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My husband and I finally contracted COVID a few weeks back. We had both avoided it for more than five years, so I honestly didn’t even think of COVID when I noticed a tickle in the back of my throat at the worst possible time: during a celebration of his parents’ 72nd wedding anniversary.
First things first: My in-laws, both in their mid-90s, have still dodged COVID completely. Hallelujah!
Rob and I decided to use all the available weapons, so we asked for prescriptions for Paxlovid, the gigantic antiviral tablets that are the current gold standard for at-home drug therapy. This is where the insanity started.
I got a text from the Kroger pharmacy notifying me that my prescription would cost $436.16 and asking me to confirm that I wanted it filled. I was surprised by the price, but I haven’t met my deductible for the year, so I figured I had to pay the full freight. I have plenty of money in a health savings account, but I hesitated to confirm. HSA money is real money. Was the benefit likely to be worth the cost?
Then my husband, who has a different insurance carrier through his employer, got a text from the same pharmacy saying that his co-payment would be $1,000 — even though he has met his deductible for the year. He wisely called the pharmacy to talk through this expensive decision, and an incredibly helpful pharmacy tech told him about a program called Paxcess that might help with the co-payments.
I went to the Paxcess website and within minutes we were approved to have the co-payments waived entirely. I just had to enter our names and birth dates and confirm that we have private health insurance rather than a government plan like Medicare or Tricare. And that was that. From more than $1,400 to $0 with a few keystrokes. This is offered by Pfizer, the maker of Paxlovid, and I am truly grateful.
But I’m also baffled. Why were our co-payments ever going to be so big if, after all, Pfizer didn’t need for us to pay anything? And how many people who are much less able to afford $400 or $1,000 scraping up the money or, more likely, doing without drug therapy because they didn’t happen to talk with a very helpful pharmacy employee in time to avoid an unnecessary expense?
It’s been four years since it was my job to fill this space weekly, and the insanity of health care pricing was one of my frequent topics. Things aren’t getting better.
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