There’s no doubt about it. Pharmaceutical companies and insurance companies run the world. At least the world of medicine in the United States of America.
Without doing any research on the why of it, my guess is because Congress allows it, because Congress obviously doesn’t do anything about it. And why does Congress allow it and not do anything about it? There again, it’s a guess, but it would be my guess that pharmaceutical and insurance companies have an awful lot of very strong lobbyists and donate an awful lot of money to Congressional campaigns.
Eylea is a perfect example.
Described as a miracle drug, which it may well be, Eylea is a prescription liquid administered by an ophthalmologist into the eyes of persons with macular degeneration. That’s a disease that means blood vessels under your macula, the back part of your eye, have started to leak or bleed, blinding your vision and an ability to read books, make out facial features, watch TV or drive. It’s also used for a few other eye problems, including swelling in the retina caused by a blockage in the blood vessels, diabetic retinopathy, an eye disorder in diabetics that can lead to a fluid buildup in the retina, causing blindness.
In any case, the doctor, under local numbing, inserts a whopping 0.05 mL directly into the eye. That’s lot a couple of teardrops full of stuff. It’s generally a once a month treat, depending on the severity and success of the injection.
The good news is it’s highly effective, and ophthalmologists have seen results they didn’t expect to see in a million years.
The bad news is if you look at the bill, it costs $5,000 a shot. That’s one 0.05mL dose. That’s without any of the other costs associated with preparing you for the shot.
Multiply by that by say ten or 12 times a year, and you’ve got a dandy down payment on a house or the hope of being able to see faces again.
Insurance covers it you say, so why worry? Well, that’s only partially right. It depends on your insurance company, Medicare, plus a few other things. Some companies will cover a part of the cost, but only if you’ve tried the cheaper stuff first. Avastin, for instance, comes in around $50 to $100 a shot. Some insurers will cover it from the start, but only a portion of the total. Some will cover it only if Medicare covers some first.
I was lucky. Besides having a doctor who cared enough to check my coverage before hitting me with the shock of a terrible debt, all those years my husband was a railroad engineer with the PRR, later AMTRAK, all those nights I got up at 3 or 4 a.m. to get his breakfast and pack his lunch so he could make his two hour call to start the engine, are worth it all. His railroad brotherhood, or union, has a wonderful insurance policy. My Eylea was paid from the first very shot, whether I had tried Avastan or not. Pays the monthly bill in full. Plus all the related costs. Thanks, BLE.
Eylea knows their miracle cure is expensive. But rather than using their strong lobbies to convince Congress to fund more drugs, why don’t they simply cut the costs? If the drug is so effective, doctors will spread the word themselves. Cut out the advertising. Pour those dollars into that expensive research and cutting costs for the blind customer. He’s got enough problems without having to face exorbitant bills.
Eylea doesn’t do any of those things. Instead, it provides customers with plenty of facts, figures, and means to get someone else to pay the bill. They have their own EYLEA copay card program for one. You can get one of these if you live in this country, if your own insurance covers EYLEA and you have a copay, or if you have Medicare AND your own policy and still have a copay. If you visit their website, they will help you seek out and find lots of different foundations that might help you out. They’ll also hook you up with help if you don’t have any insurance at all that covers eye care. Doing all that close paperwork at a time when you can’t see very well probably takes your mind off the fact you can’t see very well.
Find out the cost of Eylea in other countries. Just north of us, on the same continent, it’s around $2,000 a shot. In Europe, it’s around $1,00. But here in the United States? $5,000 per shot is about the going norm. Is there something wrong with this picture? Can I not see it clearly enough because of AMD?
By the way, the drug is made in Tarrytown, New York.