11 Most Expensive Diseases to Treat: Here's How to Save
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 12, 2021.
Low Back Pain and Neck Pain
Almost everyone experiences some form of muscle and joint pain during their lifetime. Our necks and backs are certainly at the top of the list.
- Personal healthcare spending for this group with lower back pain, who did not receive surgery, comes in at a whooping $1.8 billion annually in the US, according to a 2019 Journal of American Medical Association (JAMA) Network report.
Back pain usually originates in the spine and the muscles that support it. Neck pain can originate from poor posture and osteoarthritis, too. You could get back or neck pain by slouching at a computer all day, twisting your back during chores, or straining your neck during a sports activity.
To prevent problems it’s important to stretch before exercise, watch your posture, and lose weight if needed. Work ergonomically at your desk and use caution when lifting heavy items.
While these tips can help, sometimes pain relief is a must.
- Pain medications like acetaminophen (Tylenol), NSAIDs like ibuprofen (Motrin, Advil) or naproxen (Aleve) are available over-the-counter (OTC) and are affordable.
- Be sure to check side effects and warnings found on the OTC Drug Facts Label before you use any of these drugs.
- Ask your pharmacist if there is the possibility of any drug interactions with your prescription medicines, herbals, vitamins or other OTC agents you use.
High Blood Pressure: Often Undetected
With 1 in every 3 American adults diagnosed with high blood pressure it’s no wonder the cost for treating patients with this condition totals over $83 billion yearly, as reported in JAMA.
There is good news: many of the most popular blood pressure medications are available generically and are typically very affordable, examples include:
- angiotensin-converting enzyme inhibitors (ACE inhibitors)
- angiotensin receptor blockers (ARBs)
- calcium channel blockers
Blood pressure is the force of blood against your artery walls as it circulates through your body. It can greatly increase your risk of certain health problems like heart disease and stroke if it remains untreated.
High blood pressure often goes undetected because it has few to no warning signs or symptoms. It is important to get your blood pressure checked regularly. Adults ages 30 and older without high blood pressure should have their blood pressure checked yearly, but with heart risk factors, older age, borderline readings, or a history of high blood pressure more frequent readings may be needed.
Hepatitis C Virus: Advances Are Significant but Costly
Hepatitis C virus (HCV) is not only costly, it's frequently a hot news item. Health officials are urging baby-boomers to get tested for HCV, and new all-oral regimens offer a cure in a matter of a few months, so HCV stays in the headlines.
As with any big breakthrough, treatment of HCV does not come cheap. Even though generics are now available for some HCV products, they are still very costly. Costs for HCV are expected to peak in 2024 at over $9.1 billion.
Prices are always subject to change -- and will -- so check with your insurance or specialty pharmacy to determine the best way to pay for these drugs. Your insurance may have different preferred HCV drugs on their formulary. Cost savings for this condition are usually through insurance or possibly with a manufacturer's patient assistance program. Ask your doctor or pharmacist about these options.
Uproar started over high-priced antiviral treatments like Harvoni (ledipasvir and sofosbuvir) and Sovaldi (sofosbuvir). For these agents, total treatment costs can hover in the $16,000 to $90,000 range for 12 weeks of treatment. An authorized generic for Harvoni was released by Gilead in early 2019 and can lower the price, but is still unrealistic for most patients at $5,500 - $10,000 per month.
Discount coupons for Harvoni may work at some pharmacies if you need to pay cash for the whole prescription, but this is not realistic for most people.
Newer agents like Epclusa (sofosbuvir and velpatasvir) that can be used for all HCV genotypes also had authorized generics released in 2019. The cost for these generics of Epclusa run between $10,000 and $30,000 for 12 weeks of treatment.
Diabetes: A Common and Costly Condition
The numbers are frankly staggering: more than 100 million U.S. adults are now living with diabetes or prediabetes. Diabetes affects over 9% of Americans with medical expenses totaling over $100 billion per year as noted in a JAMA report.
In all forms of diabetes there is too much sugar in the blood which can lead to serious health complications over time including heart and kidney disease, eye disorders, and nerve damage. Plus, the CDC estimates that 84 million Americans (roughly 1 out of 3) have prediabetes, a precursor to full-blown diabetes.
Luckily, metformin, one of the most commonly used type 2 diabetes oral medications is available generically and may even be free at some pharmacies. The average cash price per month runs about $6 to $12 dollars.
