Thursday, August 15, 2013

The Price of Capitalized Medicine: Eli Lilly's Price Gouging of Cymbalta Patients

I have a lot of friends who are against Obamacare and who have issues with socialized medicine. These same people are proud that America's healthcare system is based on capitalism. Let me tell you a brief story about healthcare when it's a money-making empire. 

Two years ago, my doctor switched me to Cymbalta as a migraine preventative. And it worked really well. Really well. For over a year, we paid (after insurance) $52 a month for that prescription. 

It isn't my most expensive migraine medicine but, when you are a chronic pain patient (I take over seven medicines, three on a daily basis), you want to save money wherever you can on the oodles of medication needed to live a normal life. So, Mark and I were really looking forward to June 2013 when Cymbalta was to become generic. We hadn't been this excited since Botox was approved for migraine treatment by the FDA (that saved us $350 a month).

Only... Cymbalta didn't become generic in June. The manufacturer, Eli Lilly, sued the FDA for a six month extension. And won. There was a price change, though. Cymbalta cost more. It was now $60 a month. Mark thought that was a little odd, but he shrugged it off and paid for my most needed medication. The next month, the exact same prescription was $72. 

Okaaay... Mark asked my pain specialist, Dr. Robert Hansen, if he was writing the prescription differently; nope. No change. Hmm. So Mark asked our pharmacy if there was some new surcharge we were paying. Once again, we received a negative answer. In fact, the pharmacy said it had never levied a surcharge. 

Three days ago, Mark refilled my Cymbalta for the 8th time this year. It was now $90. Mark called the insurance company for answers. HOW could the price of my medication almost double in three months? 

Long story short, Eli Lilly is saying the cost increase reflects how difficult it is to make Cymbalta. I'm not sure how something becomes MORE difficult to make every 30 days. You'd think that, overtime, the process would become streamlined rather than problematic. 

I do know that the company has already successfully sued the government to keep Cymbalta from going generic (for no reason other than to keep money in their coffers)... and I can add two and two well enough to see that my September refill will probably go up another ten or 20 dollars.

Why? Because the company sees the end of the road, money-wise... and they want as much as they can get between their grubby little fingers. As optimistic as I usually am... I am in agreement with Mark that the company will probably sue the government, again, to avoid losing money to a generic form of its medicine. And I agree that it will continue price gouging the users of this medication. 

And it sickens me... literally. Because I cannot afford all my other medications AND my Cymbalta if this price trend continues. The manufacturer REALLY has me between the proverbial rock and a hard place because of how WELL it works in preventing my migraines. So, we will continue to pay the higher amounts for awhile. A short while. Until the price is no longer affordable. Which means I will become sick. Quite sick. Again. We can look for other medications that are similar, but I will first have to come down off the Cymbalta and then build up to the necessary levels of the new medicine. And I will suffer the 'are the side effects worth it' dance a few times until we find a medicine that keeps at least half the migraines at bay without costing me the loss of feeling in my extremities or constant shaking or insomnia or high blood pressure, etc. 

So, for about one-and-a-half to two months (best case scenario)... I will be in serious pain on a semi-daily basis. I have shots that work EXTREMELY well fighting migraines, but my insurance only covers 12 of those a year (and I've already used half of those this year). How quickly do you think I'd go through six shots if I had no major daily preventative? Yes, I also have Botox/Myobloc shots... but those keep the level of pain from a migraine from exacerbating. They do NOT prevent my migraines. 

And folks... we have decent insurance. What happens to those folks who have poor insurance or no insurance? Do you think Eli Lilly gives a damn? I don't. So please... don't tell me how horrible socialized medication would be... unless you want to pay the plus $1000 a month after insurance (and rising) for me it costs to be able to live, love, and laugh (never mind work) and function as a normal human being. 

A person's access to medication and healthcare should NOT be determined by wealth. Ever.