Agree, and most Medicare patients take a lot of generic products but when they need branded for bigger issues, the costs likely far exceed $1000 (even per month). If you have a good supplement cost to the consumer is quite low. Copay assistance programs are for people with commercial insurance. Payers sometimes use copays as penalties for taking the right treatment rather than the ‘preferred’ treatment. Preferred means they get the biggest rebate, not that it is more efficacious, better tolerated or safer…sometimes none of the three are true, usually at least two are not. A 20 or 30% copay can flat out deter patients from seeking appropriate care as it can be tens of thousands of dollars. Most companies will offer $0, $5, or $50 out-of-pocket copay programs. You will also want to have a bridge program which is free drug upfront until insurance battles can be won and kick-in on the micro and macro level. Minnesota, Michigan and Mass politicians have people fooled into thinking it is an ethical decision to ban these programs. Those three states have incredibly powerful payers who spend a ton on political support.
BTW I believe $300k is close to what is currently charged for the full course in the UK, maybe even less after converting pounds to dollars. They can probably aim higher for the US WAC price, keeping in mind that upfront will be higher but much of the cost is deferred over the next couple of years. It is the upfront dose or three that will likely be given out free through bridge for the first two years on market. If they can push this through medical benefit instead of pharmacy benefit this might be avoided, but I doubt they can get the whole loading dose billed that way. Even more doubtful subsequent doses can get billed that way.
