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pudgeder

RX Frustrations (or flustrations)

8 years ago

I have been taking new meds for my Type 2 diabetes.

Both are heavily advertised on TV. Both have been very successful in helping my A1C stay down where it's supposed to be (Of course with diet as well.)

When originally prescribed, they came with a card from the drug company. With insurance, the co-pay for both was $25 each. Apparently the card is only good for 6 months.

Imagine my shock when I went to pick up the refills and one of the meds was $800 and the other was $750!!

I declined them, came home and started searching for coupons online. I finally found from the drug manufacturer another "discount" card. Filled out the info and even with their "discount" it'll still cost me nearly $400 EACH.

it's almost like they can sell it for whatever insurance pays and the $25 to get you "hooked." (Not saying it's addictive)

Who can afford this? Certainly not me.

It's so aggravating when I know our tax dollars fund a large percent of the research that goes into making these medications. Yes, I know they have to pay their shareholders, but that is extortion!!


Rant over.

Back to the doctor I go.




Comments (28)

  • 8 years ago

    How terrible! Maybe your doctor can hook up you up with a better discount?

    pudgeder thanked Nothing Left to Say
  • 8 years ago

    I don't know if this will help you or not, but this month's Consumer Reports has an extensive article and ratings on getting the best prices on prescriptions. Their top pick is an online pharmacy, HealthWarehouse.com, and second is Costco. They checked the prices of 5 drugs, and HealthWarehouse.com was the cheapest on all of them, to the tune of $66 for all five drugs vs $928 at CVS/Target.

    pudgeder thanked terezosa / terriks
  • 8 years ago
    last modified: 8 years ago

    Pudgeder, also try Canada, places like canadadrugs.com. You will need a prescription to fax, but many doctors are happy to provide one. Ask yours.

    Many of my elderly neighbors are on Spireva or Advair, which their medicare supplemental no longer covers. A three month supply from Canada is less than one month here.

    pudgeder thanked writersblock (9b/10a)
  • 8 years ago

    This is disgusting! Grrr. What Terriks said and talk to your doctor or the nurse/nurse practitioner/PA at your office.

  • PRO
    8 years ago
    last modified: 8 years ago

    High costs are due more to marketing, sales & profits, than research & development.

    I think many patients would be shocked to see the daily lunches brought to some physician offices to feed the entire staff, where the sales reps push the drug & discount card.

    BTW, Tax $$$ rarely, directly fund the reasearch; not saying pharm companies do not get support, but it is more indirect.




  • 8 years ago
    last modified: 8 years ago

    Must you take these heavily advertised brand name drugs or is there a generic equivalent that will work for you?

    pudgeder thanked 3katz4me
  • 8 years ago

    Pudgeder, I can sympathize with you. My husband has Crohn's disease. His prescriptions last year came to a little over $102,000. The injections he takes are alone over $8,000 a month. They are considered a level 5 specialty drug. The only alternative that he hasn't already tried is even more expensive.

    pudgeder thanked mary_lu_gw
  • 8 years ago

    I just enrolled in Medicare, coverage begins May 1st. With my drug plan, the medicare rep advised me to not order over and beyond what I needed of one of my ($107, 90-day) meds as then I will fall into the "donut hole". That is, will end up paying $992 for a refill when total med costs (all three meds combined) reach like $3,300 or something in a year. Luckily I had stockpiled this inhaler while under my current insurance in anticipation of the change to medicare so I should be in good shape as long as I keep one step ahead.

    pudgeder thanked schoolhouse_gw
  • 8 years ago

    This price gouging on commonly necessary meds has been an issue for some time - remember Martin Shkreli? He's not the only one responsible this. Some friends of mine have a teen son w/diabetes and they have been heavily impacted as well.

    https://en.wikipedia.org/wiki/Martin_Shkreli

    Sadly, it seems no one in the current gov't administration is likely to change this state of affairs.

  • 8 years ago

    It's what inevitably happens when you opt for for-profit health care. BTW, pharma-bro didn't go to jail for raising prices, but rather for diddling investors.

  • 8 years ago

    Some friends of mine have a teen son w/diabetes and they have been heavily impacted as well.

