We all know chronic illness is costly, but how costly? In 2020, Americans spent over 539 BILLION DOLLARS on medications. Every year, people with chronic illness spend 5x that of healthy Americans’; spending on average over $6,000 on direct health care costs. The average hospital stay is over $11,000. The cost of chronic disease in the United States reaches $3.7 trillion each year or almost 20% of the GDP. Over 50% of Americans have medical debt and over 60% of bankruptcies are due to medical expenses. To the average, healthy American this may come as a shock, but to us with chronic illness, it’s no surprise. The system is broken, that’s no secret, but sadly we have to live within this system for the time being. Chronic illness SUCKS, but here are some resources we hope will help.
Let’s start with what can help keep
you out of the hospital. Medication and treatment non-compliance account for 25% of hospitalizations. Avoiding medical debt is difficult when you can’t afford your medications, that non-compliance then causes hospitalizations which racks up thousands of dollars in expenses. It’s a vicious cycle, and the first way to avoid medical debt is to find affordable ways to pay for medication and remain compliant with treatment. There are many programs available to help you pay for prescriptions. I will focus on the programs available for people with health insurance. If you are interested I can do a post about government programs separately! Here are some of the options you can look into:
Ask your doctor or pharmacist if the medication is available in a generic form. This is an easy way to save hundreds to thousands of dollars. Just like generic brands of c
ereal are cheaper so are generic brands of medications.
GoodRx is a coupon program that is free, all you need to do is search for your medication and show the coupon to the pharmacist. Easy peasy! It also shows you which pharmacy will offer the cheapest price.
Manufacturer drug programs. Many expensive name-brand medications offer copay assistance (for insured with high deductibles or copays) or patient assistance programs (for uninsured or underinsured). One of my medications, Humira, offers a $5 copay assist. I pay $5 instead of $36,000. Listed below are just a few of the many medications that have similar programs. There are also similar programs for medical devices such as insulin pumps. Don’t see your medication? Call or visit the medication's website to learn if they have a similar program.
Gilead Advancing Access Program drugs covered: Biktarvy, Genvoya, Stribild, Odefsey, Truvada, Viread, and more.
GSK Patient Assistance Program drugs covered Advair Diskus, Breo Ellipta, Lamictal, Serevent Diskus, Ventolin, and more.
Healthwell Foundation drugs covered: Harvoni, Colcrys, Sensipar, Neulasta, Docetaxel, LoCort, Maxidex, and more.
Horizon Cares drugs covered Actimmune, Ravicti, Procysbi, Krystexxa, Duexis, and more.
Lilly Cares Foundation Patient Assistance Program drugs covered Basaglar, Emgality, Humalog, Jardiance, Jentadueto, Prozac, Strattera, Synjardy, Trulicity, and more.
Johnson & Johnson Patient Assistance Foundation drugs covered Concerta, Invokamet, Procrit, Simponi, Sporanox, and more.
Merck Helps drugs covered Asmanex, Dulera, Gardasil, Nasonex, Singulair, Zostavax, and more.
Novartis Patient Assistance Foundation drugs covered Afinitor, Azopt, Ciprodex, Cosentyx, Gilenya, Gleevec, Pataday, and more.
Novo Patient Assistance Program drugs covered Tresiba, Levemir, Fiasp, Novolin, Victoza, and more.
Pfizer Patient Assistance Program drugs covered Chantix, Daypro, Depo-Testosterone, Eliquis, Levoxyl, Lyrica, Premarin, Torisel, Viagra, and more.
If you are struggling with paying for hospital bills try to negotiate. We talk about this more in-depth on this week’s podcast. The bill you receive isn’t set in stone, hospitals would much rather work with you and receive some payment rather than no payment. Talk to them about financial assistance. Also, direct primary care doctors are a good resource to look into especially if you are uninsured or have a high co-pay. Direct primary care (DPC) doctors operate outside of insurance and are monthly subscriptions. For example, I pay $50 a month for unlimited access to my primary care doctor. Some months I see him every week, others I only text him with my symptoms and he calls out prescriptions for me. In the long run, DPC can save you a lot of money. They also often provide low-cost medications, lab work, and more.