• Center on Health Equity and Access
  • Clinical
  • Health Care Cost
  • Health Care Delivery
  • Insurance
  • Policy
  • Technology
  • Value-Based Care

Rising Cost of 'Specialty' Drugs Prompts Employers to Limit Their Use


When Kathi Ryness’s multiple sclerosis worsened in 2000, she began taking Avonex, a drug that helps slow the progression of the disease and reduces the number of relapses. At the time, her health plan covered the drug in full.

But in 2009, she and her husband, Gary, were forced to switch plans. Under their new coverage, the Alamo, Calif., couple owed $660 every four weeks for the weekly Avonex injections, 30 percent of the $2,200 cost. Within a year, the cost went up again, leaving Kathi, who is now 62, and Gary, 66, on the hook for $800 every four weeks.

The coinsurance was killing them. “It was a choice between that and eating,” Gary Ryness says.

Working with an insurance consultant, they switched from a preferred provider organization to a health maintenance organization that didn’t have coinsurance charges for self-injectable drugs such as Avonex. Now, they pay nothing for the drug.

Read the full story: http://hcp.lv/IOd18l

Source: The Washington Post

Related Videos
Bevey Miner, executive vice president of health care strategy and policy, Consensus Cloud Solutions
dr kimberly maxfield
Amal Trivedi, MD
Ted Okon, MBA, Community Oncology Alliance
Lalan Wilfongd, MD, US Oncology Network
Allister Chang, co-founder, Fabric Health
Mike Koroscik, MBA, MHA, vice president of oncology, Allina Health and the Allina Health Cancer Institute
Margaret Liang, MD, MSHPM, gynecologic oncologist and health services researcher, program director for the gynecologic oncology fellowship program, Cedars-Sinai Medical Center, Cedars-Sinai Cancer Center
Kathy Oubre, MS, CEO, Pontchartrain Cancer Center
Related Content
© 2023 MJH Life Sciences
All rights reserved.