Mishonga inodhura kwazvo ye2019
KambaniVanhu vekuAmerican vanopedza yakawanda pamishonga yekunyorera kupfuura chero vamwe vanhu pasi rose. Wepakati mugari weUS anoshandisa $ 1,025 pagore pamushonga-ndiko kuwedzera kwemitengo-kwakagadziriswa ka11 zvakapetwa kubva 1960, maererano data kubva kuPeterson Center pa Healthcare uye Kaiser Family Foundation.
Imhaka yekuti mishonga yakadhura.
Mishonga gumi inowanzo shambadzwa ine mitengo yemitengo iri pakati pe $ 488 kusvika $ 16,938 pamwedzi kana nzira yekurapa, anodaro Dhipatimendi reHutano neHuman Services . Uye, kutsvagurudza kwedu kunoratidza kuti yakawanda-yakatemwa mishonga inogara ichidhura zvakanyanya kupfuura izvozvo.
Mune mamwe mazwi, kune akawanda chaizvo zvinodhura zvinodhaka kunze uko. Iyi ndiyo mishonga inodhura kwazvo, sekureva kweSainCare dhata. Mitengo yakanyorwa pazasi inoratidza mutengo wemari — izvo izvo mutengi angatarisirwa kubhadhara kana iye asina inishuwarenzi kana yekuvhara mishonga.
| Zvinodhaka | Avhareji mutengo wemwedzi -1 wekupa |
| Afinitor | $ 33,001.08 |
| Humira | $ 7,037.81 |
| Enbrel | $ 4,944.95 |
| Xeljanz | $ 4,694.13 |
| Forteo | $ 3,639.85 |
| Glatiramer Acetate | $ 3,378.50 |
| Norditropin | $ 3,377.89 |
| Stribild | $ 3,356.06 |
| Atripla | $ 3,215.15 |
| Biktarvy | $ 3,214.05 |
1. Mubatsiri
28-zuva rekutenga mutengo: $ 33,001.08
Afinitor, chemotherapy mushonga unoshandiswa kurapa itsvo, pancreatic, zamu, uye kenza dzehuropi, ndiwo mumwe wemishonga inodhura kwazvo kunze uko - asi avo vane mushonga vanofanirwa kuva nehurongwa hwavo hwekurapa. Kazhinji, iyo nguva yekurapwa neAfinitor inotsanangurwa neyekurapa kuongororwa. Varwere vanoonekwa kuti vane Subependymal Giant Cell Astrocytoma vakagamuchira nguva yepakati yekurapa kwemwedzi 24.4. Nguva yepakati yekurapa kwevarwere vanoonekwa vaine Renal Cell Carcinoma mazuva gumi nemana. Ndiyo mari shoma ye (gulp): $ 166, 184.01 yevhareji yekurapa kutenderera.
Parizvino, hapana imwe generic imwe nzira yekuti mushonga ubatsire kudzikisa mitengo. Aizogadzira generic akarasikirwa nematare patent mumatare pakutanga kwa2019, izvo zvingadai zvakatendera kuumbwa kweshanduro yechi generic. Varwere vanobhadhara mari vanoona kune iyo $ 33,000-pamwe nemutengo weti. Asi pane nzira dzekuchengetedza paAfinitor 5 mg mapiritsi. Maererano ne Medicare ,100 muzana yeMedicare Chikamu D uye Medicare Advantage zvirongwa zvinofukidza uyu mushonga.
2. Humira
Mazuva makumi maviri nemasere mutengo: $ 7,037.81
Humira an immunosuppressant anoshandiswa kurapa arthritis, psoriasis, chirwere cheCrohn, uye ulcerative colitis. Icho chave chiri chepamusoro-kutengesa (aka chinonyanya kubatsira) chinodhaka murudzi kubva 2012, uye hairatidzi zviratidzo zvekudzikira. Mu2018, zvinyorwa zveHumira zvakapfuura kudarika $ 14 bhiriyoni, yaive kuwedzera kweanopfuura 60% kupfuura gore rapfuura- kunyangwe mukurumbira unopokana yemishonga biologic.
