Humira in one month supply only.

http://www.edmontonsun.com/news/columnists/kerry_diotte/2009/08/13/10445326-sun.html

I wonder why bureaucrats can be so inflexible?

A regular reader wrote to say he's being treated for Crohn's disease and the Edmonton-to-Arizona snowbird can only get a month-long supply of a vital drug from Blue Cross, called Humira, that could put his disease into remission.

"My choices would be to fly back from Arizona to Edmonton every month this winter or go to an American specialist to have him prescribe the drug," said Alex Harboway.

Either way could be very costly. After months of dealing with Blue Cross and Alberta Health, Harboway has caught a bit of a break. His other insurance company, Sun Life, will pay 80% of the cost of the drug for a 100-day supply. The cost of the drug here is about $1,700 a month. He'll pay the rest out of pocket.

"I've never jumped through hoops like this in my life," he said. There's no question it's a valuable drug. Indeed, Harboway has been told it's similar to the one that has helped Oiler Fernado Pisani to recover from ulcerative colitis, a very serious disease related to Crohn's.

First of all, dood's got three insurance companies that will cover this one way or another!

The American specialist would cost this financially impoverished snowbird that flies back and forth between Canada and the US $350. With the deal that he's worked out he's already paying just about that much on his monthly deductible for the drug. A plane ticket to Canada is going to cost about that much as well.

One reason an insurance company might not want you walking away with a one year supply of $20,000 worth of drugs is that you very well might have to discontinue the drug before your one year supply is up. This happens all the time with Humira---there are all sorts of reason why this might happen. And once you've bought it, you'll have $20 grand of expensive protein sitting in your fridge right next to the leftover potato salad.

Recently a woman offered to sell me a one month supply of Humira (she had discontinued it) for a few hundred dollars cheaper than what it retails for. She would have pocketed this money, of course, at the expense of her insurance company who paid for the drug. I didn't take her up on her offer since whatever I pay her doesn't count towards my out of pocket max, and secondly, I don't trust anyone but me to keep this drug properly refrigerated.