![]() The bottom line is that patients are shelling out more and more money for needed treatments. But insurers don’t make life changing therapies. Even when patient assistance from a manufacturer helps a patient afford their drug, insurers can apply something called a copay accumulator to make the patient pay anyway. They can increase the copayments for drugs by moving them into higher “tiers” – the higher the tier the more expensive the drug. ![]() ![]() They can elect not to put a drug on their formulary, leaving 100% of the cost in the hands of the patient. On other hand, insurers and Pharmacy Benefit Managers (PBMs) also influence patient costs. That work turns into therapies like Jordan’s that improve his quality of life by reducing the frequency of relapses of his multiple sclerosis. Then again, drug companies do extensive research and development – work that takes time and money. One reason drug costs are so high is that drug companies charge a lot for their drugs. The reason most patients can’t afford life-altering drugs is not as straightforward as it may seem. Patient Assistance Programs exist because many drugs are unaffordable to patients. Genzyme (the maker of Aubagio) has a robust Patient Assistance Program that helps patients like Jordan receive the medications they need. Fewer relapses means a better overall quality of life. In Jordan’s case, Aubagio doesn’t make his day to day symptoms of MS better, it makes relapses less frequent. DMDs impact diseases in ways that may not be easy to see. Jordan Green of Texas has Multiple Sclerosis (MS) and takes Aubagio, a Disease Modifying Drug (DMD) for MS.
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