Cost prevents man with bipolar disorder from getting prescribed - WNEM TV 5

Cost prevents man with bipolar disorder from getting prescribed medication

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"I just assumed I was just having a tough time in my life."

A tough time that turned out to be a very troubling diagnosis. Bipolar disorder.

A Saginaw area man doesn't want us to reveal his identity because of the stigma still attached to mental illness, so we'll call him Joey.

From Aurora to Virginia Tech mental illness has been in the spotlight after mass shootings killed scores of innocent people.

"When I think about these mass shootings, and these people who commit them, I have some sort of thoughts like I feel how you feel," Joey said.

Through a combination of pricey drugs and insufficient insurance, the I-Team found many people with bipolar can't afford the pills they so desperately need.

"A lot of medications that are out there that treat mental illness are still under patents, so they're very expensive and most health insurance companies don't want to cover them," Joey said.

Joey knows the battle first hand.

He's prescribed Seroquel XR, an extended release anti-psychotic that he said works.

And apparently it works for many people.

AstraZeneca the maker of the drug reported more than $7 billion in global sales for the Seroquel brand.

Joey said his insurance company didn't want to cover it at first because of the price tag. He went days without his medication, and even now - he says the price tag is still too stiff.

"It costs about $1,300 and if they cover it they're only covering about $700 if they even give me the okay to have it," Joey said.

Despite a psychiatrist's order to take Seroquel, Joey insists he is left to take a less potent medicine  one that may not give him a consistent dose and the fully help he needs.

Joey's insurance company was able to offer a response: 

It's equally important in these instances to look at the prices being charged for these treatments. We're at a point where prescription drug costs have hit all-time highs. Improving access to those treatments requires fundamentally addressing the prices that drug makers are charging for these medications, recognizing that the prices being charged for those drugs is the biggest barrier to access.

According to Good RX, the average cash price of Seroquel XR is around $950.

The average cost for generic Seroquel? Only $40, and even less if you have insurance.

"I have to actually use a generic brand that is only used for immediate release, which I find very difficult to use at this point, and it's not giving me the same amount of medication throughout my day," Joey said.

And when he doesn't get the medications he needs, it's literally is a life or death situation for Joey, possibly too for those around him.

He admits he's already tried to take his own life four times.

"Lots of times it does lead to suicidal attempts, and at some point there I'm worried it's going to actually happen," Joey said.

The disease has also taken a toll on his career.

He developed an addiction to the sleeping pill Ambien and went through countless jobs, ironically, in the medical field, some even dealing with mental health.

"I would prefer to sleep my time away so I didn't feel those kinds of feelings I had when I was having depression or mania," Joey said.

For more insight on this devastating disorder we turned to psychologist Dr. Justin D'Arienzo.

"Seroquel Extended release can be very expensive," D’Arienzo said.

D'Arienzo said it all depends on the course of treatment needed by the patient.

"Someone can be treated for Bipolar disorder for as low as about $60 per month, to several thousand dollars per month," D’Arienzo said.

In Joey's case, he falls on the higher end of that cost spectrum for what he needs to stay stable and healthy.

"That's when we really run into trouble for people," D’Arienzo said.

AstraZeneca responded with this statement: 

AstraZeneca remains committed to making SEROQUEL XR available and affordable for patients who might benefit from it.  In the US, medicines are offered at a variety of different price points depending on individual insurance coverage.  Eligible commercially insured patients may pay no more than $15 for each month with the SEROQUEL XR Savings Card.

For Joey, he takes everything day by day.

"You don't need to be afraid of people like that and need to be more understanding," D’Arienzo said.

He hopes by speaking to TV5 he's able to shed some light on an issue that impacts nearly six million Americans.

Copyright 2016 WNEM (Meredith Corporation). All rights reserved. 

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