Mankhwala okwera mtengo kwambiri a 2019

Kampani

Anthu aku America amawononga ndalama zambiri pamankhwala akuchipatala kuposa anthu ena onse padziko lapansi. Nzika wamba ku U.S. $ 1,025 pachaka pa mankhwala-ndiko kuwonjezeka kwa mitengo kuwonjezeka ka 11 kuyambira pa 1960, malinga ndi deta kuchokera ku Peterson Center on Healthcare ndi Kaiser Family Foundation.

Ndi chifukwa chakuti mankhwalawa ndi okwera mtengo.

Mankhwala 10 omwe amalengezedwa kwambiri amakhala ndi mitengo kuyambira $ 488 mpaka $ 16,938 pamwezi kapena chithandizo, atero Dipatimenti ya Zaumoyo ndi Ntchito Zantchito . Ndipo kafukufuku wathu akuwonetsa kuti mankhwala ambiri omwe amapatsidwa nthawi zambiri amakhala okwera mtengo kuposa pamenepo.

Mwanjira ina, pali zambiri kwambiri mankhwala okwera mtengo kunja uko. Awa ndi mankhwala okwera mtengo kwambiri, malinga ndi data ya SingleCare. Mitengo yomwe yalembedwa pansipa ikuwonetsa mtengo wamakampani — zomwe kasitomala amayembekezeka kulipira ngati alibe inshuwaransi kapena chindapusa.

Mankhwala osokoneza bongo	Avereji ya mtengo wamwezi umodzi
Wothandizira	$ 33,001.08
Humira	$ 7,037.81
Wolemba	$ 4,944.95
Xeljanz	$ 4,694.13
Forteo	$ 3,639.85
Glatiramer nthochi	$ 3,378.50
Kuthamanga	$ 3,377.89
Kugulitsa	$ 3,356.06
Atripla	$ 3,215.15
Biktarvy	$ 3,214.05

1. Wopereka ndalama

Mtengo wamasiku 28: $ 33,001.08

Afinitor, mankhwala a chemotherapy omwe amagwiritsidwa ntchito pochizira impso, kapamba, m'mawere, ndi khansa yaubongo, ndi imodzi mwamankhwala okwera mtengo kwambiri kunja uko - koma omwe ali ndi mankhwala amafunika kuti akhale nawo kuti akalandire. Nthawi zambiri, kutalika kwa chithandizo ndi Afinitor kumatanthauzidwa ndi matenda azachipatala. Odwala omwe amapezeka ndi Subependymal Giant Cell Astrocytoma adalandira a Kutalika kwapakatikati kwamankhwala wa miyezi 24.4. Kutalika kwapakati kwamankhwala kwa odwala omwe amapezeka ndi Renal Cell Carcinoma ndi masiku 141. Ndiwo mtengo wotsika wa (gulp): $ 166, 184.01 pamlingo wothandizirana.

Pakadali pano, palibe njira yabwinobwino yothandizira mankhwalawa kuti achepetse mtengo. Wopanga generic wataya mlandu wa patent m'makhothi koyambirira kwa 2019, zomwe zikadalola kuti pakhale mtundu wa generic. Odwala olipira ndalama amawoneka pamtengo wa $ 33,000-kuphatikiza mtengo. Koma pali njira zosungira pamapiritsi a Afinitor 5 mg. Malinga ndi Mankhwala ,100% ya mapulani a Medicare Part D ndi Medicare Advantage amaphimba mankhwalawa.

2. Humira

Mtengo wamasiku 28: $ 7,037.81

Humira ndi immunosuppressant yomwe imagwiritsidwa ntchito pochiza nyamakazi, psoriasis, matenda a Crohn, ndi ulcerative colitis. Wakhala mankhwala omwe agulitsidwa kwambiri (omwe ndi opindulitsa kwambiri) mdziko muno kuyambira 2012, ndipo sakusonyeza kuti akuchedwa. Mu 2018, zolemba za Humira zidaposa $ 14 biliyoni, zomwe zidakwera kuposa 60% kuposa chaka chatha - ngakhale mbiri yotsutsana mankhwala a biologic.

