Should I feel guilty about my expensive drug?

[Anonymous]

For the past 10 years I have taken a biologic drug for rheumatoid arthritis that my insurance company says costs $5200 a month. I have never paid a penny out of pocket although I have dealt with the maze of prior authorizations, manufacturer co-pays and multiple specialty pharmacies. The biologic drug does work better than the much cheaper alternatives at keeping my inflammation near zero When I was a young child the inflammation was severe and left me with still-visible joint deformities. But since I have been an adult the inflammation has been low-level (but non-zero) even when I needed to go off the biologic drug due to insurance problems.

I am thinking that biologic drug might not be worth the expense. Even if I don't pay a penny, I am contributing to overall health costs, for a minimal benefit.

[Anonymous]

Do not feel one bit of guilt. I am glad you can get a drug that helps you. Many cannot. Your situation should be the norm.

[Anonymous]

Anonymous wrote:Do not feel one bit of guilt. I am glad you can get a drug that helps you. Many cannot. Your situation should be the norm.

Also, if you think you are not getting a benefit, try going off of it. But not because of $. Because why take something that does not provide benefit and likely has side effects.

[Anonymous]

I don't know ofc OP but we never know what is going to happen in the future and you may need this drug again.

[Anonymous]

It is not your fault that you have a disease that is helped by an expensive drug.

[Anonymous]

Of all the things I’m glad my insurance contributes to, it’s stuff like that. Don’t feel an ounce of guilt. The people who should feel guilty are PBMs and insurance companies and corporatized medicine.

[Anonymous]

It isn’t costing your insurance company 5200. It would cost you 5200 if you didn’t have insurance because that is the non insured non negotiated rate for the medication. Insurance companies negotiate their own rates with manufacturers.

[Anonymous]

You should feel angry. Your tax dollars supported the company that made the drug - probably through an NIH grant.

The company that makes the drug probably pay the CEO over $1 million per year. The company that makes the drug also employ at least 2 lobbyists that spend many times the monthly cost of that drug on getting Congress to do what they want.

The drug probably costs less than $50 to make each month but because of the insurance companies, PBMs and corporate pharmacies all needing a cut, you are being told it costs over $5000 per month.

[Anonymous]

Yes, you should.

[Anonymous]

Your drug keeps you functional. It is worth every penny.

[Anonymous]

No, you should feel like at least in your case, health insurance functions to prevent (further) disability, a huge win. And if it turns out you don’t need it, that’s an appropriate reason to stop it, as opposed to insurance suddenly taking it off the formulary or something.

The only expensive medical care I get worked up over is the super expensive trip to the Emergency Department which people make when they don’t have decent Primary Care. And to be sure, done do that out of entitlement, but I think most out of necessity.

[Anonymous]

Anonymous wrote:You should feel angry. Your tax dollars supported the company that made the drug - probably through an NIH grant.

The company that makes the drug probably pay the CEO over $1 million per year. The company that makes the drug also employ at least 2 lobbyists that spend many times the monthly cost of that drug on getting Congress to do what they want.

The drug probably costs less than $50 to make each month but because of the insurance companies, PBMs and corporate pharmacies all needing a cut, you are being told it costs over $5000 per month.

I strongly doubt that the drug costs less than $50 to make. I know for the biologic Humira, even the biosimilar drugs (roughly equivalent to generics) only cost about 20% less than the $5000/month brand name drug. The article below lists why biologic drugs are so expensive to make. (Biologics comprise only 2% of drugs on the market yet account for 37% of all drug spending in the U.S.)

https://medicalaffairsspecialist.org/blog/5-reasons-biologics-remain-expensive

[Anonymous]

Don't feel bad unless you vote GOP.
I'm not sure even Dems can sort this out. Our gov't effs us, insurance companies love it and will try to deny meds first.

[Anonymous]

HELL no.

[Anonymous]

I take a biological for inflammatory arthritis and also take insulin and use expensive equipment for type 1 diabetes. I’m annoyed at how much plastic trash the insulin pump supplies generate and bothered by how much the pharmaceutical companies charge people who don’t have good insurance for the insulin, but I definitely don’t feel guilty. It’s true that I contribute to overall health spending, but without the insulin, I’d have died 37 years ago, and I’d like to think I’ve contributed some positives economically since then to offset the costs…