This is a personal story that I'm taking public because things have got to change. What is happening in our medical system is so wrong, and it's time for people to wake up and take action against pharmacetical and insurance companies. My action steps will be to use the power of social media to educate others and make people aware of the atrocities that could happen to you if anyone in your family has a serious medical issue.
Here is my bottom line: Anyone considering taking Latuda as a medication should think twice because going on this medication will probably bankrupt them or their families. I'm sure you've all seen multiple ads for this drug on TV and if you have a family member with a serious mental illness, maybe you've counted on this as your miracle drug.
Last spring, my teenage daughter experience a meltdown of some sort that we are still struggling to work through. She became overwhelmed with school and life, most likely due to learning related issues... she has been depressed and has executive functioning issues which includes slower processing speeds and working memory. In addition to this, her body has rapidly changed in the last year or so due to adolesence. She has grown at least 3 inches. A lot is going on with her, and while she has not been diagnosed with bipolar depression or another serious mental illness, she has benefitted from taking a fairly high dose of Latuda each day. We originally had her on another drug that caused her to gain weight; her doctor then prescribed Latuda. He did not indicate that we might have issues with insurance covering this medication at that time.We hope that she can be weaned off this drug eventually if things continue to progress, but now is not the the ideal time. I'm happy to report that things are going better for her in general because we have a great support team in place in and outside of school. She is a great kid, and will come out of adolescence a better person. I will do anything to get her the help she needs.
As of January 1, 2015, we switched to a new insurance plan through my husband's work that we thought would help us save money. My husband made sure that all of our daughter's medications were covered under the new insurance plan (same company, new plan). I went to refill this a few days ago, only to find out that that we need to pay $2000 for a month's supply of Latuda. Until we pay $3600 out of pocket for medications, this medication is not covered. It's one thing if you're paying $3600 over the course of year's worth of medication for a family of four; it's another when you have to shell out the equivalent of your mortgage for ONE MONTH of medication.
Yesterday, Blue Cross told my husband that the medication is priced this way because it is a new medication. It can't be that new; my daughter started taking it late last spring or in the early summer.
My husband called Blue Cross today, and they have no record of his conversation with them in November when they said Julia's medication would be covered at a reasonable cost. My husband also has checked the company web site of Sunovion, manufacturers of Latuda, and they do have a program for reducing costs, but only if the patient is over 18 years of age. Our daughter is 16.
We now have a call into our doctor's office, and hopefully, he will have a solution. If not, I am not sure what recourse we have. I guess it will be a choice between medicating my kid and sending my kids to summer camp, something that is so beneficial to their personal growth. Maybe another option is that I stop consulting work and get a job with insurance benefits that are better than my husband's. That will take me away from my daughter even more. I honestly don't know where to go with this one for help. Perhaps we should consult with a laywer about legal possibilities.
I've been reluctant to talk about my daughter's issues because she deserves privacy, but it is absolutely outrageous what insurance companies and drug companies are trying to do and I will call them on the carpet. At the very least, perhaps our story will educate another family.