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Eponine

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CALS
Country
US
State
MA
City
Springfield
Hello Everyone,

I just need to get this off my chest. I went to pick up my Dad's prescription for Riultek last night. I get there, the pharmacist says "wow, this is expenisve". I said I know that because it's a special order, etc. I told him that with insurance it's around $30.00. (This will be his 3rd refill since July 30 day supply each). The guy says "no, it's $500.00". What?!?!

Well, appearantly we have reached the maximum the insurance company is willing to pay for the YEAR and we now have to pay up to $3,600.00 before they will have the insurance kick back in. So, he will only get covered for 2 months worth of pills a year and we have to pay the rest.

How nice of them, let my dad pay for the past 60 years for this stupid insurance and we he needs the most, don't cover anything!

We were denied a hospital bed, cane, etc from the insurance company because "due to his illness, there is no need for those items".

INSURANCE COMPANIES ARE A RIP OFF!

So, now to give my dad some hope, I will pick up this $500.00 bottle of medication, $16.67 per pill to give to him even though he will die and it will not save his life.

Ok, I think I feel better.

Anyone out there have a similar situation?

Thanks for listening
 

DavidGL

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Aug 18, 2006
Messages
41
Reason
Learn about ALS
Country
US
State
PA
City
Huntingdon Valley
Hi,
I have no great love for the insurance companies but in this case I find it easy to understand. Seeing it from *their* perspective--this drug does not really help so why should they spend people's money on it? In the end, it causes everyone's monthly payments to rise. You can rest assured that, if a drug came out that passed clinical trials, the companies would indeed pay for it. I'm surprised that they would pay for any of it, actually. I wonder if other plans pay for it? Maybe if you paid more per month?

David L
 
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ronney525

Active member
Joined
Dec 14, 2005
Messages
51
hi. whereas i do not take rilutek... i recently signed up for hospice and they take care of all meds as well as all extras... hosp bed, walkers, anything and everything. maybe look into this in your area. good wishes
 

Eponine

Member
Joined
Jul 20, 2006
Messages
18
Reason
CALS
Country
US
State
MA
City
Springfield
Hello!

Thanks for the responses. Yes, I understand that the pills are expensive and it then adds onto the cost down the line but the problem is, he is on other medication that now must come out of our pockets.

The insurance companies are always making money, trust me, I highly doubt they lose money even in a case like this.

What happens to people who have cancer, etc and the medication would actually cure them yet the insurance company won't pay because of the cost? That's what irritates me. I'm sure there are people who have died because of this.

Yes, I know that Riultek does not cure ALS and it's a different situation than say cancer, that is sometimes curable.

Ronney525: I will look into that. I still think it's wrong that year after year after year, someone pays into insurance only to be denied when you really need it.

Thanks!
 

Al

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Joined
May 25, 2004
Messages
7,960
Reason
PALS
Diagnosis
10/2003
Country
CA
State
On
City
NW of Toronto
Although the Ins. Co. pays for Rilutek for me I am not a fan. Have you tried contacting ALSA or MDA for help with the cost of the drugs. I have heard a rumor also and that is all it is that sometimes the drug companies will subsidize costs for patients not able to afford expensive drugs. They don't advertise this but it's worth a phone call. AL.
 

rcharlton

Moderator emeritus
Joined
Jun 20, 2005
Messages
610
Reason
PALS
Diagnosis
11/2005
Country
CA
State
Ontario
City
Toronto
I'm pretty sure the manufacturers of Rilutek have a program to help PALS pay for the drug in cases where they don't have insurance.

If your Dad goes to an ALS clinic - they could probably help - if not MDA or ALSA should help as Al suggested.

I wonder if the price of Rilutek will ever come down...it surely does not cost $20.00 a pill to manufacture...they just need to recoup their R&D costs - but I wonder if their is any obligation on a drug company to reduce the price once the costs are recovered - I guess that's where generic drugs come into play - but I doubt there is enough of a market for generic Rilutek
 
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