KU Phunziro la 2016 lofalitsidwa ndi Zolemba pa American Medical Association zomwe sizinapeze umboni uliwonse wolumikizana pakati pa mitengo yakufufuza ndi chitukuko ndi mitengo; M'malo mwake, mankhwala ochokera ku mankhwala amtengo amakhala ku United States makamaka pamsika wazomwe msika ungakhale. Komabe, mtengo wa Humira ukupitilizabe kukwera.TMtengo wa Humira wakwera kuchokera pafupifupi $ 19,000 pachaka (mu 2012) kufika pa $ 38,000 pachaka (mu 2019), wodwala aliyense, atapatsidwa ndalama-malinga ndi zomwe zidanenedwa ndi New York Times , ochokera ku SSR Health, kampani yofufuza. Uku ndi kuwonjezeka kwa 100%. Komar iwo amene amadalira mankhwalawa, pali uthenga wabwino ukubwera mu 2023: mankhwala osokoneza bongo otchedwa Hyrimoz. Osati kusokonezedwa ndi mankhwala achibadwa, biosimilarsali ofanana kwambiri mankhwala omwe ali pafupi kwambiri pakubwereza kuti akwaniritse zomwezo zochiritsira komanso zamankhwala (pomwe ma geniciki ali ofanana ndimankhwala oyambawo). A FDA avomereza Hyrimoz ndipo ipezeka kuti igulitsidwe ku United States pa Seputembara 30, 2023.

3. Wachibale

Mtengo wamasiku 28: $ 4,944.95

Enbrel ndi mankhwala a biopharmaceutical omwe amagwiritsidwa ntchito pochiza nyamakazi ya nyamakazi, nyamakazi ya psoriatic, ndi zovuta zina. Monga Humira, Enbrel akuwona kukwera kwa malonda ndi mankhwala akudzazidwa, ngakhale atawononga chikwama.Enbrel-yomwe idafika pamsika waku US ku 1998-idalemba $ 4.8 biliyoni pakugulitsa ku US ku 2018, malinga ndi wopanga Amgen , Inc.

Pakadali pano, wopanga mankhwalawa amagula mtengo wapachaka wa Enbrel's 50-mg dose yoposa $ 67,000.Ndipo palibenso zowonjezera zomwe zingathandize kuchepetsa ndalama kwa odwala.Ma biosimilars awiri a Enbrel adavomerezedwa ndi a FDA ndipo sanayambitsidwebe - kuphatikiza m'modzi kuchokera kwa omwe amapanga mankhwala osokoneza bongo aku SwitzerlandNovartis AGkuti ofesi yazaumoyo idavomereza mu 2016,Malinga ndi Wall Street Journal mtolankhani wa zaumoyo Jared S. Hopkins . Zovomerezeka zoposa 40 zimateteza Enbrel, ndipo omwe amapanga, Amgen Inc., adapambana chigamulo cha khothi mu Ogasiti chokhudzana ndi ma Enbrel.

4. Xeljanz

Mtengo wamasiku 30: $ 4,694.13

Xeljanz ndi biopharmaceutical yotchuka yomwe imaperekedwa kuti ichiritse nyamakazi, nyamakazi ya psoriatic, ndi ulcerative colitis. Koma posachedwa, mankhwalawa adakhala mitu yankhani chifukwa cha FDA yatsopano chenjezo lakuda kutiJAK inhibitor's 10-mg kawiri kawiri tsiku lililonse, yomwe idapangidwa kuti ichepetse kupweteka kwamagulu ndi kutupa,ukuwonjezekachiopsezo cha magazi kuundana-ndipo mwinanso, imfa.

Tchilolezo cha mankhwala omwe amachiza ulcerative colitis sichinavomerezedwe - tsopano chimangovomerezedwa kwa odwala omwe samayankha kapena osayenera mankhwala ena.Koma ngakhale pali machenjezo onse okhudzana ndi kuchuluka kwa 10-mg, 5-mg imawonekerabe kuti ndiyotetezeka, ndikuwonanso kuwonjezeka kwa malonda ndi ntchito.

5. Forteo

Mtengo wamasiku 28: $ 3,639.85

Forteo ndi mankhwala ojambulidwa omwe amathandiza kulimbitsa mafupa kwa anthu omwe ali ndi matenda ofooka mafupa omwe ali pachiwopsezo chachikulu chophwanyika-makamaka omwe ali ndi matenda otupa mafupa akamamwa ma steroids monga prednisone. Ndi mtundu wopanga mahomoni mwachilengedwe omwe amapezeka mthupi omwe amalimbikitsa kukula kwa mafupa atsopano ndikuwonjezera kuchuluka kwa mafupa. Majekeseni nthawi zambiri amatengedwa ntchafu kapena m'mimba. Zimavomerezedwa kwa miyezi 24 yogwiritsira ntchito.

Pakadali pano palibe generic yomwe ikupezeka. Koma, Pfenix adapambana chilolezo cha patent chimodzimodzi mankhwala , zomwe zitha kuyendetsa mtengo pansi zikafika pakupanga. Pali kale mankhwala awiri ofanana ku Europe, koma adatsekedwa ku United States. Ngati mukufuna Forteo, pali fayilo ya kuchotsera kwa wopanga kupezeka kwa odwala oyenerera.

