When Doctor's Charge For Patient Assistance Medications Forms

This month I had to leave two of my prescriptions at the pharmacy because I didn't have the money to pay the co-pay. Next month my COBRA is running out and I cannot fathom what I will do without it on July 31.

Many of my doctors have been more than generous with me giving me samples to help me off set the prices of my drugs. One of my doctors even helped me fill out a "Patient Assistance Program" Application and faxed it in for one of my injection drugs that costs over $3k but even with my co-pay costs $1k each month. With the Assistance program I received the drug from the drug company.

I take between 14 and 20 medications on any given day. Because I had a flare I'm taking medication for thrush right now. It wasn't expensive but I couldn't afford the mouth rinse and had to take an oral medication. Meanwhile, I am already having difficult keeping many of my medications down. I vomit them with regularity. Then my specialist will ask if I want omeprazole to help. More pills. (More expense. For what? Side effects of side effects?)

Anyway- I often leave prescriptions at the pharmacy or I snap my thyroid medication in half for a week or every other day (to make the samples last longer).

A year and a half ago my credit cards were at zero balance (my car is also paid off). I don't like debt. Then I had to use them for medical emergencies. This meant co-pays to doctors and medications. Slowly they crept up but the balance on them was still not very high. But higher than I could pay off because I am on so many medications.

I have never missed a payment to them AND I was late ONLY ONCE and it was when I was in the hospital. I payed them the moment I was out and explained it. They removed the late fee. Over time they raised the APR to OVER 30% on both cards. Each month I have been unable to pay the balance down because of this high APR. I called them several times explaining that I will never pay off the card with this high APR and that making the payments was getting difficult. No one worked with me. They have cost society so much money and gotten bailed out and then they charge ME that much when I have NEVER missed a payment and in integrity have asked for a lower APR?

Last week I made the decision that leaving MY DRUGS at the pharmacy but paying people who were charging me 30% was not wise. So I paid each of my doctors $10 on the balance I owe for past amounts, then I bought my medications, and I didn't pay my credit cards (that have ONLY been used for medications or co-pays). And it freed up enough money for more medications.

And I had $3 dollars left over this month.

I don't take medications like antidepressants BECAUSE THEY COST SO MUCH. It is one less co-pay. I don't take pain meds and muscle relaxants BECAUSE it is a copay. I suck it up.

But I don't have that choice with my anti-seizure medications. And I am on two of them. Brand. I tried to take a non-brand and I had seizures. My insurance covers brand anti-seizures at half for one and not at all for the other. And THOSE are the ones that work for me.

Yesterday I sat down with a list of everything I am taking and checked the co-pays. Then I found out the annual prices I am paying. (Some are about $2500 or more per year- a few are only $40 copays- but they all ad up).

I printed out Patient Assistance Program applications for every major drug I am on or take with regularity (more than 14 days per month). I then put them in a pile for each doctor and specialist to make an appointment for them. They all need my tax returns and signatures and forms filled out.

Then I realized that a few of my doctors require me to pay $200 per PAGE for any form. This puts me in a bind. I don't have the money to buy my drugs now. A few of these doctors who do charge require the money up front. You have to give them money to sign these forms.

I called the Patient Assistance Program and said, "If I am on INSERT YOUR DRUG HERE and my specialist charges $200 per page and you make them fill out 7 pages, I cannot afford to APPLY for the PAP. Because you will often deny it the first time and then I have to appeal. Then it is MORE paperwork. I might as well pay the $1000 co-pay from my insurance every month. It is less than I'm paying my doctor up front even though over time it is cheaper. BUT I DON'T HAVE THAT MUCH RIGHT NOW."

The woman on the phone said, "I didn't realize doctors do that." I said, "Many of mine do. They are charging for their time. They cannot get reimbursed from insurance for filling out paperwork so they charge their patients to value their time. Maybe your company can rectify this by making the forms shorter and less expensive or just do what we all know you do and pay the doctors to sell your drug for you."

I was angry. But I was also being realistic.

I also am at my very last rope. I have exactly one month and 13 days to even make appointments that are covered with COBRA. I need to make this happen. It is my job to stay alive.

I pay for my COBRA. When it runs out I will pay out of pocket for many of my medications. And though I do not qualify for many of the low income programs and assistance, after taxes and my medical write-off's, last year I netted $600. But that was AFTER my documented expenses. Most programs check your income BEFORE. Many people cannot believe how much I spend on my medications and healthcare each month. But yes - I do. Doctors, and medications, and sundry expenses ad up. And many of these PAP's want to know what you spend on your medications each year. So I will have to submit each year. That means I will have to pay my doctors each year for the same paperwork.

Doctors who have patients on medications that cost more than a mortgage payment should let their patients fill out the forms rather than charge us for the forms AND watch us try to scramble to pay for the meds.

After all, I already tapped out my 401k paying for the first few months of treatment. It isn't like I haven't invested in myself.

There has to be a middle ground. I value my doctors time but I value my life too. If they want me to take a medication and it is working we need to find a way to keep me on it. Doctors charging for forms is happening BECAUSE of the need to be compensated (and insurance won't). I'm recognizing it. I'm also not sure of the answer other than maybe the medications and drugs could be priced more fairly?

Patients like me don't get $5 co-pays. And even in the generic form the drugs I take aren't cheap. (And some aren't generic yet).

If there is an answer I don't know it. If there is a middle ground I haven't found it. But much of it is insurance compensation, the pharmaceutical over pricing, and every man in it for themselves.

I never asked to be chronically ill. It isn't a personality fault. But if society has paid the price for me, I want you to know, I have paid my share too. I have paid and paid and paid - everything I have, everything I have worked for, and everything I consider goes into how to pay for my healthcare and my medications.