MS Meds Lead the Pack as Costs of Neuro Medications Rise

Ed Tobias avatar

by Ed Tobias |

Share this article:

Share article via email
Ponesimod, telemedicine

Ouch!

The out-of-pocket cash that people with multiple sclerosis (MS) lay out for their medications increased 20-fold between 2004 and 2016. That information comes from a study recently published on the Neurology websiteLooked at another way, monthly out-of-pocket costs for MS meds rose from about $15 to about $309 over 12 years.

To calculate this rise, researchers at the University of Michigan looked at a large database of insurance claims for people with five neurological diseases: MS, peripheral neuropathy, epilepsy, dementia, and Parkinson’s disease. They tracked the top five most commonly prescribed medications for each condition as well as any other known high-cost therapies. Out of those diseases, MS meds topped the cost-increase list.

High-deductible plans don’t save money for MSers

The study reports that people who had high-deductible insurance plans had monthly out-of-pocket expenses that were more than double those of people with traditional deductibles. In 2016, the folks with the high deductibles paid an average of $661 per month for their meds compared with $246 a month for those whose deductibles weren’t considered to be high.

“With many new, high-priced neurologic drugs coming to market and a recent rise in use of high-deductible insurance plans, which shift costs to patients, it is likely out-of-pocket costs will continue to increase,” the study’s author, Brian C. Callaghan, MD, MS, of the University of Michigan, said in a news release.

What can be done about this?

Callaghan then raises an important issue. Doctors, he says, need to consider these high costs when they prescribe treatments.

“Out-of-pocket costs have risen to the point where neurologists should be able to consider the potential financial burden for the patient when prescribing medication, but they do not have this information available to them. Neurologists need access to precise cost information for these drugs in the clinic so when they meet with patients to make treatment decisions, they can help minimize the financial burden.”

I couldn’t agree more. Medication costs were the subject of one of my columns in 2017. I wrote then, “I wonder if cost is, too often, an overlooked factor when we discuss our MS therapy options with our doctors. … Cost is the elephant in the room — hard to ignore, but not easy to deal with.”

I don’t have a sense that anything has changed since I wrote that. How do we deal with that elephant in the examining room? If doctors are given access to cost information, as Callaghan suggests, would they use it when deciding which medication to prescribe? Who initiates the doctor-patient conversation about the cost of a treatment? Where do we begin?

You’re invited to visit my personal blog at www.themswire.com.

***

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.

Comments

Larry williams avatar

Larry williams

Big pharm companies should not be allowed to price this way and make insurers pay so much and leave so many MS patients out in the cold (Medicare participants) put the people over charging in jail

Reply
Laura Brown avatar

Laura Brown

When I first went on Avonex it retailed for $8000 per year. Now the same product I used runs over $22000 per year.

Every time a new treatment comes out at a higher price the companies raise their prices because the figure the market can bear it.

GREED!!!

Reply
Lorraine Gerbino avatar

Lorraine Gerbino

The cost of my Avonex is more than 70K per year; I was able to get copay assistance when I retired and went on Medicare or I would’ve stopped the meds; the copay would have been $2000 per month.

Reply
Lynn avatar

Lynn

It was suggested by my neurologist that I start on Ocrevus last year -- I have primary progressivite MS. With the prospect of moving to Medicare within a year or so, the prospect of paying about $80,000 out of pocket for the med was really not an option. I am not taking any MS meds currently.

Reply
Ed Tobias avatar

Ed Tobias

Hi Lynn,

I'm sorry that you haven't been able to make use of Ocrevus because of cost. When you do begin Medicare it should cover 80-percent and if you have secondary insurance it should cover the remaining 20-percent. Until then, have you contacted Genentech to see if you're eligible for their payment assistance program? https://ocrevuscopay.com/

Reply
Lorraine Gerbino avatar

Lorraine Gerbino

Medicare does not cover 80% of injectables; when I went on Medicare, my copay for Avonex went from $25 a month to over $2000; I was able to get copay assistance through Biogen; most companies have programs to help with copays.

Reply
Ed Tobias avatar

Ed Tobias

Hi Lorraine,

You're absolutely correct. It also doesn't cover 80% of oral meds. (Both, as I'm sure you know, are covered under Part D of traditional Medicare).

My income is too high (unfortunately and fortunately) to qualify for copay assistance, so when I went on Medicare I switched from Aubagio (pill) to Lemtrada (infusion). Since infusions come under Part B (and, sometimes, Part A) they get the 80% coverage.

Ed

Reply
Rae Garcia avatar

Rae Garcia

My medication charges my insurance $96,000 a year. They should be prisoned for over charging.

Reply

Leave a comment

Fill in the required fields to post. Your email address will not be published.

Dancing Doodle

Did you know some of the news and columns on Multiple Sclerosis News Today are recorded and available for listening on SoundCloud? These flash briefings give our readers an alternative option for accessing information important for them.

Listen Here

Survey Icon

Video