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Through the "Donut Hole"

So Edie's free lights are continuing their upward trend, and her doctor has recommended adding Vorinostat (Zolinza) to the mix (4 - 100 mg tablets per day for two weeks, then off a week). A recently completed clinical trial has shown it to be efficacious when combined with Velcade, and since the Velcade alone hasn't been doing the trick, this seemed like the logical alternative.

The only problem with Vorinostat is it's given in pill form. That means it comes under the Medicare Part D Prescription drug plan, and this drug is not cheap. $4,945 for a 14 day supply. Fortunately we were only on the hook for about $2,300, but it could have been a lot worse.

We would have been on the hook for the entire amount, if it weren't for the Affordable Care Act [AKA ObamaCare], which mandated a 50% discount once you enter the donut hole. In addition, thanks to the Affordable Care Act (ACA), the amount of the discount provided by the manufacturer is also counted towards the Out-of-Pocket cost, and gets Edie to within $300 of the catastrophic coverage portion of Medicare Part D, where the cost of drugs is reduced dramatically.

Fortunately we're able to afford the $2,000, but I can't help but think about those who don't have an extra $2,000 ($4,000 if it weren't for the ACA) laying around? What do they do? Go without? Yeah, there are programs, but just how poor do you have to be before you qualify?

I never did understand the reasoning behind the "donut hole in the first place? What kind of mind(s) comes up with such a concept? I just hope it's not the same minds that want to destroy the Affordable Care Act, and along with it many of the inequities it tries to correct in an otherwise dysfunctional health care system often working in a manner irrespective of patient needs.

Isn’t it enough having to endure a debilitating or life threatening disease? Do most people in the US really think it’s moral to make those same people also suffer the indignity and humiliation of financial ruin just because they had the misfortune of getting sick?

Wouldn't it be nice if everyone in the US thought of health care as a right, rather than a privilege provided only to those that can afford it?
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Robert said…
I was scheduled to have eight rondus of four injections each. After only four rondus, I was in remission! However, I did develop neuropothy in my feet, experienced vomiting and diarrhea, chills and weakness. It was not easy, but I would do it again, as I have been in remission for six years.GD Star Ratingloading...
11:57 PM
Marc said…
Using Vorinostat?
12:12 AM
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