6. Glatiramer Acetate jekeseni

Mtengo wamasiku 30: $ 3,378.50

Jekeseni wa Glatiramer acetate ndiye mtundu wa Copaxone , mankhwala ojambulidwa omwe amagwiritsidwa ntchito pochiza multiple sclerosis komanso kupewa MS kuyambiranso. Ngakhale monga generic, mtengo wake ndiwokwera kwambiri - osati wotsika kwambiri kuposa mnzake wotsatsa dzina.

M'zaka 20 zapitazi, pakhala kupita patsogolo kwakukulu mu chithandizo cha MS, koma kuwonjezeka kwa njira zamankhwala zomwe zapezeka sikunachititse kuti mitengo ichepetse. Zakhala zikukula. Kuchokera mu 2013 mpaka 2018, mtengo wapakatikati wamatenda osintha mankhwala monga glatiramer acetate adakwera kuchoka pa $ 60,000 mpaka $ 80,000 malinga ndi Nyuzipepala ya National Multiple Sclerosis . Ngati mukuvutika kupereka mankhwala anu, Mylan imapereka ndalama kwa anthu ena.

7. jekeseni wa Norditropin

Mtengo wamasiku 30: $ 3,377.89

Norditropin ndimankhwala opangira kukula omwe amatsanzira mahomoni amtundu wa pituitary omwe amalimbikitsa kukula m'thupi: kutalika, ziwalo, mafupa, ndi minofu. Pogwiritsidwa ntchito kwa ana omwe samapanga mahomoni okula mokwanira, amatha kuwathandiza kukhala aatali. Kwa akulu, zimatha kulimbikitsa kukula kwa minofu. Pogwiritsidwa ntchito kwa odwala opanda chosowa, sizothandiza.

Amawonedwa ngati mankhwala apadera, monga omwe amagwiritsidwa ntchito pochiza matenda monga khansa, HIV, kapena nyamakazi. Mitundu yamankhwala iyi ndi yokwera mtengo kwambiri, ndipo norditropin ndizosiyana. Novo Nordisk ali ndi pulogalamu yothandizira odwala m'malo othandizira maubwino a inshuwaransi komanso kugula mankhwala.

8. Kugawirana

Mtengo wamasiku 30: $ 3,356.06

Stribild ndi malo omwera mankhwala anayi piritsi limodzi lomwe limagwiritsidwa ntchito pochizira HIV ndikuchepetsa chiopsezo chotengera ena vutoli. Lili ndi mankhwala atatu ochepetsa mphamvu ya kachilombo ka HIV komanso mankhwala omwe amathandiza enawo kugwira ntchito bwino. Ngakhale mtengo wake, ulipo umboni wina kuti kamodzi patsiku mankhwala ophatikizana a kachilombo ka HIV sakhala okwera mtengo nthawi yayitali kuposa njira zina chifukwa amathandizira kutsatira mankhwala kwa odwala, zomwe zimachepetsa chiopsezo chazovuta kapena kugona kuchipatala. Wopanga Stribild, Giliyadi , imapereka mapulogalamu othandizira odwala ngati mukuvutika kupereka chithandizo.

9. Atripla

Mtengo wamasiku 30: $ 3,215.15

Atripla ndi mankhwala ena ophatikizira omwe amagwiritsidwa ntchito pochiza HIV, ndikuchepetsa chiopsezo chotengera ena vutoli. Lili ndi mankhwala atatu. Pakadali pano palibe mtundu wa mankhwalawa, womwe umapangitsa kuti mtengo ukhale wokwera. Koma, kuyambira kumapeto kwa Seputembara 2020, Mankhwala a Teva ivomerezedwa kukhazikitsa mitundu ya generic, yomwe ingathandize kukonzanso mtengo. Wopanga Atripla, Giliyadi , imapereka mapulogalamu othandizira odwala ngati mukuvutika kupereka chithandizo.

10. Biktarvy

Mtengo wamasiku 30: $ 3,214.05

Biktarvy ndi mapiritsi osakaniza atatu omwe amagwiritsidwa ntchito pochizira HIV. Palibe mtundu wa generic womwe ulipo. Chatsopano deta akuwonetsa kuti ndi othandiza kwambiri kwa odwala atsopano, komanso odwala akusintha mankhwala ena, zomwe zadzetsa pafupifupi kuwirikiza kanayi Kugulitsa kwamankhwalawa chaka chimodzi ngakhale adawononga. Monga mankhwala ena ophatikizira HIV, pali umboni wina kuti umachepetsa ndalama zothandizira nthawi yayitali chifukwa chotsatira bwino. Wopanga Biktarvy, Giliyadi , imapereka mapulogalamu othandizira odwala ngati mukuvutika kupereka chithandizo.

Ndiye chikuchititsa chiyani kukwera mitengo?

