After my late husband was diagnosed with liver cancer, we drained almost all our retirement savings to afford the medications to keep him alive. Despite Medicare coverage, we had to find a way to cover the $1,000 monthly copays. Five years later and now on Medicare myself, high drug costs are forcing me to make impossible sacrifices to afford my medications.
For decades, Democratic leaders in Congress have fought to break the strangle-hold of Big Pharma and pass meaningful prescription drug price reform. Seniors on a fixed budget are often left with no choice but to ration or skip filling their prescriptions. But since the passage of the Inflation Reduction Act, seniors like me will finally have some relief for soaring prescription drug prices.
I was diagnosed with Rheumatoid Arthritis (RA) and Psoriatic Arthritis in 2016. Women are three times more likely to develop RA and while the condition won’t kill me, the pain is miserable. It affects mobility in my hands and makes everyday tasks next to impossible. Picking things up proves difficult and I often drop things like pans and cups. Even dressing myself has become more challenging.
My doctor prescribed a specialty drug, retailing at $25,000 a month. While on private insurance, there were a few years that I couldn’t afford the medication and had to go without. Eventually, I found coupons that made the high price somewhat mangable.
When I enrolled in Medicare, I was shocked to see my medication copay jump from $5 to $160. My treatment plan requires biweekly injections, meaning my annual out of pocket costs for prescriptions would be over $4,000.
At that price, I had to say no to this medication, even though it would help me. And I’m not the only senior forgoing filling their prescriptions; in fact I’m part of the one in four Americans who don’t take their medication as prescribed due to cost.
I felt defeated knowing the drugs to help my condition were kept just out of my reach. I returned to my doctor to ask for a new prescription I could afford. Now, on a new prescription, I can just barely afford the copay. I don’t know if my copay will increase, and if it does, I must return to skipping my prescription, searching for yet another option, and in pain the whole time.
My health care should not be dictated by which copays I can afford. And finally, thanks to the Inflation Reduction Act, I can take back control over my healthcare.
This historic legislation enables Medicare to begin negotiating lower prices on some of the most expensive drugs, something that Medicare has been barred from doing for nearly 20 years. With the provision to cap annual out-of-pocket copays at $2,000, I can confidently afford the best treatment for my condition. I won’t have to worry whether I can afford my prescriptions from year to year.
As we approach the winter months, I planned to use less heat to keep costs down, so I could afford my medication. Although Michigan winters are brutal, I thought I had no other option. But thanks to President Biden and Democrats in Congress, I won’t have to do that.
Another critical reform in the law caps copays for insulin at $35 a month for Medicare recipients. My late husband’s liver cancer diagnosis damaged his pancreas causing diabetes. The bulk of his monthly expenses came from hundreds of dollars in insulin copays. If his insulin copays were capped back in 2017, we wouldn’t have drained nearly as much of our retirement savings on his care.
I know just how life-changing this provision will be for millions of Medicare recipients. Unfortunately, people with diabetes on private insurance can’t access the same $35 insulin copay cap after Senate Republicans blocked the measure.
While the Inflation Reduction Act is a big victory for Medicare recipients, there is still much work to do to ensure every American can afford their medication. But I’m grateful that President Biden is standing up to Big Pharma to protect seniors like me. With the Inflation Reduction Act, I won’t have to decide between my bills or my prescriptions.
DeAnn Roesner lives in Alpena, Michigan, where she volunteers as a swim coach since retiring.