6 days ago
Medications are expensive
So, being unemployed, I have to pay my own health insurance. This is currently around $500/month.
This insurance uses high copays on medication in order to “encourage the use” of cheaper medications. I have four medications which are expensive and get a $100/month copay, so I’m still paying $400/month on those meds.
Two of those meds have copay assistance programs, which present their own set of problems, and insurance companies _hate_ that they exist, because they’re a retroactive incentive to make it easier for people to swallow the high copays on the meds while insurance still has to pay the bulk of the price, and the pharmaceutical companies bake the copay assistance program discount into the retail price of the medicine anyway so it’s not like they’re hurt by it _at all_.
But if I had to pay out-of-pocket for these meds, I’d be paying more for them than for my house.
Here’s the four medications that I’m on which are this expensive, and why they really shouldn’t be:
### Xarelto (rivaroxaban)
* Purpose: Blood thinner
* Copay: $100/month
* Retail price: $600
After my first DVT (the one which turned into an embolism and almost killed me) I was on warfarin, a very cheap, generic blood thinner, but it requires constant monitoring and since it was my first DVT, treatment called for only a six-month course with monitoring.
After my second DVT indicated that this is a chronic condition, I’ve been on Xarelto, a blood thinner that is self-regulating and doesn’t put me in as much danger of spontaneous hemorrhages. It also means not having to do weekly bloodwork with my doctor.
Xarelto’s patents have all expired as of 2025 and there are several generics that have been approved by the FDA, but they all cost just as much as the original and aren’t available in the dose I take anyway.
### Repatha (evolocumab)
* Purpose: anti-cholesterol
* Copay: $100/month
* Retail price: $240
I have familial hypercholesterolemia, which is to say that at a genetic level my liver produces way too much cholesterol. I inherited this from my dad. Regardless of diet or exercise my cholesterol levels are always super high.
I also cannot tolerate statins, which cause me massive, _excruciating_ full-body pain, along with muscle failure.
So, Repatha is the only cholesterol-lowering treatment that I can tolerate, and it works great! It’s a biweekly injection of monoclonal antibodies which break down the cholesterol itself. It’s a really cool immune system hack and it’s been super effective.
But it will be protected by patents until 2033 at the very earliest.
### Depo-Estradiol (estradiol cypionate)
* Purpose: hormone replacement
* Copay: $100/month
* Retail price: $240
I’ve written extensively about my ongoing HRT battles, and Depo-Estradiol is what I’ve been taking for the last few weeks. It’s been pretty effective so far.
There are two common forms of injectable estradiol: valerate and cypionate. The main difference between them is the carrier oil that’s used. Valerate uses castor oil, which is cross-reactive for folks with peanut allergies, and also has a tendency to generate allergies of its own.
I am sensitive to peanuts and have a bunch of other allergies, so out of an abundance of caution, I take cypionate instead.
Valerate’s retail price is $52, and my copay on it would be $5. Cypionate costs 50x as much. All for a different carrier oil.
Cypionate’s patents don’t expire until 2034.
### Tonmya (cyclobenzaprine, sublingual)
* Purpose: sleep aid, chronic pain relief
* Copay: $100/month
* Retail price: $1800
Cyclobenzaprine is a muscle relaxant that also helps with other aspects of fibromyalgia. It’s a well-known, super-cheap medication. Its ordinary oral formulation has a retail price of around $13.
Unfortunately, as an oral formulation it lingers in the system and has other long-term effects, as it’s processed by the liver. For me it’s a suitable rescue medication when I’m having especially bad pain flareups, but it makes me unable to do anything the next day due to extreme fatigue.
Recently, Tonmya came to market, as a sublingual, rapid-release formulation of cyclobenzaprine. As far as I can tell it is the exact same medication as before, just in a different carrier that allows it to be taken sublingually, so that it absorbs right into my blood stream and bypasses the liver. It’s also a much smaller dose, as 2.5mg knocks me out in 10-15 minutes and gives me 7-8 hours of pretty decent sleep (albeit with some _really_ intense dreams). My generic cyclobenzaprine has a dose of 10mg (4x as much), takes hours to kick in, and stays with me all day long.
Just by changing up the carrier, though, they were able to jack up the price by around 140x, for a drug that only has niche usage (namely fibromyalgia) from a population that just plan can’t afford it (because folks with fibromyalgia tend not to be super-employed).
Its patents don’t expire until 2034.
### Blaaaah
If I had to pay the full retail price of these medications, I’d be spending about $2880/month. By comparison, the mortgage on my house in Seattle, one of the most expensive housing markets in the US, is $1800. Which is the retail price of Tonmya _alone_.
Pharmaceutical pricing is inhumane, and it’s only getting worse, as more and more drugs keep on getting “reformulated” for the sole purpose of protecting them by all-new patents. In most cases these “reformulations” are just different carriers or they add in additional side drugs to supposedly increase the effectiveness.
busybee: fluffy rambles: Medications are expensive beesbuzz.biz/blog/8443-Medications-ar... #Hypercholesterolemia #ClottingDisorder #Fibromyalgia #Medication #Blog #HRT
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