The Cost of Being Well

I’m still debating the eye thing.

There was so much coming at me so quickly that I focused on just one bit of info. What size needle gauge? (30) What immediate effect will it have on my vision? (“Some patients report seeing bubbly for few minutes.”)

I said I had to coordinate with someone to drive me, at least for the first one. It’s not the distance I said, it’s the traffic. You need more than two good eyes some days.

But what I really should have asked is:

What is the med?
What are its side effects?
What is the cost?
How much will insurance cover?
And: Is it experimental?

That’s why it’s recommended that you take someone with you when you go to the doctor. I’m everyone’s patient advocate for my family, but who is mine? I have the luxury of working at home. I work at will, when I have the will. The rest of my family doesn’t, they have to show up at the office every day. And anyway, it would be like the blind leading the blind.

Of course there is such a thing as moral support and I know I won’t have to go alone if I don’t want to. But in the end, all I could think of during my time with the doctor was: A needle in my eye? Are you sh*****g me?

All this got me to thinking of drugs and medicine in general. Things are changing a bit. Insurances now have to specify how much goes toward your care and how much to running their company. But what about the pharmaceuticals? Who’s yanking at those reins?

AARP Bulletin (Jan/Feb 2015) has a good article on specialty drugs. The first on the list is Humira. According to their chart, it had 5.4 billion in sales for 2013. Billions. I can’t even comprehend one million, let alone a billion.

When I was on it back in ’06 and ’07, the pharmacy said it cost $1,500 for two shots. My prescription was for an injection every two weeks. So every month I doled out a co-pay of $250. I have no idea what it costs now, but something tells me it’s not less.

A while back my ophthalmologist put me on Restasis to treat dry eyes. When I went to pick it up at the pharmacy, I almost lost my cookies. My co-pay was forty bucks, but the actual cost of the prescription for one month’s worth was $367. You’d think the sting you feel when you use the drops would be insult enough.

I won’t even spend that much on a quality leather purse, maybe at a nice resort hotel for a couple of nights, but geez, louise, how can anybody afford to be sick?

Sick on a chronic basis. Or even, sick on an acute basis. A few weeks ago, I got the insurance statement for my five-day hospital stay in November. If the numbers are true, I could have bought a very nice car with that amount.


6 thoughts on “The Cost of Being Well

  1. phat50chick

    Irma, the one constant med for me has been 100 mg of Celebrex everyday for 14 years. My provider sent 3 months of meds at a time for a $125 copay. I just got my new shipment that I ordered 1/7/15. Celebrex now has a generic form. Which is what they sent me. Great, I thought. But they still charged me $125.

    I haven’t called blue cross yet, but they’re on my list. How dare they sell me generic at same cost as non generic.

    1. Irma Post author

      Wow, i can’t get past Celebrex for 14 years. That’s a long time, but I’m glad it helps you, if not your pocketbook. But, they should definitely not charge you the same for generic as they do for brand. Hope they fixed it for you!

  2. Carla Kienast

    Irma: First of all, again, I’m sorry you’re having to deal with this. A needle in your eye? I know, ick, right? I take eight different medications and it frightens the dickens out of me when I look up the “cash” price on the receipt. My Remicade infusions were more than $16K each, and you start out with a loading dose of three in the first four weeks. (That’s $48K.) The number of people, particularly those elderly and on fixed income, who routinely don’t take their medications because they can’t afford it is about 25%. That’s one quarter of the people who need the medicine, who have been prescribed the medicine, who can’t get the medicine because it’s a choice between food or drugs. It’s insane. If you get the opportunity, pick up this week’s Time magazine with the cover story of “What I learned from my $190,000 open heart surgery.” It’s a discussion of how to fix health insurance. Hang in there.

    1. Irma Post author

      Hi, Carla. It’s a sad fact that many people had to choose between food and medicine. I hope that with these changes put in place that percentage has gone down. I am very lucky to be able to afford what has been prescribed for me so far, excluding the eye thing, don’t know the specifics on that yet, money-wise. I think I remember a show called; “That’s Incredible.” If there wasn’t one called that, they should start one about all the medical stories and their related expenses, because it is very incredible.

  3. J.G. Chayko

    Our medical system is different over here, but we still fight with our insurance companies and deductibles with the government. We have reams of paperwork to fill out to have arthritis drugs covered and it’s worse than pulling teeth to have individual insurance companies reimburse our costs. It’s a very frustrating process, so I feel the pain in your wallet. I hope your eye procedure, if and when it happens, goes smoothly. Stay well and here’s to focusing on the good stuff in life.

    1. Irma Post author

      I wondered how things worked up there. Guess not much different, sigh. But in the end it’s worth the trials and tribulations to stay well, or as well as we can be. The thing is that when you’re sick, you’re not up to dealing with all the bureaucracy. It’s almost a catch-22. Hope you’re feeling well, and yes we must focus on the positive.


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