TO 2016 kudzidza rakaburitswa ne Zvinyorwa zveAmerican Medical Association iyo haina kuwana humbowo hwehukama pakati pekutsvagisa nekusimudzira mari nemitengo; asi, mishonga inonyorerwa inotengwa muUnited States kunyanya pahwaro hwezotakurwa nemusika. Asi zvakadaro, Humira mutengo unoramba uchikwira.Tiye mutengo weHumira wakwira kubva pamadhora makumi mapfumbamwe nemana pagore (muna2012) kuenda kumadhora anodarika makumi matatu nemasere (mugore ra2019), pamurwere, mushure mekudzoserwa - zvinoenderana nedata rakataurwa ne New York Times , kubva kuSSR Health, kambani yekutsvaga. Iko kuwedzera kwe100 muzana. Asi for avo vanovimba nemushonga, pane nhau dzakanaka dzinouya muna 2023: biosimilar drug called Hyrimoz. Kwete yekusavhiringidzwa nemageneral madhiragi, biosimilarsvari zvakafanana mishonga iri padyo zvakakwana mukudzokorodza kuti iite imwecheteyo yekurapa uye yekiriniki mhedzisiro (nepo mageniki akaenzana nemakemikari akafanana nemushonga wepakutanga). Iyo FDA yakabvumidza Hyrimoz uye ichave iri kutengeswa muUnited States musi waGunyana 30, 2023.
3. Mutumwa
Mazuva makumi maviri nemasere mutengo: $ 4,944.95
Enbrel ndeye biopharmaceutical mishonga iyo inoshandiswa kurapa rheumatoid arthritis, psoriatic arthritis, uye mamwe mamiriro e autoimmune. SaHumira, Enbrel ari kuona kukwira kwekutengesa uye mishonga yakazadzwa, kunyangwe paine chikwama-chinokanganisa mutengo.Enbrel - iyo yakamhara mumusika weU.S. muna 1998 - yakanyorera $ 4.8 bhiriyoni mukutengesa kweUS muna 2018, sekureva kwemugadziri Amgen , Inc.
Parizvino, mutengesi wezvinodhaka anotengesa gore rekupa Enbrel's 50-mg dose inopfuura $ 67,000.Uye hapana majenareta ari kumusoro kuti abatsire kurerutsa mutengo wevarwere.Biosimilars mbiri dzeEnbrel dzakatenderwa neDFA uye hadzina kuvhurwa nazvino-kusanganisira imwe kubva kuSwitzerland inogadzira zvinodhakaNovartis AGiyo agency yehutano yakabvumidzwa mu2016,maererano ne Wall Street Journal mutori wenhau Jared S. Hopkins . Vanopfuura makumi mana mavoti vanodzivirira Enbrel, uye mugadziri wayo, Amgen Inc., akahwina mutongo wedare muna Nyamavhuvhu une chekuita neEnbrel patents.
4. Xeljanz
Mazuva makumi matatu-mutengo wekutengeswa: $ 4,694.13
Xeljanz inozivikanwa biopharmaceutical iyo inorayirwa kurapa rheumatoid arthritis, psoriatic arthritis, uye ulcerative colitis. Asi munguva pfupi yapfuura, mushonga uyu wakagadzira misoro nekuda kweiyo FDA nyowani nhema-chitupa yambiro izvoiyo JAK inhibitor's 10-mg kaviri zuva nezuva dosi, iyo yakagadzirirwa kugadzirisa marwadzo pamwe uye kuzvimba,inowedzeranjodzi yekugwamba kweropa — uye zvingangoita, kufa.
Tmvumo yemushonga yekurapa ulcerative colitis yakaiswa nino-ikozvino yabvumidzwa chete kune varwere vasingapindure kana vasina kukodzera mimwe mishonga.Asi kunyangwe paine yambiro dzakakomba dzakakomberedza iyo 10-mg dosi, iyo 5-mg ichiri kutarisirwa yakachengeteka, uyezve yakaona kuwedzera mukutengesa nekushandisa.
5. Forteo
28-zuva rekutenga mutengo: $ 3,639.85
Forteo mushonga unobayiwa jekiseni unobatsira kusimbisa mapfupa kune vanhu vane osteoporosis vari panjodzi huru yekutyoka-kunyanya avo vane osteoporosis kubva pakutora steroid senge prednisone. Iyo fomati yekugadzira yehormone inowanzoonekwa mumuviri inokurudzira kukura kwefupa idzva uye kuwedzerwa kwemapfupa. Majekiseni anowanzo kutorwa muhudyu kana mudumbu. Inotenderwa kusvika pamwedzi makumi maviri nemana yekushandisa.
Ikozvino hapana generic inowanikwa. Asi, Pfenix akahwina patent mvumo yekufanana chigadzirwa , iyo inogona kutyaira mutengo pasi painorova kugadzirwa. Kune atove maviri marapirwo akafanana muEurope, asi akavharirwa muUnited States. Kana iwe uchida Forteo, pane dhisikaundi yemugadziri inowanikwa kune vanokodzera varwere.
