Amarin Corp Plc (AMRN)

[sts66]

Thanks a lot Congress - they giveth then taketh away. Ready to pick up my 3rd 3/mo V scrip from CVS, cost was $300 - last time was $105 - WTF? It's only early August, did I already hit the Medicare donut hole?!? (no unusual meds this year) Yup, with this refill I met the $4130 donut hole amount (total drug costs) - now I can't get out of it until I pay a total of $6,550 out-of-pocket, which I'll never hit, with this V scrip I'm only at $1700 for the year.

I had read that the donut hole was closing so this surprised me - but wait, it gets even worse - in 2022 the coverage gap cost number goes up $300 to $4,430 and ends when you spend a total of $7,050 out-of-pocket, $500 more than 2021 ($6550) - the diff in limits means patients will need to pay an extra $200 out of pocket to escape the donut hole next year. So for those of us on V and some other maintenance drugs, our out of pocket costs are actually going higher next year, not lower - that's ass backwards! AMRN raising the price of V 8%/yr hurts Part D patients too, wipes out the entire savings from increasing in amount of spending needed to hit the donut hole in 2022 ($500/$6550 = 7.6%), plus we'll pay more out of pocket while in the gap. Insurance coverage and drug costs aren't included in inflation calcs, definitely not part of the calcs the Feds use to come up with COL increases for SS, so the Fed inflation numbers were nowhere close to accurate (as if anyone actually believed them to start with***)

I'll point out again why GV will hit patients in the wallet HARD, probably leading them to drop it completely - when you're in the coverage gap, a brand name company pays 70% of the drug's costs, the Part D provided pays a tiny 5%, and you pay the remaining 25% of retail cost - all of those costs count towards getting to catastrophic coverage. But if you are forced to take GV, Medicare pays 75% of the drug cost (Hikma doesn't pay a penny in discounts), and you pay 25% - here's the catch - only your 25% of costs goes towards meeting the donut hole out of pocket maximum - most will never escape the donut hole in that scenario. Hikma will actually make mint when patients hit the gap, they get full reimbursement of drug costs.

For those who take multiple drugs, they would see their cost of V or GV shoot up from $35/mo to $100/mo and may decide they can't afford V so they stop filling their scrip - we know most people only stay on V for an avg. of 6 months, and I just hit the donut hole only 8 months into the year, close to that 6 month avg. - wonder if Medicare patients are the primary cause of people stopping V because of costs? The majority of the target population for R-IT is eligible for Medicare, although we don't know what the %'s are for commercial coverage vs. Medicare coverage - not sure AMRN knows either, but they might - if they do know, why haven't they mentioned that when answering questions about why people quit taking V? AMRN knows what % of V scrips are for MARINE vs. R-IT, so they should know commercial vs. Medicare scrips (I think) - the coupon use would give them a decent idea if they can't get that data directly from Symphony/IQVIA. Does anyone know whether pharma companies get data on what type of insurance is used to pay for their drugs?


*** Inflation is real now - went to fill up my car with gas yesterday and the price of premium was a whopping $4.40/gal (!?!), was around $3.60 the last time I filled up - that's a massive increase - even the price of regular looked like it had gone up around 50 cents. Also read an article in the paper last night about food costs going up and how it's killing restaurants, along with the drive to increase the min wage to $15 - owners are getting squeezed from two sides, and they've had to raise prices so much that they're seeing customers walk out when they look at the menu and see how much prices have gone up for meals they used to eat regularly. Some have even had to drop certain dishes off the menu entirely because they know customers would refuse to pay the amount owners would need to charge to make a tiny profit - around here the crab cake is King - used to cost around $25 in a decent restaurant, now it costs around $50! (wholesale price of chicken wings has also doubled) NOBODY is going to pay $50 for a crab cake, so restaurants have lost one of their biggest sellers. This $15 min wage is not helping the lower class like progressives thought it would (no surprise to me) - it's more than offset by increased food and housing costs, which also hit the middle class who don't work for min wage - nobody is winning here.