How Will I Pay For My MS Medications?

Being diagnosed with Multiple Sclerosis is not only a difficult diagnosis to handle, it is also an expensive one.  Knowing how to pay for your medication is an important, and often daunting task as treatment costs continue to skyrocket.

How can we pay for our medication if we are unemployed?  If we have private health insurance, what will our copay and deductible be?  What will our out of pocket expenses be?  What is our Medicare “donut hole”?

I have been taking Copaxone since it was first FDA approved 17 years ago.  I remember what the cost for Copaxone was back then, but somehow I lost track of its cost today.  For the purpose of this article, I was curious about today’s cost for all of the FDA approved MS medications.  The answers I found were astounding.

According to MedCity News1 (which only discussed a couple of MS drugs), Biogen charges $54,900 a year for its newly approved oral medication, Tecfidera, and the cost for rival Teva Pharmaceutical Industries’ drug, Copaxone, is the same.  Novartis AG charges $60,000 a year for its oral drug, Gilenya, and Sanofi charges $48,000 for its treatment, Aubagio.

The website also quotes the research firm ISI as believing that Biogen Idec will charge $51,000 for Tecfidera, while Teva will reportedly charge $50,000 a year for Copaxone.

How will we pay for the medications we need?

There are ways to find some assistance.

If you have private health insurance, or get insurance through your employer, speak with an insurance representative.  (Many MS Center’s know there is usually a social worker on hand who can help with insurance matters.)

Also, know your rights under The Affordable Care Act.  In 2014 people with pre-existing conditions can no longer be denied health insurance. Many uninsured people living without health insurance will now have access to coverage.

The National Multiple Sclerosis Society2 provides all of the information you need to become knowledgeable about ACA, and how it applies to your MS.  It is stated that, “Uninsured people with pre-existing conditions, including MS, who have been without insurance for six months or more may buy a health plan through the Pre-Existing Condition Insurance Program (PCIP), which has established temporary high risk pools.” Additionally, “as of July 2011, the cost of this coverage is going down in many states.”

Here are some other ways to find the help you need:

  • The National Multiple Sclerosis Society has a financial assistance program to help guide and support you in finding ways to pay for your prescriptions.  Give them a call at 1-800-344-4867 to speak to an MS Navigator, or visit their website at www.nmss.org.  Your local chapter will be more than happy to assist you.
  • Many pharmaceutical companies have financial assistance programs and are ready to speak with you about your specific needs.  The National Multiple Sclerosis Society offers a page of information about each company, and where you can find answers to your questions.  Be sure to take a look at it.
  • If you are presently on Medicare and need help, you can see if you qualify for extra assistance through their Medicare Prescription Coverage.  Check out The National Council on Aging for more information.
  • There are some national foundations that provide help for people with MS. They include NeedyMeds, The Patient Access Network Foundation and Chronic Disease Fund.
  • Social Security Disability Insurance is available for people who are unable to work, but are entitled to receive disability benefits.  Once again, The National Multiple Sclerosis Society will help you better understand the maze of getting approved for SSDI.

You are not alone in finding ways to pay for your MS medications.  As always, we are for you at MultipleSclerosis.net.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MultipleSclerosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
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