For NBC DFW’s Affording America series, we’re hearing from North Texans about how rising costs are affecting their everyday lives and financial decisions. ‘Always lived under my means‘ When Linda Clark answered our NBC DFW affordability audience survey, she described herself as financi ally comfortable. “I’m comfortable, in terms of I don’t have any things that stress me out. It’s not like I can’t pay my bills every month,” Clark said. After a career in financial services, Clark said she felt prepared to retire. “That means paying for your home, paying for all other essentials, just making sure you don’t have any significant debt,” said Clark. “I’ve also always lived under my means, just financially, just been taught that.” One expense changed after Clark transitioned to retirement and Medicare. She said a medication she used to get with no out-of-pocket cost through her employer’s health plan now costs just over $1,500 for a one-month supply. Clark said switching medications isn’t so simple. “For me, alternatives haven’t worked before, and this is the one medicine that actually resolved it,” said Clark. “Now I have to go back through looking at other meds, try this one, does this work? And then what’s the cost of that?” Drug Cost We asked Amgen, the maker of Otezla, about the cost. In an email, a company spokesperson wrote, “We recognize that navigating the U.S. healthcare system can be complicated, particularly when patients transition to Medicare coverage, and have connected directly with Ms. Clark to explain her options.” “Out-of-pocket costs for Otezla depend on a patient’s individual Medicare prescription drug plan benefit design and cost-sharing requirements. Due to federal program requirements, the Otezla Co-Pay Program is only available to eligible patients with commercial or private insurance. Under the program’s terms, patients whose prescriptions are covered in whole or in part by Medicare, Medicaid or other federal or state healthcare programs (such as Ms. Clark) are not eligible,” a company spokesperson continued. “While federal rules prevent Medicare patients from participating in the Otezla Co-Pay Program, other support options may be available. Patients can contact Otezla SupportPlus at 1-844-4OTEZLA to learn more,” the company spokesperson added. “For 2026, Medicare Part D includes a $2,100 annual out-of-pocket cap for covered prescription medications, including Otezla if covered by a patient’s Part D plan or approved through a formulary exception. If Otezla is covered for Ms. Clark, her total out-of-pocket spending on covered Part D medications should not exceed $2,100 for the 2026 calendar year,” the spokesperson wrote. Clark told us she’s not currently enrolled in a Part D drug plan, but she said she’s looking into it. Price Negotiations In 2027, Medicare-negotiated prices for 15 medications covered under Medicare Part D take effect. The maximum fair price is negotiated between the federal government and the drugmaker. According to this Centers for Medicare Medicaid Services fact sheet, the Medicare-negotiated price for Otezla is $1,650 for a 30-day supply, compared with a 2024 list price of $4,722. “What we’ve seen so far is that the price can come down substantially with Medicare negotiating these drug prices,” said Cynthia Cox with KFF, a nonpartisan health policy research nonprofit. “It still is the case that in the U.S., we generally pay more for prescription drugs than people in other countries do for those same drugs, but it becomes much closer of a comparison when Medicare has started negotiating for the drugs that are on the list,” Cox said. When we reached out to Amgen, Clark said the company contacted her with information about the Medicare Prescription Payment Plan. It allows people with Medicare drug coverage to spread their out-of-pocket prescription costs across the calendar year. Medicare.gov says participants get a bill from their drug or health plan to pay for prescription drugs instead of paying the pharmacy. It says the payment plan doesn’t lower the cost of the drugs. Clark said her condition affects her quality of life, but her experience left her wondering what other patients do if they can’t afford a drug they need. “It made me think, for me, it’s an itch where if it’s someone who has a heart medication or something like that, what do you do in those cases?” said Clark. “I just feel like there is an opportunity, huge opportunity, but also there’s a possibility for some sort of solution to make this more affordable for everybody,” Clark added. More from Affording America Explore more stories about how the cost of living is affecting North Texans and their families. NBC 5 Responds Nov 4 Groceries, rent and rising costs squeeze North TX family budgets: survey finds NBC 5 Responds Nov 9 Families making trade-offs to afford healthcare: survey finds ...read more read less