As an organ transplant recipient, there are a few things that are always on our minds in regard to medications. These are taking our meds on-time, watching our inventory closely and lastly, HOW MUCH WILL IT COST!!
Specifically our immunosuppressants, but the other medications add to the overall cost as well.
My 2 biggest immunosuppressants and dosages are Neoral, which I take 125mg / 100mg (morning/evening) and Cellcept 1500mg / 1500mg (morning / evening). These are very pricey meds, but they keep me alive.
In 2007 when I received my heart transplant, I had decent insurance which was a HUGE help in paying for these very expensive medications. This was a health insurance policy, with partial pharmacy coverage. I maintained this insurance over the past 3 years and this year the policy costs forced me to switch to a new policy. Even though I used due diligence when switching to the new policy, there are always unknowns …… did I miss to fine print clause ….. the insurance is attached to a new pharmacy, how much will the out-of-pocket actually be? Will they deliver on-time? And about 20 other nagging questions in the back of my mind.
As I looked back to my transplant, which was in the middle of May in 2007 for the 7.5 months after my transplant, my out-of-pocket cost was almost $6,000. Reductions in medications, as well as switching to generics in 2008, as well as using the pharmacy’s 90 day plan greatly reduced my annual cost to about $1,200. Further reductions in 2009 = $800 out-of-pocket, 2010 came in at an even lower $550. Actually this is pretty inexpensive for any heart transplant recipient, thus the trepidation in making any changes.
As I switched plans this month, not everything has gone smoothly. There have been some insurance issues that required more than a few phone calls, a few of which were heated, and a few well written, to the point emails. (I believe the insurance companies don’t think anyone actually reads the fine print, bad assumption) regardless, everything has been worked out and if nothing major changes for me this year, my projected annual out-of-pocket cost for all of my medication should be around $275. Simply incredible!!
As happy as I am with these numbers, I also want to be clear that the true cost of these medications are, in my case, $19.550 per year. I am concerned for my fellow transplant recipients that aren’t blessed with decent insurance. I keep these people in my thoughts and prayers.