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Congress can’t let drug firms price-gouge

You can never anticipate a health crisis that will change your whole life. I know I didn’t. But when I turned 40, the onset of Multiple Sclerosis (MS) left me unable to work and eventually homeless. Fourteen years later, I’m still trying to rebuild my life. But the high costs of health care and prescription drugs threaten my livelihood as much as my health conditions do.

Back in 2009, I began experiencing symptoms doctors had yet to pinpoint the exact cause of. After tests with neurologists, cardiologists, endocrinologists, and more, I felt like a guinea pig. Even though I had great health insurance through my employer, the doctor bills and prescription drugs costs were unbelievable. As my condition worsened, I became too sick to work. With no income, the medical bills quickly piled up.

Kathy Saulsberry

Five years later, I officially received an MS diagnosis, and I began properly managing my condition. With a diagnosis, I qualified for partial Social Security disability and Medicare to cover some of my health care costs. While MS can’t be cured, I got well enough to work at least part-time and began putting my life and finances back on track.

That sense of mind evaporated, however, when I contracted Covid early in 2020. The infection exacerbated my MS symptoms and likely caused a new Type 2 diabetes diagnosis. MS lesions on my neck worsened. Leg cramps made it impossible to walk and my respiration problems sent me to the doctor six times over a couple of months. After missing so much work due to my health problems and with medical costs soaring, I found myself slipping back into financial insecurity.

Between my MS, breathing problems, and diabetes, my medications cost me around $200 a month. My co-pays were already difficult to cover. But when I fell into the Medicare “donut hole,” my co-pays were impossible to afford. The cost for a one-month supply of my diabetes prescription, Tradjenta, increased $129 for three months to a staggering $249. When I went to the pharmacy to fill my prescription, I was shocked. I couldn’t afford it, so I left without my medication and without any idea of what I would do.

My reality is now shared by millions of Americans who, by just contracting Covid, now have health conditions that will require a lifetime of doctor visits, procedures, and prescription medications. In a country where one in four already report difficulty affording their prescription drugs, Covid survivors like me face an expensive and potentially dangerous future.

In fear of going without diabetes medication, my doctor gave me samples to get by. I also asked my doctor to change my prescription to something I could afford. I was doing so well on the previous medication, and she didn’t want to change my medication to something that would be less effective. But she understood my financial situation and gave me a new prescription for a cheaper generic.

My health care and quality of medication should be determined by my doctor – not the drug manufacturers.

Senator Mark Kelly recently hosted a congressional hearing with Arizonans who have similar stories to mine. I hope that with his leadership and President Biden’s plan to cut health care prescription drug costs, we won’t have to live in a system that puts pharmaceutical profits over the health of patients like me.

President Biden’s plan would allow Medicare to negotiate prices with pharmaceutical companies and cap out-of-pocket prescription spending at $2,000 annually. This would save seniors and Americans with disabilities thousands. For the drug I was priced out of, Tradjenta, I could save around $50 a month. On a fixed budget, those extra dollars are vital.

Looking back on my life, it’s hard to believe I’d experience a period of homelessness and later live paycheck to paycheck due to medical conditions out of my control. But the reality in America is that we are all one diagnosis away from financial ruin. The Covid pandemic has both revealed and worsened the cracks in our nation’s health care system. I urge Congress to support Biden’s health care plan and lower health care costs for Americans like me.

Kathy Saulsberry lives in Phoenix with her daughter and grandchild.

 

One comment

  1. I understand your plight. But if Medicare negotiates prices, we will have fewer drugs available at affordable prices & less research. The drug companies aren’t price-gouging. Years of research & development go into making a drug & then years of tests. That’s the main reason it takes a few years for a generic to come on the market. Pharmaceutical companies need to recoup at least some of their investment.

    Medicare does not negotiate with drug companies directly. But the prescription plans they contract with for Part D, do. Generic drugs have a low cost once you meet the deductible, but name-brand non-generic drugs are either not covered or cost a great deal & we all have to choose to forgo a particular medication or find another way to help with costs.

    Many drug companies offer a prescription assistance program (PAP) for people who lack insurance. NeedyMeds.org can direct you to a program with assistance with insulin & other drugs.

    Everyone looks to the government to solve problems, but in the end, they do more harm than good. You’re looking at an entrenched bureaucracy with very little efficiency & accountability. Plus they make decisions without a long-term view. It ends up hurting all of us in the end.

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