3/6/2016
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`Costs of MS Treatment | Everyday Health
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`Multiple Sclerosis
`The Costs of Multiple Sclerosis Treatment
`By Alisa Woods, PhD, MS
`
`Don't Miss This
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`http://www.everydayhealth.com/multiple-sclerosis/treatment/costs-of-ms-treatment/
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`MYLAN PHARMS. INC. EXHIBIT 1129 PAGE 1
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`

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`Costs of MS Treatment | Everyday Health
`3/6/2016
`Drug treatments for MS can decrease relapses and slow disease progression. But the costs of
`these treatments are high.
`
`The treatment of multiple sclerosis (MS) typically includes prescription drugs and various forms of
`
`rehabilitation, such as physical therapy, speech therapy, and the use of mobility aids.
`
`A study published in 2013 in the Journal of Medical Economics found that the total costs of
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`healthcare for MS ranged from about $8,500 to over $50,000 per year during the period studied
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`(2007 to 2012), with prescription drugs accounting for a large percentage of those costs.
`
`On the bright side, the number of people with MS with private health insurance or coverage under a
`
`government program such as Medicare and/or Medicaid appears to be increasing due to changes
`
`brought about by the Affordable Care Act of 2014, according to Nicholas LaRocca, Ph.D., vice
`
`president of health care delivery and policy research at the National Multiple Sclerosis Society
`
`(NMSS).
`
`But even with insurance, high deductibles and/or co-payments can make paying for healthcare
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`difficult for many individuals with MS, particularly since many people are unable to work because of
`
`their disease.
`
`Rising Costs of MS Drugs
`
`According to Dr. LaRocca, “Over the last few years, the prices of the MS disease-modifying drugs
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`have escalated faster than inflation. Most people with MS are able to cover their healthcare
`
`expenses, but it is challenging and has led many of them to make compromises, such as skipping
`
`doses or taking drug holidays.” Other money-saving compromises may include reducing general
`
`costs of living or eliminating luxuries such as vacations.
`
`A study published in the journal Neurology in 2015 found that the cost of first-generation, disease-
`
`modifying medications for MS increased from between $8,000 - $11,000 annually in the 1990s to
`
`approximately $60,000 per year currently. Newer disease-modifying drugs can cost even more.
`
`However, the prices quoted in this study do not take into account possible discounts negotiated by
`
`government or private insurance programs, nor do they reflect the lower prices an individual might
`
`pay if obtaining a drug through a patient assistance programs.
`
`RELATED: Rehab Options for Living with Multiple Sclerosis
`
`http://www.everydayhealth.com/multiple-sclerosis/treatment/costs-of-ms-treatment/
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`

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`3/6/2016
`How Do People Pay for MS Treatment?
`
`Costs of MS Treatment | Everyday Health
`
`The most common ways people with MS pay for treatment in the United States are:
`
`Job-based health insurance
`
`Individual health insurance
`
`Medicare
`
`Medicaid or a State Child Health Insurance Program
`
`Programs for the uninsured and underinsured
`
`As they can for anyone, life changes such as losing a job, changing jobs, or getting divorced can
`
`affect health insurance options and coverage for people with MS.
`
`Barbara, a 69-year-old retired computer programmer/analyst who lives near Denver, describes how
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`MS has affected her financially. “I am on disability because I had to retire at 46 and take a 60
`
`percent pay cut. That's what the disability payments amount to. I also got a big reduction in
`
`assistance with medical insurance as a retiree.”
`
`If you’re having trouble stretching your budget to pay for needed care, there are sources of help
`
`you may be able to tap into.
`
`Sources of Help for Paying for MS Treatment
`
`Private insurance companies typically have representatives who can advise people with chronic
`
`conditions such as MS on healthcare coverage and costs. If you have health insurance through your
`
`job, ask your employer for the contact information of the representative, or contact the insurance
`
`company directly to find out who to talk to.
`
`If you receive care in a clinic that specializes in MS, there will likely be someone on staff, such as a
`
`social worker, who’s familiar with insurance issues and financial assistance programs.
`
`In addition, here are some links to resources for helping to pay for MS medications and medical
`
`care:
`
`HealthCare.gov Since January 1, 2014, people with pre-existing conditions in the United States can
`
`no longer be denied health insurance, thanks to the Affordable Care Act. Many formerly uninsured
`
`people now have health insurance as a result of this law, and premium subsidies are available to
`
`http://www.everydayhealth.com/multiple-sclerosis/treatment/costs-of-ms-treatment/
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`MYLAN PHARMS. INC. EXHIBIT 1129 PAGE 3
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`

