Expensive specialty drugs are forcing seniors to make hard choices

Wednesday, 15 November 2017, 05:59:38 AM. There is a growing problem with Medicare prescription drug coverage for seniors who take high-priced specialty drugs: There is no cap on how much they pay.
For 23 years, Diane Whitcraft injected herself every other day with Betaseron, a drug that helps prevent flare-ups from . The drug worked well, drastically reducing Whitcraft's trips to the hospital. But as her 65th birthday approached last September, she made a scary decision: to halt the medication altogether. With health insurance through her job, Whitcraft had paid a $50 or $100 monthly co-pay for the drug; she hadn't even realized that the price of Betaseron had soared to more than $86,000 a year. Shopping around for drug coverage through , the out-of-pocket costs were mind-boggling: close to $7,000 annually. "I was just feeling really bad that my disease was going to affect our retirement budget," Whitcraft said. "You're retired; you're on a fixed income. And it just really was bothersome to me. I was doing this to us. This disease was doing this to us." Whitcraft's dilemma highlights a growing problem with Medicare prescription drug coverage for seniors who take high-priced specialty drugs: There is no cap on how much they pay. Each prescription drug plan is structured a little differently, but people with very high drug costs almost inevitably enter what's called the "catastrophic" phase of coverage. Then, they pay 5 percent of the list price of their drug - no small sum in an age of $10,000-a-month cancer drugs or, in Whitcraft's case, a more than $7,000-a-month multiple sclerosis therapy. The number of seniors who reach the catastrophic phase has almost doubled over...Read more
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