The great scam: CoPay Cards

It never fails.  Someone needs to be started on a drug like Eliquis.  The insurance company wants a prior authorization.  It denies the drug.  The company wants you to start Xarelto, instead.

Okay, sure.  Whatever… It should work just fine.

Except… the copay is $500 for 90 days. You can try and explain to the patient that the GoodRx price is a horrifying $1800 for 90 days, so the copay is still a significant discount.  Unfortunately, it is still out of reach.

Yet, never fear!  Those compassionate drug companies want to help!  If you meet certain criteria, your copay will be zero with a special six-month copay card!  Wow! What a deal!

There is just one problem. What happens after six months?  Six months will be here faster than you expect and your patient will still need the drug.  The unaffordable copay will resume.

The drug rep will do a lot of “blah blah blah” about programs for those who can’t afford their medicines, but rarely does this cover the person in front of you who has drug coverage.

The patient says sadly, “I guess I can’t afford the medicine.. I’ll just have to get a stroke and die.”

I sigh and say: “Well…There’s always Warfarin,” as I wonder if the patient can keep up with the frequent blood draws and dosing changes.

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