    This is my reality. Insulin prices have been increasing exponentially. The problem is compounded by the fact that because of the class of drug insulin falls into, there is no hope of a generic, although there is a bio-similar but that is not at generic pricing, either. There have been great technological advances to help with diabetes management for type 1, but of course, the cost is exorbitant, limiting who will benefit from it. I supposed I should at least take comfort in the fact that if my daughter's kidneys fail and she needs dialysis, then she will qualify for Medicare. To my mind, it would be better to provide better coverage for management of her diabetes so that she would never need dialysis (which of course is incredibly expensive). Then again, those making the rules really do not care what I think.

  • 8 years ago

    Regarding the slides with the pharma detailers calling on physicians. All the healthcare enterprises where I live pretty much ban vendors from calling on physicians directly. Purchasing controls who comes and goes. My company acquired another company that had a product related to physician prescribing patterns based on drug rep activity with that doc. That business went out of business because so many healthcare providers were banned from seeing drug reps so the product fizzled out. That seemed to coincide with the increase in TV advertising, coupons, etc. direct to the consumer.

    Fortunately the meds I take are generic. DH uses albuterol so that is not but he doesn't use much of it.

  • 8 years ago

    Ask your doctor's office if they can submit a prior auth for these medications; this may help with the cost.

    pudgeder thanked maddie260
  • 8 years ago

    Pudgeder, your rant should not be over. Did you ever watch a Netflix series called Dirty Money? One of the episodes was called Drug Short. It is your story. It is why you are in the position that you are in. You are spot on with your closing sentence that it is extortion in order to pay the shareholders. And I want to be very careful with my words so that I do not politicize this post, but, as mentioned above, this is the consequence of for profit healthcare. And it is not going away any time soon.

    pudgeder thanked rockypointdog
  • 8 years ago

    To my mind, it would be better to provide better coverage for management of her diabetes so that she would never need dialysis (which of course is incredibly expensive).

    Yeah. I have pernicious anemia, and without a regular B12 shot I would eventually become blind, demented, and dead, but my insurance never would pay the lousy seven bucks for the shot. (Shots are "only therapeutic" was their response when questioned about it.)

    They'd rather pay for what happens if I don't have it. Go figure.

  • PRO
    8 years ago

    @3katz, that is true for many/most large healthcare organizations, esp. academic ones (including where I practice).

    However, in small/individual physician office practices - it is still very much going on.

  • 8 years ago

    pudgeder I wanted to mention to you that since you have type 2 diabetes you have the potential for coming off all medicine assuming your pancreas still produce insulin and also achieve normal A1Cs preferably below 5 to truly avoid complications that comes with high bloodsugars. To do this I recommend you research a ketogenic diet. There is a good facebook group called Reversing Diabetes that teaches this way of eating for those with Diabetes. In a nutshell it is cut your carbs down to less than 20g total a day, eat the minimum protein your body needs and supplement extra calories if you're hungry with healthy fats.


    I'm a type 1 and have at the suggestion of my endo done this for 2 years now. My a1c is at 5.1 which is close to being into the fours and cutting out damage due to high bloodsugars. I still need insulin since I'm a type 1, but have cut the usage to less than 1/3 of what I used to take. I've lost 25 lbs without any work other than keeping track of macros. The nerves causing my neuropathy in feet are healing and I no longer have burning feeling feet. I have in my 20 years as a type 1 diabetic never had an a1c above 6.5 - the old recommendation by my endo to avoid most complications. However anything above 5 puts you at a risk. All my other lab work is also excellent and have improved since I started eating this way. It is super simple. Some good quality protein at each meal, and handful of quality vegetables for micronutrients, and a good sauce such as home made aoli, hollandaise, bernaise, alfredo etc. I'm no longer feeling the need for snacks and only eat when I'm hungry and I keep nice stable bloodsugars without spikes which can be damaging as well.


    A note you do have to be committed to the way of eating as if you go back to eating a high carb diet you'll be right back where you started.


