For most Americans, $280,000 might represent the price of a home or perhaps their entire retirement savings. But for the 1.3 million people in this country stricken by rheumatoid arthritis (RA)that quarter million dollars could be their drug bill.
Rheumatoid arthritis is a debilitating disease that causes painful inflammation and swelling of the joints. Left untreated, it can lead to permanent disability. Thankfully medications such as Enbrel, Humira and Zeljanzcan keep patients healthy enough to stay active and keep working. Yet the price tag is quickly becoming out of reach.
One recent report from Express Scripts found that spending on drugs that treat inflammatory conditions such as arthritis rose 25 percent in the last year alone. The annual cost of treating the nation’s RA sufferers is expected to reach $9.3 billion by 2020 – a 45 percent jump from 2013.
For a 45-year-old patient recently diagnosed with RA, the lifetime cost of medication is likely to exceed $1.4 million. Even if that person has 80 percent of their costs covered through insurance, the math works out to $280,000 in copays alone.
There’s something out of kilter when families may be forced to choose between investing in a home or easing a loved one’s pain. Yet that is exactly the sort of Catch-22 some will face if we do not find a sensible way to price drugs.
When I started medical school, my South Asian immigrant parents quietly hoped I would find my way to cardiology or another glamorous specialty. Instead, I spent a decade — first as a medical student, then as an intern and resident in internal medicine — focused on advancing the right to health among poor people and others with little access to quality health care.
A decade ago, electronic health records were aggressively promoted for a number of reasons.
Think about your experience in going to a standard doctor’s appointment. You fight traffic or parking hassles to get to the doctor’s office. You often wait past your appointment time in the lobby, and once you actually get into the exam room, you wait again for the doctor to actually arrive. While it may be a few minutes, it can sometimes feel excruciatingly long. The doctor arrives, and despite all the paperwork and information you shared with the receptionist or the nurse, you repeat much of this information. Once you finish your exam and discussion with the doctor – during which you sometimes take notes, sometimes not – you walk out and have that awkward moment at the front desk, wondering if you can leave freely or if you owe large sums of cash.
