IBD Drugs 'Prohibitively' Expensive for Medicare Patients

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IBD Drugs 'Prohibitively' Expensive for Medicare Patients
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Medicare beneficiaries with IBD can expect to pay thousands of dollars per year in out-of-pocket costs for many specialty medications. MedTwitter GastroTwitter

For maintenance Part D medications, median retail prices in 2022 range from $60,038 for certolizumab pegol to $154,930 forFor maintenance Part B medications, median retail prices in 2022 range from $9636 forto $88,733 for natalizumab annually, corresponding to an OOP cost of $1927 to $17,747 annually without Medigap , they note.

Without Medigap, Medicare beneficiaries with $30,000 in annual income could expect total OOP costs to equal 20%-30% of annual income for several medications, Dong and colleagues found. Medicare beneficiaries with higher annual incomes of $55,000-$90,000 could still expect to pay 6%-20% of annual income on OOP costs for IBD medications and 20%-40% of first-month income in OOP costs for most medications.

The researchers note that recent legislation contains several provisions aimed at reducing OOP costs.

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