When drugs are too expensive even for working people with insurance | Arkansas Blog

Friday, July 10, 2015

When drugs are too expensive even for working people with insurance

Posted By on Fri, Jul 10, 2015 at 11:39 AM

Kristin Agar, a Little Rock social worker, provides the example for a Washington Post article about a growing problem in American health care — expensive drugs.

Agar has a job and health insurance. She also has a disease treatable by only one drug on the market.

Her doctor diagnosed her with lupus, a disease in which the body’s immune system mistakenly attacks healthy tissue, including the skin, joints, brain, or kidneys. Agar’s doctor prescribed Benlysta, the only treatment on the market specifically for lupus.

But Agar says that, although she works hard and makes decent money, she isn’t able to afford Benlysta. Agar’s insurance policy pays for 80 percent of the drug’s price, or about $2,500 per dose. But Benlysta is so expensive that Agar would still have to pay $450 once or twice a month for the medicine — on top of a $770 monthly insurance premium, and her other medical costs.

“I make too much money to qualify for assistance, but I don’t make enough to pay the bills,” she says.

Agar is by no means alone.

Patients with HIV, cancer, lupus, leukemia, hepatitis C and other serious conditions are paying huge out-of-pocket sums for necessary medication. These costs are putting heavy mental and financial stress on some of America’s most vulnerable people.

And the trend is getting worse. According to Truveris, a drug pricing research firm, the combined prices for brand, generic and specialty drugs rose 10.9 percent in 2014 compared with the previous year.

These rising prices are forcing some patients to take on huge amounts of debt. Others, like Kristin Agar, are forgoing medications altogether – increasing the risk that they will have more serious health complications down the road.

The article didn't specifically identify another pressing problem: Politicians like the controlling Republicans in Arkansas who don't want to contribute to universal health care and who believe people can look out for themselves — presumably by working harder, as Jeb Bush has suggested, or smarter or by choosing a rich birth parent. In Arkansas, legislators are spoiling to cut back extended insurance benefits that still don't manage to help people like Agar.

For those who work hard and play by the rules, Sen. Hendren? Those are the breaks?

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