Fact Checked

High Prices Force Health Insurance Providers To Think Twice

High Prices Force Health Insurance Providers To Think TwiceHepatitis C is a very dangerous, very deadly disease that affects 3.5 million Americans and sees over 200,000 new cases every year. Like its cousins, hepatitis A and B, the disease is caused by a virus and damages the liver. Patients with the disease may have no symptoms at first, but most eventually develop a chronic infection with symptoms like stomach pains, nausea, fatigue, and most particularly jaundice, a condition where your skin and eyes turn yellow. And unlike its cousins, we don’t have a vaccine for hepatitis C which can easily prevent infections.

However, pharmaceutical companies have recently developed antiviral drugs which can cure the disease in the large majority of infected individuals. But while that sounds like it should be nothing but good news, the prices which companies are demanding for their lifesaving drugs are causing health care providers to turn pale. Sovaldi, for instance, comes with a sticker price of $84,000 per treatment, or $1,000 per pill, and while every health care plan can negotiate that price down by around half, it still means they have to buy a luxury car for every single hepatitis C patient.

It’s somewhat understandable, then, that health insurance suppliers are less than enthusiastic about making sure their patients get these treatments. It helps that hepatitis C is a long-term disease that takes years to seriously damage a liver, and it’s only rarely fatal, so health plans can afford to take their time in approving Sovaldi or one of its equally expensive competitors. On the other hand, curing the disease can still cost less in the long run thanks to fewer medical procedures and by making one less person a vector for a new infection.

Because of the costs, and because of a traditional bias against the drug users who are most often affected by hepatitis C, state plans are still in the process of reducing restrictions on who gets to be treated. For instance, Pennsylvania recently removed a requirement that the patient prove he or she is clean and sober first, and California now covers the drug for anyone who has mild liver scarring instead of just severe scarring, reducing the number of rejected patients from two-thirds down to half.

The USA Rx pharmacy discount card may not be able to cause pharmaceutical companies to drop their prices out of the stratosphere, but it can offer discounts of up to 75 percent on almost all prescription medications, discounts which are often lower than bronze-level copays. The discounts also stay in effect whether your health plan covers a given medication or not. To learn more, you can call our toll-free number at 888-277-3911 or send an email to [email protected]

Published July 5th, 2016 by Stephanie Clegg
Fact Checked by Chris Riley

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