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Specialty Drug Costs to Surge

Cancer Patients Face Massive Copays

May 13, 2013
By RICARDO ALONSO-ZALDIVAR - Associated Press , The Intelligencer / Wheeling News-Register

WASHINGTON - Consumer alert: If you or someone you know needs costly medications and you're hoping President Barack Obama's health care law will meet the need, you may be in for a surprise.

Where you live could make a huge difference in what you'll pay.

To keep premiums low, some states are allowing insurers to charge patients a large share of the cost for expensive medications for cancer and other serious conditions.

Article Photos

AP Photo
Daniel N. Mendelson, CEO of data analysis firm Avalere Health, which caters to the health care industry and government, poses for a photograph at their Washington office.

These "specialty drugs" cost thousands of dollars a month.

In California, the patient's share would be up to 30 percent. New York is doing it differently, setting flat copayments for all medications. The highest is $70.

Critics fear most states will follow California's lead.

Daniel N. Mendelson, CEO of data analysis firm Avalere Health, which caters to the healthcare industry and government said cancer patients could face high costs for medications under President Barack Obama's health care law.

Avalere's research shows that one in four cancer patients walks away from the pharmacy counter empty-handed when facing a copay of $500 or more for a newly prescribed drug. "It's important that the benefit design not discriminate against people with chronic illness, and high copays do that," he said.

 
 
 

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