6. Glatiramer Acetate Jekiseni
Mazuva makumi matatu-mutengo wekutengeswa: $ 3,378.50
Glatiramer acetate jekiseni ndiyo generic vhezheni ye Copaxone , jekiseni mishonga inoshandiswa kurapa multiple sclerosis uye kudzivirira MS kudzokazve. Kunyangwe seyakajairwa, mutengo wacho wakakwira-kwete wakanyanya kuderera pane wezita rezita.
Mumakore makumi maviri apfuura, pakave nekufambira mberi kukuru mukurapa kweMMS, asi kuwedzera kwesarudzo dziripo dzekurapa hakuna kutungamira mukudzikira kwakafanana kwemitengo. Vanga vachiwedzera. Kubva 2013 kusvika 2018, avhareji yepakati medhi yezvirwere zvinoshandura marapirwo senge glatiramer acetate yakakwira kubva pamadhora makumi matanhatu kusvika makumi masere emadhora maererano National Multiple Sclerosis Society . Kana iwe uchinetseka kupa yako mishonga, Mylan inopa kuchengetedza kune vamwe vanhu.
7. Norditropin jekiseni
Mazuva makumi matatu-mutengo wekutengeswa: $ 3,377.89
Norditropin ndeyekugadzira kukura mahormone iyo inoteedzera mahormone mune yepituitary gland inokurudzira kukura mumuviri: kureba, nhengo, mapfupa, uye mhasuru. Kana ikashandiswa kuvana vasina kugadzira zvakakwana kukura kwehormone, inogona kuvabatsira kuve vakareba. Kune vanhu vakuru, inogona kukurudzira mhasuru kukura. Kana ikashandiswa kune varwere vasina kushomeka, haina kushanda.
Inoonekwa seyakakosha mishonga, seiya inoshandiswa kurapa mamiriro akaita segomarara, HIV, kana rheumatoid arthritis. Aya marudzi emishonga anowanzo kudhura, uye norditropin haina kudaro. Novo Nordisk ane chirongwa chekubatsira varwere munzvimbo yekubatsira kufambisa inishuwarenzi mabhenefiti uye kutenga mishonga.
8. Kugadzira
30-zuva mutengo wekutenga: $ 3,356.06
Stribild imana-yekurapa cocktail mune rimwe piritsi rinoshandiswa kurapa HIV uye kudzikisa njodzi yekuendesa mamiriro kune vamwe. Ine mishonga mitatu yemaARV uye mushonga unobatsira vamwe kuti vashande zvirinani. Kunyangwe ichidhura, pane humwe humbowo kuti kamwe pazuva kusangana kwekurapa kweHIV hakudhure kwenguva refu kupfuura zvimwe zvingasarudzwa nekuti vanovandudza kunamatira kwemishonga muvarwere, izvo zvinogona kudzikisa njodzi yezvinetso kana zvipatara zvinodhura. Mugadziri weStribild, Giriyadhi , inopa zvirongwa zvekubatsira varwere kana iwe uchinetseka kupa kurapwa.
9. Atripla
Mazuva makumi matatu-mutengo wekutengeswa: $ 3,215.15
Atripla mumwe musanganiswa wemishonga inoshandiswa kurapa HIV, uye kudzikisira njodzi yekuendesa mamiriro kune vamwe. Iine mishonga mitatu. Ikozvino hapana generic vhezheni yemushonga uyu uripo, izvo zvinoita kuti mutengo ukwire. Asi, kutanga pakupera kwaGunyana 2020, Teva Mishonga inobvumidzwa kuvhura generic vhezheni, izvo zvinogona kubatsira kuwedzera mutengo. Mugadziri weAtripla, Giriyadhi , inopa zvirongwa zvekubatsira varwere kana iwe uchinetseka kupa kurapwa.
10. Biktarvy
Mazuva makumi matatu-mutengo wekutengeswa: $ 3,214.05
Biktarvy mushonga wemishonga wemishonga mitatu unoshandiswa kurapa HIV. Iko hakuna generic vhezheni inowanikwa. Nyowani data inoratidza kuti inoshanda kwazvo kuvarwere vatsva, uye varwere vachichinja kubva kune imwe mishonga, izvo zvakatungamira inenge-kane kutengesa kwemushonga uyu mugore rimwe chete kunyangwe paine mari. Kunge mimwe mishonga yekubatanidza yeHIV, pane humwe humbowo hwekuti inoderera kwenguva refu yekurapa mutengo nekuda kwekuvandudzwa kwekuteerera. Mugadziri weBiktarvy, Giriyadhi , inopa zvirongwa zvekubatsira varwere kana iwe uchinetseka kupa kurapwa.
Saka chii chiri kukonzera mitengo yakakwira?
Sei (uye nei) mutengo wemishonga yakawanda kudaro inokwira kudaro? Izvo zvakaoma-uye zvinokanganiswa nehuwandu hwezvinhu.
