Kip Burgess was relieved last year when pharmaceutical giant Amgen overnighted him a $2,976 check to help pay for his go-to arthritis drug, Enbrel. The 36-year-old psychologist had run into an increasingly common problem: The copay coupon sent by Amgen couldn’t cover the drug’s more than $4,000 monthly price.
“Nothing in the world gives me more anxiety than just getting my medication,” Burgess said. “There’s nothing you can do but beg.”
Panicked, Burgess had called Amgen and pleaded for help. The drugmaker sent him the check after he provided a credit card statement and an explanation of benefits to prove he bought its drug.
It’s one of the little-known secrets in health care: When financial incentives like copay coupons and debit cards won’t work, pharmaceutical companies sometimes will write a check — what they call direct reimbursement — to make sure a loyal patient will stay on a high-cost, brand-name drug.