Earlier this week, CreakyJoints surveyed 69 U.S. members aged 18 and older with self-reported rheumatoid arthritis (RA) to determine how much patients are paying out-of-pocket for biologics.
Of the 69 individuals who completed the survey, one-third stated that they do not have any co-pay—their medication costs are fully covered by insurance. The other two-thirds reported paying a co-pay. Of the forty-six respondents who pay a co-pay, more than half (twenty-seven) pay once per month. For those paying once per month, the range is from $3 to $1600. A handful of respondents (eight) pay once every three months. For those paying once every three months, the range is $30 to $710. Among the remaining eleven, most said they pay for medications once per year. In other words, these respondents pay their annual deductible for prescription costs. In short, some patients may pay thousands of dollars out-of-pocket for RA medications each year.
Respondents also had the opportunity to make additional comments about the cost of RA medications. Some noted the importance of patient assistance programs to facilitate access to RA medications. One respondent stated, “If not for my patient assistance, I would not be able to afford this medicine since we are on a high deductible plan.”
Several respondents highlighted the high cost of medications even with patient assistance programs. One wrote:
Co-pay assistance for Rituxin only covers the cost of the medication itself – for which I am very grateful as the medication costs $10,000+. However, I am still left with the administration costs of the IV/nurse/etc. that my insurance won’t cover, which is almost $500 per infusion. It is not a small amount money. This is not easy for us and would certainly be a barrier for others.
Others blamed a changing health care reimbursement environment. One patient wrote:
Personally, the drug costs are getting out of hand because insurance companies do not pay like they used to. Everything changed once Obamacare went into effect. It seems the price of drugs skyrocketed. And, if you are on Medicare (like me), you are unable to qualify through patient assistance through the drug company. Not fair at all.
This brief, anonymous survey was done in preparation for a larger study that CreakyJoints is conducting in partnership with Yale University (Principal Investigator: Liana Fraenkel, MD, MPH) to better understand RA patients and treatment preferences, such as medication costs. Specifically, this survey helped to inform definitions of low, middle and high out-of-pocket RA medication expenses for the upcoming study.