Tier 4 drugs make prescription prices soar
Case Management Weekly, April 23, 2008
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In an effort to lower premiums, many insurance companies are adopting a new prescription pricing plan for very expensive drugs. The program is referred to as Tier 4 and was initially put into place by Medicare, according to an article in The New York Times.
The drugs affected by this plan are costly ones, usually used to treat serious illnesses such as anemia, cancer, and multiple sclerosis. Instead of paying a flat co-payment, the patient pays a percentage of the total cost of the drug, usually 20-33%, says The Times.
Because of the high cost of these drugs, the new co-pay is often hundreds or thousands of dollars instead of the former typical $10, $20, or $30. This new system transfers more of the burden to the very ill, while attempting to keep costs low for the insured population as a whole.
Source: The New York Times
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