They’re saying that the insurance they have will not cover any of the cost of the other brand, so they have to pay full price. Many medicines are absurdly expensive here because the drug maker makes their money from insurance companies, not so much the people buying it. It’s absurd, stupid, and backwards.

Yes, after insurance prices. In this case it’s because their insurance provider told them that they will not cover any of the cost of the $1800 infusion because the one that is out of stock is already approved.

If you get one of the cheap plans (high deductible health plan, HDHP), you might pay $200 per month depending on how much of the premium your employer covers and then still have to pay $8,500 a year before your insurance provider will cover anything that isn’t considered preventative care buried in the fine print of the policy.

I went for an annual physical, standard check up and blood work, but my insurance decided the blood tests weren’t part of the physical and tried to bill me $700. Had to appeal it with the insurance company which took several phone calls over a month to get them to void the bill.

If it’s covered under insurance then it’s $5-$30 (depending on policy) for a co-pay and that’s it. If it’s not covered under your policy then it’s eleventy bajillion dollars. The insurance will also pull stupid shit like not letting you pick up your refill early, or making you get some other medication that is similar, but not what your doctor prescribed. Of course the insurance company doesn’t pay eleventy bajillion dollars, they’ve negotiated it down to 50¢, but that’s what you’ll pay if you don’t have insurance.