For individuals like Kim Adamski’s husband, who suffers from Crohn’s disease, the cost of necessary medications can be overwhelming. Despite having insurance through Connecticare, they still face high out-of-pocket costs for medications like adalimumab, which can cost up to $7,000 per month before insurance payments.

The Challenge of Affording Life-Saving Medications

The introduction of generic versions of adalimumab has not significantly reduced costs for consumers, as insurance companies often only cover 50-70% of the cost after deductibles are met. This leaves patients with significant copays, which can be unaffordable for many families. In Connecticut, the median per capita income is around $56,000, making it difficult for individuals to afford these costs, which can amount to almost 45% of their annual income.

The situation is further complicated by the fact that insurance companies often change their coverage and assistance programs, leaving patients to navigate complex and time-consuming processes to access their medications. In some cases, patients are forced to choose between their medication and other essential expenses, such as rent or groceries.

According to national statistics, approximately 74,000 Connecticut residents take high-cost biologics like adalimumab, highlighting the need for more affordable and accessible healthcare options. The issue is not limited to Connecticut, as many individuals across the country struggle to afford necessary medications.

A Call to Action for Lawmakers

Kim Adamski argues that lawmakers at both the state and national levels should prioritize addressing this issue, not just for individuals with chronic illnesses but for all residents. She advocates for universal healthcare, paid for by taxes on millionaires and billionaires, as a long-term solution. In the meantime, lawmakers should work to cap the amount that insurance companies can charge their customers, ensuring that necessary medications are more affordable and accessible.

Original reporting: The Connecticut Mirror — read the source article.