    I just wanted to share as I wish I had been told taught this a long time ago. I've never eaten a high carb diet since diagnosis, but I still had swings in my bloodsugar. I feel so much better with lower bloodsugars, sleep better, and have a lot of energy and my mental focus is much improved. My target value is 83 and I hover around there all day even with doing the manual job of a pancreas using insulin.

    pudgeder thanked lyfia
  • 8 years ago
    last modified: 8 years ago

    Well, you are not the only one. Most of the modest income folks I know with crappy insurance forgo many life-extending prescriptions or take them catch as catch can due to finances, myself included. And yes, I have investigated options. There are few for folks in the middle between abject poverty and good insurance coverage.

  • 8 years ago
    last modified: 8 years ago

    This confuses me a little...there's advertising in various forms in all that we buy.

    Plus...we pay for years and years of research by many many people before a drug goes to market. Drug research is NOT volunteer work...

  • 8 years ago
    last modified: 8 years ago

    Pennydesign, do you know that there are only two countries in the whole world where the kind of drug advertising that bombards us every day is legal? Us and New Zealand. Every other country on earth bans it. Why do you suppose that is?

    Plus...we pay for years and years of research by many many people before a drug goes to market. Drug research is NOT volunteer work...

    Yes, and we already pay for a lot of that through our taxes, because most of that research is grant-supported.

  • 8 years ago
    last modified: 8 years ago

    It's very very expensive to bring a drug to market...It's not just paying for a pill.

    Frankly I get very tired of this sort of myopic vision..

    My husband went through years of school to become a microbiologist. He makes sure that what he does makes a difference. He works with people who have extensive educations and who care enough to make sure to follow protocols so that people might be able to fight disease and live a little longer...That isn't volunteer work, either. There is equipment and supplies. There are also the drugs that DON'T make it through one of the steps in research that has to be paid for too.

    We are NOT wealthy. We are not rolling in it while simultaneously laughing at the stupidity of the American Public. If you think that we are, then I suggest you walk a mile in my coupon-clipping, third-hand car travelling, Walmart shopping shoes...

    I won't be subscribing to this thread anymore. It's so incredibly hurtful to me. So go ahead as I'm sure you will...fire away. I won't see it.

    Good luck to all of you who are ill. I hope you find the relief you need and I hope that some of you think about those things that others do for you that are not done out of greed.

  • 8 years ago
    last modified: 8 years ago

    Pennydesign, I don't think anyone here (well, except maybe one person) thinks that the scientists are rolling in dough, but big pharma unquestionably is. When the cost for established drugs whose research costs have been paid back years ago suddenly go up 600% or more, what else can we think? We know darned well that your husband and people like him aren't getting a cut of that.

  • 8 years ago

    I also read the Consumer Reports article. Good suggestions. They also suggested trying different pharmacies in your area and what their prices are in comparison. It's crazy that we have to do this. It's like textbooks; we pay more in the U.S. because we CAN because of for-profit healthcare in this case.

  • 8 years ago
    last modified: 8 years ago

    pennydesign, since you flounced out of this thread, you may not read this, but please know that I do not in any way, shape or form blame workers of any company or governmental agency for the current healthcare debacle in the US, no, the blame rests on the weak, bigoted (writ broadly), short sighted and greedy politicians of both major parties and the lobbying culture of the US. Your husband is but a tiny cog in the wheel (no offense intended), and I get that, he is doing work that, when brought to market, means better outcomes for patients, and even if the outcomes are tragic; drugs don't work, people die or are hurt further, I'm OK with that, no progress comes without trial and error, and the most promising work can fail, it's just life. Please know that when some of us talk about single payer we don't want to RIF the employees of drug companies, of course we still want research, in fact, I want MORE research, on more drugs/treatments and trials done on more people, and done more equitably, meaning parity on female/male research subjects.

  • PRO
    8 years ago
    .
  • 8 years ago

    They make giant contributions to campaigns and then there is the lobbying.


    https://www.opensecrets.org/industries/summary.php?cycle=2018&ind=H04

  • 8 years ago

    Sorry the discussion is hurtful because I seriously doubt anyone here or any place else is blaming pharmaceutical researchers for high drug costs. Fellow scientist here, and I know that even the biggest paid ones have salaries that pale in comparison to what people make at the top of other fields.

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