Last year, 576,000 Americans took at least $50,000 worth of prescription drugs, up from 352,000 the year before, according to a report by Express Scripts.
While insurance companies pay 97 percent of the cost, many people with chronic illnesses can’t afford their share — up to $6,600 for plans purchased on the federal health care exchange.
Some researchers have found evidence that insurers offering health plans through the federal marketplace are purposefully passing on higher costs to those with chronic illnesses, to discourage the sickest, and therefore most expensive, people from joining their plans.
Insurance companies say they’re not using adverse tiering to discriminate against the sickest patients but that the real issue is the exorbitant prices of prescription drugs.
The pharmaceutical industry says the high costs are necessary to recoup its investments.
Medicare is big enough to force drug makers to lower their prices, but the government decided not to negotiate for lower drug prices when crafting Obamacare — “the price of pharma’s acquiescence in the Affordable Care Act politically,” says John Rother, president of the National Coalition on Health Care, which advocates for sustainable drug prices.