injection this week, actually my dad has been the reason I have been able to do my medications. I am not afraid to tell you all that I had to turn to my family for help. With out it I would not be writing these posts and having somewhat a better quality of life. Asking for help is very hard to do. The best part is I am one of the lucky few who get most of it back it is only a short term loan. I want you to think of this though............in the life of an arthritis patient the cost of my medication from now til I am lets say 65....is roughly $465,000......that my friends is a tough pill to swallow!!!

When you wonder why I always post I want to win the lottery or I wish for a money fairy to drop off little enevlopes of money you can see why....By the way I am positive one day I will win the lottery!!!!!


  1. Yes...it is stressful to say the least....i have had to put numerous drugs on my VISA just to meet my deductible. i hate to break it to ya...but the prices only get higher after Humira...so i really hope it works for ya!!!!
    the government & pharmacare really needs to step it up!!
    arthritis matters...it effects every part of your day from the second u wake....yet our drugs are shelved for special approval..and even at that...pharmacare doesnt cover half of them!!! treatment should not be just for the rich...

  2. Hey Erin - hopefully you are using the amount you paid for your drugs (your portion) on your Income Tax as a deduction. You can only be reimbursed a certain percentage (I believe you can claim up to 4% of your gross) but every little bit helps.

  3. So glad you are blessed with family that can help as much as possible. I don't know what I would do without mine. There are so many people out there that have neither family nor good insurance. For those, the reality of life is very real and suffering great.
    I don't think the average person has an understanding of how much medications cost. I sure didn't. I thought the world was ending when my copayment went up from 32 to 42 a few years back! Now, my IVIg infusions - which I get every two weeks, but had been getting weekly for the first year - are $40,000 a pop! Yes, that is every two weeks! And that is only one medication out of many. On Mondays I take over 30 pills by the end of the day! It's crazy, to say the least.
    You are a strong women, Erin. As tough as these days are, you seem to handle them well. And a little love from Dad always helps!! ;-)