High-priced insulin, a life-saving drug for many patients with diabetes, has been the subject of debate for many years. The average price of insulin in the U.S. nearly tripled between 2002 and 2013 according to the American Diabetes Association. Insulin is about 10 times cheaper in Canada.
- However, in January 2020, Novo Nordisk lowered the price of insulin aspart by 50%, their authorized generic version of fast-acting Novolog and Novolog Mix. Vials (10 mL) are as a low as $70 - $160 using an online coupon, while 5 pens (3 mL each) are about $150. Compare that to the brand products at roughly $300 to $350 per vial.
- The authorized generic version of Eli Lilly's insulin lispro (Humalog), another fast-acting insulin, has also come down by 50%. A 3 mL vial is roughly $95 or less.
- Sanofi has also established a savings program, where people can pay $99 for up to 10 boxes of pens and/or 10 mL vials per month. This includes Admelog, Apidra, Toujeo and Lantus.
- Other copay cards may also be available from insulin manufacturers. Be sure to use the online coupons, too. Check with your pharmacist for the most affordable option.
Learn More: Treatment of Diabetes
Costs of Osteoarthritis & Joint Problems
The back, neck, knees, hips, and hands are common targets of osteoarthritis (OA). It is no surprise then that annual costs for OA exceeds $47 billion annually, and it was listed in the top 20 of health care spending by condition according to JAMA. OA is also among the most expensive conditions to treat when costly joint replacement surgery is required.
By the year 2040, an estimated 78.4 million adults aged 18 years and older (1 in 4 adults) will have doctor-diagnosed arthritis. The age of the U.S. elderly population is expanding and so will the diagnosis of arthritis.
How to contain your personal costs?
- Engage in a program to maintain your weight and flexibility. Maintaining a healthy body weight and non-weight bearing exercise like swimming or cycling may help to keep the joints mobile without pain.
- Inexpensive OTC medications, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can provide quick relief for acute pain. Make sure your doctor recommends these OTCs for you.
- Ask your doctor about the use of heat and ice to help relieve pain, too.
Chronic Obstructive Pulmonary Disease (COPD) and Asthma
Roughly 11 million American adults are living with some form of COPD, and 25 million have asthma.
- Smoking tobacco is the main cause of COPD but air pollutants and genetics are also culprits.
- To control asthma attacks, avoid triggers, like tobacco smoke, dust mites, and pollution.
- Take anti-inflammatory inhalers, fast-acting inhalers, or other medications as instructed.
- Check with your insurance, who may have specifically preferred agents covered at an affordable copay.
Common medications for asthma and COPD are still pricey if you are paying out-of-pocket, but costs are coming down.
- Ventoin HFA inhaler is now available as a generic at roughly $30 cash price. Proair HFA and Proventil now have more affordable have generics, too.
- An inhaled corticosteroid like Teva's Qvar Redihaler (beclomethasone) runs over $200 cash, also with no generic options. If you are willing to use a nebulizer, much more affordable inhaler solutions are available for some agents. Ask your pharmacist for details.
- Advair (fluticasone and salmeterol) and Symbicort (budesonide and formoterol), used commonly for COPD and asthma, are now in an authorized generic. However, each can still set you back $150 per inhaler, even using an online coupon.
- Also, check with the manufacturer of your medicines, who may offer a copay card or patient assistance to help.
Mental & Behavioral Health Disorders
Mental health disorders encompass many different conditions.
- Annual U.S. medical cost for depression runs over $71 billion. About 15 million live with major depressive disease.
- Anxiety disorders result in a cost of over $29 billion, and attention-deficit hyperactivity disorder (ADHD) tallies $23 billion per year.
Luckily, many of the most commonly used antidepressants, like the selective serotonin reuptake inhibitors (SSRIs) are now available generically and are very affordable. For example, generic sertraline (Zoloft), one of the most popular SSRIs for depression, runs about $8 to $30 per month.
Anti-anxiety drugs, often used short-term, and medications for ADHD are typically cost-effective, as well. If you are prescribed an expensive brand without a generic option, ask your doctor if there's another similar, but more affordable, generic option.
Doctor check-ups can be frequent, so be sure to tally that into the total cost.
