for its drug tafamidis to treat a rare heart disease, but whether the treatment that costs $225,000 year will be covered by heath insurers and employers remains unclear.
“This drug is currently excluded from our National Preferred Formulary until our Pharmacy and Therapeutics Committee reviews and provides guidance,” a spokeswoman for the PBM Express Scripts, a unit of health insurer Cigna said, referring to the board of doctors that reviews clinical research for medications and advises whether the medicine should be included on preferred lists of drugs known as a formularies. “We don’t have a timeframe on that at the moment.
No matter whether the drug is covered or not by health insurance companies, the industry says the cost of such drugs will eventually hit consumers directly and that comes as a result of drug maker pricing decisions.
Insurance has denied this drug for my husband . Don’t know what’s next to do
My husband needs this! 225k a year ...please let there be patient assistance !
So the business plan is to increase diagnosed cases of a rare disease to increase profits. Sounds a lot like what they've done with ADHD, Cholesterol, and Acid Reflux.
No average American can afford that? They probably give it away overseas!
Kind of a double edge sword . They develop the drugs in the first place because of the huge profit potential , but hardly anyone with heart disease has the funds to buy them. Kind of hard to keep working with a bad ticker.