Kodi (ndipo chifukwa chiyani) mtengo wamankhwala ambiri ofunikira umakwera kwambiri? Ndizovuta-ndipo zimakhudzidwa ndi zinthu zingapo.

Mankhwala odziwika ndi dzina

Msika wodziwika ndi komwe mankhwala amapangidwira koyamba, ndipo kupanga mankhwala atsopano ndi njira yotsika mtengo komanso yodya nthawi. Makampani ali ndi chilolezo chololeza komanso kusungitsa chitetezo pamsika wawo wogulitsa, kupangitsa opanga kuti azitha kugwiritsa ntchito bwino mankhwala awo, ndikupatsanso mphotho kwa omwe amaleza mtima komanso kukwera mtengo pakufufuza ndi chitukuko, akufotokoza a Dana Goldman, wapampando wa director ku USC Schaeffer Center Za Health Policy ndi Economics komanso Pulofesa wa Public Policy, Pharmacy, ndi Economics. Mwanjira ina, mitengo yazithandizo zatsopano ndiyokwera chifukwa cha mtengo wokwera kubweretsa kumsika.

Mankhwala achibadwa

Msika wa generic, ndi nkhani ina. Patent ya mankhwala atsopano ikatha, opanga amatha kupanga mtundu wa generic ndikuugulitsa pamtengo wotsika kwambiri chifukwa wopanga woyambayo wabweza ndalama. Komabe, nthawi zina, mankhwala opangira mankhwala amakhala okwera mtengo mofanana ndi anzawo odziwika, monga mtengo wadzidzidzi womwe umakwera chifukwa cha mankhwala a malungo Daraprim , yomwe inalengeza mu 2015.

Martin Shkreli ndi Turing Pharmaceuticals adatenga $ 13.50 pa piritsi Daraprim (yomwe yakhala ikupezeka kuyambira ma 1950) ndikuwonjezera mtengo mpaka $ 750 piritsi. Shrkeli amatha kuchita izi chifukwa mtengo wa Daraprim udatsika kwambiri kotero kuti onse omwe adakupatsani katundu adatuluka. Turing adalowa m'malo mwake ndikuwonjezera mphamvu zake pamankhwala omwe analibe chitetezo chamatenti.

Izi zikutsimikizira momwe, zodabwitsa, ndi mankhwala achibadwa Msika nthawi zina ungagwire ntchito bwino: Mankhwala osokoneza bongo amatsika mtengo kwambiri mofulumira kwambiri ndipo kupezeka kokwanira kumaika pangozi.

Momwe SingleCare ingathandizire

Chifukwa cha kukwera mtengo kwa mankhwala, anthu ambiri amadalira makampani azachipatala ngati Osakwatira kuwathandiza kupulumutsa madola mazana (ndi masauzande) pamankhwala awo. Ku SingleCare, timakhulupirira kuti ndikofunikira kwambiri kupereka kuchotsera kwa aliyense ku America omwe ali ndi ufulu wopeza, mosasamala kanthu za inshuwaransi, akutero Manav Malhotra, VP wa data ku SingleCare. Ndipo pamene tikuyesetsa kuti mankhwala azitsika mtengo komanso kuti athe kupezeka, gawo lalikulu la izi ndikuwonetsetsa kuti kuwonetsetsa pamtengo kuli koyenera.

Ndipo pomwe aku America azolowera kugula pamtengo, samachita ndi mankhwala. Ndizovuta kulingalira kugula chinthu chilichonse osadziwa chilichonse chomwe chingakutayireni ndalama mpaka mukafike ku kaundula, koma mwamwambo momwe makampani ogulitsa mankhwala amagwirira ntchito, Malhotra akutero. Tikufuna kuti ogula adziwe bwino zomwe azilipira kwa anzathu apamadzi asanalowe mkati. Ogula ambiri sazindikira ngakhale pang'ono kuti mitengo imasiyanasiyana pakati pamasitolo omwe ali kutsidya kwa msewu wina ndi mnzake. Msika woyendetsedwa ndi wogula wodziwa kupanga zisankho zanzeru ndiye gawo loyamba pakuchepetsa mitengo.

SingleCare imapereka ma chart owonekera poyera omwe amakulolani kufananizira mtengo wamtengo ndi kusungidwa kwa SingleCare kwa mankhwala chaka chatha.Kupereka ndalama zabwino kwambiri kuli pamtima pazonse zomwe SingleCare amachita. Tikuwonanso mankhwala omwe ogula amasamala kuti adziwe komwe angalimbikitsire kuyendetsa mitengo, Malhotra akuti. Zimayendetsa momwe timapangira zisankho zathu zamitengo ndi zokambirana zathu ndi anzathu ogulitsa mankhwala.

Yambani kufunafuna mankhwala anu Pano kuti muwone kuchuluka komwe mungasunge.