Medication Co-Pays Are Out of Control: We Need a Cap Now

It’s time we face the harsh reality of rising healthcare costs, particularly when it comes to prescription medications. For many people, paying a $3,000 co-pay for life-saving medicine is not just unreasonable—it’s impossible. Medication is a necessity for millions of individuals who rely on it to manage chronic conditions, recover from illnesses, or maintain their quality of life. But the skyrocketing costs of co-pays are creating an unbearable burden, forcing many to make impossible decisions: do they fill their prescriptions, or do they pay their rent or put food on the table? This simply isn’t fair, and it’s time for a change.

The current system is leaving too many people behind. No average person, especially those with lower or even middle incomes, can afford a $3,000 co-pay for medications that they need to survive. It’s hard to imagine being in a situation where you must choose between taking medicine that could save or maintain your health and covering basic necessities. But this is a reality that far too many Americans are facing today.

The cost of medication should never force someone into bankruptcy or cause them to forgo necessary treatment. Health insurance is supposed to protect people from financial ruin in times of illness, but that protection is fading when people are asked to cover such large co-pays for essential drugs. Whether it’s insulin for diabetes, life-saving cancer treatments, or medications to manage high blood pressure, the high out-of-pocket costs are creating a barrier to proper healthcare.

What we need is a clear, firm cap on medication co-pays. A reasonable co-pay cap—one that reflects what everyday people can actually afford—would ensure that no one has to face a $3,000 bill just to access the medication they need. Setting co-pay limits, such as $100 or less per prescription, could drastically reduce the financial stress that so many families are currently under. This would allow people to get their medications without worrying about draining their savings or going into debt.

A co-pay cap would have a tremendous impact, especially on those managing chronic conditions that require ongoing medication. For instance, people with diabetes often rely on insulin, a medication that has seen dramatic price increases over the years. Even with insurance, many people are forced to pay hundreds or even thousands of dollars out of pocket for this essential medication. Similarly, cancer patients undergoing chemotherapy treatments are often left with overwhelming co-pays for their prescriptions. This is unacceptable, and the system must change to ensure that everyone can afford the medications they need.

Lowering co-pays would not only provide immediate financial relief, but it would also prevent long-term healthcare costs from spiraling out of control. When people can’t afford their medications, they may stop taking them, leading to worsening health conditions and, ultimately, more expensive emergency care or hospital stays. By capping co-pays, we can ensure that people can afford to stay healthy, reducing the need for costly interventions down the line.

In conclusion, the current state of medication co-pays is unsustainable. No one should be asked to pay $3,000 out of pocket for necessary medications, especially when many people don’t even earn that much in a month. A co-pay cap is an essential step in making healthcare more affordable and accessible for all. By capping co-pays at a reasonable level, expanding support programs, and increasing transparency, we can ensure that people are able to afford the medications they need without sacrificing their financial security. It’s time for real reform that puts people’s health and well-being first.

I strongly agree. I have had multiple sclerosis for 30 years. I have taken Copaxone by Teva for that long. When I first started the full price was $900/month. It is currently $7200/month. There is nothing that explains this increase but big pharma greed and corruption.

Teva was sued by the DOJ a few years back for Medicare Fraud and kick back schemes involving Copaxone. I was shocked and had no idea of this corruption at the time. I did some research and learned quickly how bad it is in all the pharma companies. For several years Teva was using The Assistance Fund and Advanced Scripts specialty pharmacy in their scheme. The Assistance Fund is a non profit that takes donations to help patients with co-pays. During this time The Assistance Fund was reporting to Teva how many patients had applied for assistance for an upcoming year. Then Teva would secretly pay them money for each patient and Advanced Express Scripts worked with both to dispense Copaxone. Teva was increasing the cost of this medication exponentially each year. Because these were Medicare patients, it is illegal for a pharmaceutical company to pay the cost of a mediation. They had control over the price, while collecting from Medicare for the cost.

I felt like I had commented a crime when I found this out. The three involved were charged, paid their fines and stopped doing this. I found many cases on the DOJ site of the same happening with other manufacturers.

They all compete for the top spot in the stock market and try to shut each other down. But they also protect each other so they can get away with all of these illegal scams to make more money, as if the cost for patients isn’t already enough!!

This is absolutely evil. The corruption goes very deep. Something needs to be done!