Why Do My Meds Cost $1,700?

And why do I have to jump through so many hoops to get them?

As I’ve mentioned before, I went on new meds about 10 months ago. My old meds, which were new at the time that I started taking them, cost about $1,200 without insurance at the time for the name-brand pills. They were so new that there was no generic.

Thankfully, I had insurance to cover them. As such, they only cost me $50-$75 a month (depending on which job I was at during a given point in time). Eventually, they went generic, and my copay…stayed the same because the medication was a particular class of drug that was on a higher tier than most others. Oh, and they were now $1,000 without insurance, despite being generic.

Anyway, I went on a new medication recently that is also a newer drug that costs $1,700 without insurance. And, because it’s also on a higher tier than most other drugs, it now costs me $200 per month with insurance.

Oh, and I also need prior authorization from my prescriber, which is fancy insurance terms for “I know you prescribed this medication, but are you really sure you want to do that?” The prior authorization needs to be renewed every year so I can continue taking the drugs that, you know, I need to function as a human being.

Oh yeah, and the $200 is on top of the $150 or so that I already pay each month for my insurance coverage. So, at a pure baseline, I am paying $350 every month for the privilege of being a functioning adult.

To be fair, that coverage also supports my regular mental health, such as my biweekly therapy and periodic prescriber visits. My therapy now only costs $15 per session, as opposed to the $65 or so that I would be paying. So, to take care of my mental health, a basic part of everyone’s lives, I am up to $380 or so a month, with the odd month where I have an extra therapy session or prescriber appointment.

Now, my insurance also affords me regular checkups, specialists, and emergency care services, so I probably won’t go broke if I need to go to the hospital. Unless I have the audacity to get one of many forms of cancer, which my insurance may choose to not cover for any number of reasons. There are also many other illnesses that my insurance may or may not feel like covering depending on how the wind is blowing that day.

Now, many people would say “why don’t you just take a cheaper drug so you don’t have to pay so much and jump through so many hoops?” To them, I ask, if you were given the choice between a drug that gave you a 0.5 chance of dying versus a much cheaper drug that gave you a 20% chance of dying, which would you choose?

Plenty of you would probably say the cheaper drug, which misses the point of the exercise: why is this a question at all? Why do we, the so-called “greatest country in the world,” force our citizens to pay through the nose for the lifesaving drugs that they need to live? Why do Americans need GoFundMe campaigns to pay for insulin, to the point where the GoFundMe website has suggestions for how to get insulin when you can’t afford it.

I’ve heard the excuse that Americans “support the groundbreaking research” that makes new drugs by paying through the nose for them. I think that’s a pretty bad excuse for killing poor people because they dared to have a treatable illness, all in the name of profits.

Of course profit drives these companies to jack up the price of lifesaving drugs, like insulin and epi-pens. It’s the American way after all: profit over people.

There’s no reason that we can’t have a universal healthcare system. Every other industrialized nation in the world has one, and many non-industrialized nations do too. And, for being the “greatest country in the world,” we sure don’t do well in healthcare rankings despite spending more money per capita than any other similar nation.

But again, that’s America for you. Corporations are people, and the humans that work at those corporations are cogs in the blood machine that feeds the billionaire class. Many people say the system is broken, and they have a point, but they’re fundamentally wrong.

The American capitalistic system is not broken. Sure, it suppresses minorities and the poor in favor of enriching a select few privileged people who hold all the keys, but that’s a feature, not a bug. The system is not broken; it is working exactly as intended. Absurd medical costs, low health rankings, and a shrinking life expectancy are just the costs of admission.

We just pay the price.

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