And they call this coverage

$8.80 a puff

Boys and girls, the price you see on the package of Advair (thirty day supply) is my frigging copay. Well, it would be if I’d actually taken that little inhaler home with me.

Yep. I’ve got health insurance again, as mandated by the laws of my country. Coverage that is designed for people like me who are lower income. Coverage that barely covers anything.

First, there is the fact that I had to get this insurance two months before the end of the next enrollment period. I had already met my deductible with my last policy but now I’m back to ground zero and unlike my previous policy, this one aims to meet said deductible in one fell swoop.

And….I can’t. I simply do not have the money to pay $528.11 for an inhaler that will last me thirty days.

I’d been hoping against hope that my health would hold until the end of this calendar year so that I could avoid the necessity of maxing out my deductible. Not. I just had scans and a month from today I am scheduled for a needle biopsy, a surgical procedure. Historically, every single needle biopsy I have had has resulted in a partial pneumothorax or collapsed lung. And that means an overnight in the big house; aka the hospital.

So I guess there is no avoiding hitting that deductible in every category. And then it will be January and I’ll start all over again. Hopefully the tires on my car will hold, because income taxes come due in April.

I’ve said this before but in case you did not hear me, I will say it again. It is not tenable.

This is health care in America when you are caught between poverty and prosperity. My income qualifies me as lower middle class and yet, with a chronic illness, far too much of that income goes toward medical costs.

The stress is unrelenting. And, unlike veterans of other wars, there is no agency to make certain that in recognition of my service as a clinical trial participant my medical needs are met.

It’s crazy. All of it. Lousy health insurance. $528.11 copays. And the fact that Pfizer is now poised to make beaucoup bucks off of the experimental therapeutic that I, one of the first trial participants to ever take lorlatinib, (three people in each cohort–does escalation phase–I was in the third) helped bring to fruition. And here I am, unable to pay for an inhaler.

Really kinda blows, doesn’t it.

38 responses to “And they call this coverage

  1. Hi Linnea,
    What is your home address?
    Linda

  2. There are also some discount programs (GoodRx) that have it for $396.00 which is some savings.  There may be others that have better discounts.    

  3. Cynthia Garrison

    Do you have MassHealth or a plan through the exchange? MassHealth is also for low income folks, but the coverage is much better. I’m sure you’ve checked it out as you have been unrelenting in securing health insurance coverage.

  4. Advair inhaler has a patient assistance program. I get them all the time for patients go to the website and fill out the application

    Sent from my iPhone

    >

  5. Northdrugstore.com a Canadian drug store, has advair $158 for 180 doses. I have use them for years to get my migraine meds and ordered my brothers HIV meds from them, since he had no insurance. The meds are name brands or generic.

  6. I wouldn’t be able to pay either. It’s sad. Have you tried calling GSK Financial Assistance. They may be able to help. https://www.gskforyou.com/uninsured-patient-assistance/prescription-medicines/

  7. Linnea, I just called in prescription for Adair HFA 230-21MCG INHALER
    from my pharmacy. I actually take a different one, and have plenty of what I need. I’m picking it up at 1:00 and will mail to you today. Please email me or text me your address one more time. I know you gave it to me before, but I lost it. My cell is 818-370-6306 if you want to text it to me. I live in CA. and have “Obama Care”

    Thank you,
    Linda

  8. That is just.not.right!

  9. Looks like you have one inhaler winging it’s way to you. Let me know as soon as you are close to needing another and I’ll have it in the mail. This is ridiculous!

  10. Linnea, I am horrified and yet not surprised. As you said we live this nightmare every day. Have you checked a site called Global Pharmacy? They are based in Canada, and ship drugs to the US for quarter of the price. A friend of mine with HIV gets his meds for $250 a month instead of 2500. Not sure if there are any meds where it might help you but thought I’d let you know

  11. Linnea

    Here is the link. It looks like the prices are between $65 and $85
    https://www.globalpharmacyplus.com/advair-diskus-fluticasone-salmetero

  12. I love your friends! If I took Advair I would give you mine or share.

  13. Hi Linnea, I am so glad that someone had a refill of Advair they could send to you. I ran to my closet to see if I had one, but it expired a year ago. Nothing a quick visit to the doc wouldn’t fix though. I am Steve Wright’s sister-in-law. I have Stage IV Adenocarcinoma, Exon 20. Please feel free to text him if it is ever a need.

  14. Buggenhoudt Viviane

    Dear,
    I am following your blog several years now, since my husband was diagnosed with lung cancer in 2009. We are from Belgium, so please forgive me my poor English. My husband was also in the same trial for ALK since 2012.
    All the time he was in the trial, all medical costs, scans and so on were paid by the hospital.
    I find it unhuman, that you have to encaunter these financial problems, that you have to pay so much for médecine you helped to test with your own life.
    I wish you all the best, and hope you will find the strength to go on on the positive way I am used to read from you.
    I hope to read your blog for many more years from now.
    Viviane Buggenhoudt

    • Thank you Vivianne. I am not unaware that there are advantages to healthcare in the US—for instance, we often have drugs available to us sooner than in other countries. But the costs are astronomical. Years ago, when I was nineteen, I sprained my ankle while traveling with backpack through Europe (alone). I was in Germany at this juncture and someone insisted I go to a clinic. I did, but had left most of my money back at the Hostel and was unable to pay. When I returned the next day, they looked at me like I was crazy (they clearly didn’t expect me to come back) and sent me away without charging me. So very different then health care in America where often you must pay upfront—one of my sons knocked his front tooth out and the emergency dentist wouldn’t even look at him until I’d written a check for $800. Medicine should be driven by compassion, not capitalism.

      xo Linnea

  15. If you started a Go Fund Me many of us would contribute. I’m retired and was never good at saving money so I’m not well off but I could certainly contribute something and would do so gladly.

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