re: My doctor charged me 28,000 for Skyrizi

You need to make sure insurance covers most before accepting that.
I was on Humira for free for a few years. Switched jobs and of course BCBS was like…. Nah you get the biosimilar. Still free though

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Physicians don’t make money off of prescriptions.

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Your doctor didn’t charge that.

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So depends. This is an injectable and if it was administered in an outpatient setting, the "doctor" bill will have the "list price" listed on the initial bill. This will get sent to the insurance provider who will then send you an explanation of benefits and you will see the negotiated price. Virtually same process if administered in a hospital.

Regarding the physicians don't make money, if it is a buy and bill drug (Medicare Part B which is mostly injectables, as Skyrizi is), the practice can get from Medicare ASP (average selling price) +~ 4.3%. Private insurance might pay a little more (6-8%) as they want to avoid injectables given in a hospital setting where the administration costs is more. But the practice has to buy the drug and await payment and if payment is delayed, they have to borrow money to buy next drug, so they are at risk of losing money and why they send patients to hospitals to get expensive injections.

The ASP is calculated based on the "real price" after any discounts. So mega-large systems get better pricing and small practices pay higher purchase prices, so no margin.

Hospitals (not doctor's offices) that deliver lots of babies, as an example, get 340B pricing, so they get the drug at 50% discounts so if a drug like skirizi is given in a hospital outpatient facility, the hospital is possibly making about 10K (WAC is 22K).

Health care is paid at approximately 26 cents on the dollar. The real number is much closer to 7k.

We must quit playing this game and get back to 'truth in billing'

Pray it doesn't turn into PsA

My son has a very rare disease and gets an infusion of Sylvant every 3 weeks. They bill the insurance around $40,000 per infusion. I think the insurance only pays about $15,000 of that. Still insane that any treatment costs that much. My son gets a grant from the drug manufacturer of up to $25,000 per year which more than covers his deductible.

Now you know why the "Sky" in Skyrizi. It's for the sky-high cost of that drug.

Alter alert..

Correct. Or 5 dollars

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I just looked this up. Looks like its used to treat 4 different things.

You can't just put some calamine lotion on it?







Is calamine lotion still a thing?

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will yall shut the frick up saying put lotion on it?

its a god damn auto immune disease not something you can treat with an epson salt bath and lotion.

you sound even more fricking retarded than the OP with this shite

and no OP your doctor didnt charge you anything, the pharmacy did and as i mentioned, they have copay cards that will take care of this.