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by zevets 367 days ago
My actual co-pay is $10/mo for the good stuff, plus warfarin (eliquiis/xeralto were too weak for me :/) which is ~$12 for a 90 day supply from the mail order PBM pharmacy. I average about $1500/yr in out-of-pocket medical expenses. My company self insures, and has an extremely generous insurance plan.

Plan B is wait until 2028, when it goes off patent. I think I can keep my job til then. I've learned from the HR folks that they just signed another 3 yr contract with the insurance company, so I'm not forseeing any major changes to coverage. This drug is super pricey, as it was originally targeted towards people with acute cancers, but now the largest market is the chronic disease patients, but they never lowered the price.

I suspect the insurer/PBM are making a small fortune off of my care. They are also being sued by the pharmaceutical industry for using a "co-pay maximizer" which caps (patients) out-of-pocket co-pays, and goes after the pharmaceutical companies' "charities" which help patients purchase their products, which the insurer then takes a cut from.

And the weight gain isn't fluid, it's definitely body fat. I think the weight gain is from the "baseline" treatment being a mutagenic chemotherapy, and the likely fact that my (previously) enlarged spleen was impinging on my stomach limiting my appetite, and the lived fact that it massively slows your metabolism, as I'm always a bit cold.