Anna Sutton was shocked when she received a letter from her husband's job-based health plan stating that Humira, an expensive drug used to treat her daughter's juvenile arthritis, was now on a long list of medications considered "nonessential benefits."
The July 2021 letter said the family could either participate in a new effort overseen by a company called SaveOnSP and get the drug free of charge or be saddled with a monthly copayment that could top $1,000.
"It really gave us no choice," said Sutton, of Woodinville, Washington. She added that "every single FDA-approved medication for juvenile arthritis" was on the list of nonessential benefits.
Sutton had unwittingly become part of a strategy that employers are using to deal with the high cost of drugs prescribed to treat conditions such as arthritis, psoriasis, cancer, and hemophilia.