Cancer Advances Lead to Increased Survival
Every year, cancer ends the lives of more than 500,000 Americans. In fact, 1 in every 4 deaths in the US is due to a cancer-related illness.
Three of the top cancer costs include:
U.S. costs can run into the billions just for these 3 cancers. Based on the continued aging and growth of the U.S. population, costs of new immunotherapy agents, and new diagnostic tools, these costs are predicted to only increase.
It’s not all bad news though -- the cancer death rate has significantly decreased over the last decade. Factors driving this drop include less tobacco use, sun protection, eating well, regular exercise, earlier detection and better treatments.
The best way to prevent costs due to these cancers: early detection and prevention through regular, recommended testing. All of these cancers can be screened for, using tests such as a colonoscopy, a mammagram or a full-body skin exam.
Falls, Injuries, and Broken Bones
Falls are costly and serious events. In fact, 1 out of every 5 falls causes a serious injury such as a broken bone or a head injury, according to the CDC. Annual costs due to injuries from falls comes in at over $50 billion annually.
- Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.
- Each year at least 300,000 older people are hospitalized for hip fractures. Falls in the elderly are a top concern due to effects on independent living.
- Research shows that women have a 5-fold increase of death within one year after sustaining a hip fracture, and men an 8-fold increase.
Prevention is your best bet in avoiding the costs linked with a fall. Here's a few things you can do:
- Ask your doctor to evaluate you for the risk for a fall. Ask your doctor or pharmacist to review your medications to see if they might make you dizzy or drowsy, which might boost your risk for a fall.
- Ask your doctor if you need a bone density test or medicines to strengthen your bones, such as vitamin D or osteoporosis medications.
- Consider balance strengthening exercises to help prevent a fall, such as Tai Chi.
- Get your vision checked at least once a year, and keep your glasses updated, if needed.
- Make your home safe by moving items that can lead to a fall, such as unsecured rugs or bulky furniture. Add grab bars to the shower or railings on both side of the stairs.
Heart Disease: The #1 Killer
Heart disease is the number one cause of death in the United States, killing over 600,000 people a year, according to the CDC.
- As reported by the American Heart Association (AHA), costs of cardiovascular disease total more than $318 billion. By 2035, these costs are expected to reach $749 billion.
- Cardiovascular disease includes coronary heart disease ($89 billion), high blood pressure ($68 billion), and stroke ($37 billion) as the 3 top cost generators, according to AHA.
- Hospitalization, surgery, diagnostic tests, monitoring, specialist doctor visits and medicines all contribute to the price.
To reduce your risk of heart disease, adjust your lifestyle by maintaining a normal weight, eating a healthy diet, not smoking, and getting regular exercise. Preventing and controlling high blood pressure and high cholesterol play a significant role in heart health.
The good news is that many medications for heart disease are affordable. Blood pressure medications, high cholesterol treatments, and drugs used for heart failure and coronary artery disease are often available in generic form and easy to afford. If you are having trouble with costs, talk to your doctor or pharmacist about ways to save.
Rare Pediatric Diseases and Gene Therapy
Sometimes it's a single drug that can skyrocket the costs of treatment. More and more, with the evolution of gene therapies and other personalized immunotherapy drugs, this is becoming the norm. But what if a drug can cure a small child from a deadly genetic disease? Here, the question is not how to save money, but how to save a life.
- SMA is a rare genetic motor neuron disease that leads to problems with breathing, holding up the head, and swallowing. The majority of children with SMA do not survive past early childhood due to the inability to breathe (respiratory failure).
- The total cost for Zolgensma is $2.125 million and it's considered the world's most expensive single-dose drug. However, help with insurance benefits and coordination of financial assistance programs for eligible patients is offered. It is payable on a five-year payment plan for an annual cost of $425,000 for insurance companies.
- Zolgensma is given as a one-time intravenous injection leading to expression of the survival motor neuron protein in the motor neurons and survival of the child.
According to Novartis, the $2.125 million price is half the 10-year cost of Biogen's Spinraza, the only other approved SMA treatment. Novartis estimated Spinraza cost at $4.1 million over a decade.
How can patients afford these therapies? Drug manufacturers have stated they are committed to providing access to these drugs. Outcomes-based pricing and long-term payments plans are just 2 of the strategies in use to encourage insurance coverage for gene therapies.
Finished: 11 Most Expensive Diseases to Treat: Here's How to Save
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