As insurers move away from fixed co-payments on certain prescription drugs, many patients with life-threatening illnesses are feeling the financial impact.  Co-payments of only $10, $20, and $30 are increasingly being replaced with a new system that requires on average 20-33 percent of the total costs of Tier 4 drugs to be paid by the patient.  This is a financial burden that many are struggling to afford.

Tier 4 drugs, typically classified as high-cost medications and biologics, are used to treat complex medical conditions such as hepatitis-C, multiple sclerosis, and some cancers.  With the new system, paying for these drugs can cost patients hundreds to thousands of dollars a month, a more than slight increase from the previous $20 average monthly prescription co-payment.  Unfortunately due to the conditions these drugs treat, many patients have no other choice but to pay.  It is simply a matter of life and death.

The Tier 4 system was originally part of the Medicare plan and almost non-existent in the private sector.  Now adopted into an estimated 10% of all private plans and 86% of Medicare plans, Tier 4 has spread at an alarming rate.  As employers seek ways to cut costs, these figures are expected to continue on the rise creating an even more significant financial impact on patients throughout the United States. 

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