Brand-zita mishonga
Musika-wezita musika ndipo panotanga kugadzirwa mishonga, uye kugadzira mushonga mutsva inzira inodhura uye inopedza nguva. Mhando dzine patent uye dziviriro yepamutemo mumakore avo ekutanga emusika, zvichigonesa vagadziri kutora mukana wakazara wevanoda kurapwa kwavo, uye kupa mubairo kuvarimi mukutsungirira kwavo uye nemutengo wakakwira wekutsvagisa nekusimudzira, anotsanangura Dana Goldman, sachigaro wemutungamiriri kuUSC Schaeffer Center. yeHutano Policy uye Economics uye Muzvinafundo wePublic Policy, Pharmacy, uye Economics. Mune mamwe mazwi, mitengo yemishonga mitsva yakakwira nekuda kwemutengo wakakwira wekuvaunza kumusika.
Generic mishonga
Mumusika wegeneral, inyaya yakasiyana. Kana patent pamushonga mutsva wapera, vagadziri vanogona kugadzira generic vobva vatengesa nemutengo wakaderera zvikuru nekuti mushambadzi wekutanga adzora mari. Asi, pano neapo, majenareta anongodhura sevamwe vavo vane mazita, zvakadai semutengo wakangoerekana wavapo wemushonga we malaria Daraprim , iyo yakaita nhau muna 2015.
Martin Shkreli naTuring Pharmaceuticals vakatora madhora 13.50 piritsi reDaraprim (iro rave richiwanikwa kubva kuma1950) ndokuwedzera mutengo kusvika pamadhora mazana manomwe nemakumi mashanu piritsi. Shrkeli aigona kuita izvi nekuti mutengo weDaraprim wainge wakadzika zvakanyanya zvekuti vese vatengesi vaive vasarudza kubuda. Kuyedza kwakazopunzika mukati ndokusimbisa simba rayo rekuzvitonga pamusoro pemushonga waive usina patent kudzivirira.
Izvi zvinoratidza sei, zvinoshamisa kuti, iyo generic mishonga musika dzimwe nguva unokwanisa kushanda zvakanyanyisa: Zvinodhaka zvinodhura zvakanyanya nekukurumidza uye kupihwa kwakakwana kunoiswa panjodzi.
Sei SingleCare inogona kubatsira
Nekuda kwemutengo wakakwira wemishonga, vanhu vazhinji uye vazhinji vanovimba nemakambani ekuchengetedza hutano senge SingleCare kuvabatsira kuponesa mazana (nezviuru) zvemadhora pane zvavanonyorwa. KuSingleCare, tinotenda kuti zvakakosha chaizvo kupa mapiritsi ekuraira kune wese munhu muAmerica akasununguka kuwana, zvisinei nemamiriro einishuwarenzi, anodaro Manav Malhotra, VP yedata kuSingleCare. Uye apo isu patinoedza kuita kuti mishonga ive inokwanisika uye isvikike, chikamu chikuru cheicho chiri kuve nechokwadi kuti kune mutengo wekujekesa kumutengi.
Uye nepo maAmerican vajaira kushopota pamitengo, havaiti nemishonga. Zvakaoma kufungidzira kutenga chero chigadzirwa usina kana zano rekuti chii chiri kuzokubhadharira iwe kusvika iwe wasvika kune rejista, asi ndozvakajairwa mashandiro eindasitiri yemishonga, Malhotra anodaro. Tinoda kuti vatengi vazive chaizvo zvavachazobhadhara kune chero vedu vatinoshanda navo vemishonga vasati vatanga kutsika mukati. Vatengi vazhinji havatomboziva kuti mitengo inosiyana pakati pemapharmacies ari mhiri kwemugwagwa kubva kune mumwe. Musika unofambiswa nemutengi ane ruzivo kuita sarudzo zvine ruzivo ndiro danho rekutanga kudzikisa mitengo.
SingleCare inopa mutengo pachena machati ayo anorega iwe uenzanise mutengo wemari kune iyo ImweCare yekuchengetedza zvinodhaka mugore rapfuura.Kupa yakanakisa kuchengetedza iri pamoyo pechinhu chega SingleCare. Isu tinotarisawo mishonga iyo vatengi vane hanya navo chaizvo kuti vaone kwekutarisa kwedu kwekutyaira mitengo pasi, Malhotra anodaro. Inotyaira maitiro atinoita sarudzo dzemitengo uye nhaurirano dzedu nevatinoshamwaridzana navo.
Kutanga kutsvaga kwako mushonga pano kuti uone kuti ungachengeta zvakadii.