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`Costs of MS Treatment | Everyday Health
`3/6/2016
`many low- and middle-income people. You can investigate your options and start the enrollment
`
`process at HealthCare.gov.
`
`National Multiple Sclerosis Society The NMSS has a team of MS navigators in place to help with
`
`questions or concerns about paying for medications. The navigators can assist with changes in
`
`insurance coverage for medications, transitioning into a different health plan or Medicare, covering
`
`co-payments for medications, and other issues. The NMSS can be contacted online or at 1-800-344-
`
`4867.
`
`Pharmaceutical assistance programs Drug companies often have their own patient assistance
`
`programs for people who can’t afford particular drugs. The NMSS maintains a contact list, including
`
`phone numbers, for patient assistance programs for many medications. The Multiple Sclerosis
`
`Association of American also maintains a patient assistance program list. If you don’t see the
`
`medication you need on either of these lists, your healthcare provider or pharmacist may know who
`
`to call.
`
`Medicare Those with Medicare may qualify for help with out-of-pocket costs for prescription drugs
`
`through Medicare’s Rx Extra Help.
`
`National foundations NeedyMeds maintains a free information website describing programs to
`
`help people who cannot afford medications and healthcare costs. Partnership for Prescription
`
`Assistance also helps eligible people who cannot afford their medications. And Patient Advocate
`
`Foundation's Co-Pay Relief program has a new pharmaceutical assistance program for people with
`
`MS who have Medicare, Medicaid, or Military benefits.
`
`Social Security Disability Insurance (SSDI) People with MS who cannot work due to MS-related
`
`disability may be entitled to SSDI and/or Supplemental Security Income benefits. Information is
`
`available at the Social Security website. Your healthcare provider can help explain whether you may
`
`qualify, based on your level of disability.
`
`Local community services There may be local services that can help out with transportation,
`
`meals, and other needs. Barbara described her use of local services in Colorado, “I have used
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`community support when needed, specifically Project Angel Heart for meals and, through our
`
`Denver Metro bus system, Access-A-Ride.”
`
`Health centers Federally-funded health centers offer low-cost preventive and primary medical
`
`care, with payment dependent on your income.
`
`http://www.everydayhealth.com/multiple-sclerosis/treatment/costs-of-ms-treatment/
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`MYLAN PHARMS. INC. EXHIBIT 1129 PAGE 4
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`

`
`Costs of MS Treatment | Everyday Health
`3/6/2016
`Hospital or physician patient assistance plans Tom, a 54-year-old Chicago resident living with
`
`MS, recommends making a payment plan directly with your physician or hospital if costs or co-pays
`
`are a problem. Many major hospitals have their own assistance plans, allowing for reduced costs or
`
`payments in installments over time. Tom recommends that people “talk and ask,” and emphasizes
`
`that it is particularly important to arrange payment before a bill goes to collection, at which point
`
`reductions are no longer possible.
`
`Persistence Necessary
`
`Struggling with MS symptoms is stressful by itself, and dealing with the costs of healthcare and
`
`medications can add to that stress. Fortunately there is some assistance available through
`
`foundations, government organizations, patient assistance programs, and local organizations.
`
`However, the person with MS or a friend or family member will likely need to be a strong, persistent
`
`advocate to obtain the help that is needed.
`
`Last Updated: 2/22/2016
`
`Money
`
`Treatment
`
`More in Multiple Sclerosis
`
`http://www.everydayhealth.com/multiple-sclerosis/treatment/costs-of-ms-treatment/
`
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`MYLAN PHARMS. INC. EXHIBIT 1129 PAGE 5
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`

`
`3/6/2016
`
`Costs of MS Treatment | Everyday Health
`
`7 Foods to Avoid With Multiple Sclerosis
`
`
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`
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`Early Signs of Multiple Sclerosis
`
`http://www.everydayhealth.com/multiple-sclerosis/treatment/costs-of-ms-treatment/
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`MYLAN PHARMS. INC. EXHIBIT 1129 PAGE 6
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`

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`3/6/2016
`
`Costs of MS Treatment | Everyday Health
`
`How to Fall Without Breaking a Bone
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`http://www.everydayhealth.com/multiple-sclerosis/treatment/costs-of-ms-treatment/
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`MYLAN PHARMS. INC. EXHIBIT 1129 PAGE 7
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`

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`3/6/2016
`
`Costs of MS Treatment | Everyday Health
`
`The Top 6 Reasons Kate Hudson's New Activewear Is A Game Changer
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`MYLAN PHARMS. INC. EXHIBIT 1129 PAGE 8