How's this for a broken RX / insurance system?
Drug (every two weeks at-home injectable) costs $4500/month. I am well-insured with a HDHP. I do research and find out the drug's manufacturer offers a co-pay card. Great.
Co-pay card pays the ENTIRE co-pay, even though it's start of year, wiping out my entire annual deductible ($3500!) for me in one month. I essentially have a no deductible high deductible health plan thanks to this drug. (1/?)
On what planet does it make sense for the manufacturer to pay the entire co-pay like this every year? The planet on which they're massively over-charging for the drug, so they'll just make up the difference out of the profit they're booking the rest of the year from my insurance.
How is this any different from a drug dealer's "first hit is free"? Why are they allowed to make so much profit that they can give away the first dose (but only if you have insurance!)? This is maddening. (2/n)
@tim Well it's because behind the scenes drug manufacturers engage in really substantial negotiations with health insurance companies and employers and drug managers, and everyone else, and what pops out is just the result of that negotiation.
It would make sense if we could see the negotiation that all of these parties engaged in. But it's not a public negotiation.
But that's what both laws and norms tell them to do, so they do.
This is the planet that we asked for as we vote for the legislators who set this up.
