Article that may help with prescription costs.

[LuvOrlando]

So I was just reading "Readers Digest" and the July issue has an article titled, "Healthier and Wealthier". In this article they mention a coalition of pharmaceutical companies, healthcare providers, and patient advocacy groups that help people get free or discounted medications. They cite an on-line site pparx.org where you can see if you qualify.

I hope this info helps someone out there, if it does Pay it forward

 

[AllyandJack]

I actually used a program through a pharmaceutical company. We have great insurance. But, my middle DD was given Pepcid in a liquid form. There is no generic counterpart and the Pepcid liquid isn't on my insurance formulary and cost quite a bit.

I called my ins co and they gave me alternatives - all tablets. I said she's 7mo old! She can't take a tablet. They said the doctor had to write an appeal, blah, blah. Meanwhile, I was facing shelling out this $$.

Back in my old days as an attorney, one of our biggest clients was a big pharmaceutical company and I remember when they first started the program and they happened to manufacture this medication. I called them and they gave me a free 30 day supply while the appeal when through.

I got it for free - no questions asked about income or other qualifications. They said if ins denied the appeal to call them back and they'd see if we qualified for free or discounted rates on it. Thankfully, the appeal was approved in 2wks and we never had to apply, but they were amazing in just giving us the free 30 day supply.

Unfortunately, not many people know about these programs. There should be signs up in every pharmacy and in every doctor's office. I can't speak for all pharmaceutical companies, but the one we represented wanted more exposure about their program - and, for a while, I saw a ton of commercials about it and then it tapered off.

I had hesitated to even call because we have insurance, we're not struggling financially, but we also couldn't afford hundreds of dollars a month for this specially compounded brand-name suspension. But, I swallowed my pride and called them and they couldn't have been nicer and the medication was approved, so it all ended well.

I'm glad they appear to be getting the word out again about these programs because they're there to benefit everyone - not just people who are below poverty limits or uninsured, but even people who are simply waiting on an approval of coverage for a medication.

 

[C.Ann]

I once had to use one of these - and may have to use it again at some point in time.. I forgot what the web site was though.. Thanks for the reminder!

 

[Turner Drugs]

I actually used a program through a pharmaceutical company. We have great insurance. But, my middle DD was given Pepcid in a liquid form. There is no generic counterpart and the Pepcid liquid isn't on my insurance formulary and cost quite a bit.

I called my ins co and they gave me alternatives - all tablets. I said she's 7mo old! She can't take a tablet. They said the doctor had to write an appeal, blah, blah. Meanwhile, I was facing shelling out this $$.

Back in my old days as an attorney, one of our biggest clients was a big pharmaceutical company and I remember when they first started the program and they happened to manufacture this medication. I called them and they gave me a free 30 day supply while the appeal when through.

I got it for free - no questions asked about income or other qualifications. They said if ins denied the appeal to call them back and they'd see if we qualified for free or discounted rates on it. Thankfully, the appeal was approved in 2wks and we never had to apply, but they were amazing in just giving us the free 30 day supply.

Unfortunately, not many people know about these programs. There should be signs up in every pharmacy and in every doctor's office. I can't speak for all pharmaceutical companies, but the one we represented wanted more exposure about their program - and, for a while, I saw a ton of commercials about it and then it tapered off.

I had hesitated to even call because we have insurance, we're not struggling financially, but we also couldn't afford hundreds of dollars a month for this specially compounded brand-name suspension. But, I swallowed my pride and called them and they couldn't have been nicer and the medication was approved, so it all ended well.

I'm glad they appear to be getting the word out again about these programs because they're there to benefit everyone - not just people who are below poverty limits or uninsured, but even people who are simply waiting on an approval of coverage for a medication.

I have worked in a pharmacy for over 15 years (I am NOT a pharmacist) and I will tell you that drug companies will alwys make their $$ as long as the general public has this fear of what the MD prescribes.

Example: Prilosec sold for about $280 if you had to pay out-of-pocket for a month's supply 5 years ago. Priosec OTC is now available OTC for 28 days for about $20-$30 in tablet form. The shame of it all is if your MD writes an Rx for prilosec, the pharmacist is bound by law to give you the capsule form (even in generic form, it is quite a bit more than $20-$30) but the drug OTC works as well as the Rx form. Why, you ask? Well, R&D is what we hear all day long and until we die and it will always be. Drugs you buy with cash in this country (USA) will always cost people more than in countries such as Great Britain, Ireland, Canada and even Mexico.

 

[DisneyBamaFan]

If you want less expensive drugs, order them on-line from Canada. Over 12 million Rx filled per year at tremendously lower prices...

 

[jax677]

You can also go online and see if the company that makes each of the meds you use has a discount card that gives you money off the top. We use that for 2 of my very expensive ones. You qualify because you use their product, not by how much money you have. Its a great plan.

 

[DawnCt1]

One of the best deals is Walmart's $4 and $10 prescription list. If one of those generics meets your needs, it is better than a co-pay!

 

[PrincessKsMom]

I am fortunate to gave great healthcare coverage and prescription coverage, but this is fabulous for others who are need of assistance.

 

[Forevryoung]

I recently wrote a vent on the budget board regarding my healthcare costs. I pay out of pocket for my insurance and while I have prescription coverage, my monthly costs are high.

I have found that I am ineligible for all programs based on the fact that I have prescription coverage (yet paying $110 for 2 meds). I'm feeling lucky that I can pay but in order to pay for my health care, I'm living with my parents.

Canada isn't cheaper for me- $535 ($495 in the USA, $75/month with insurance).

Nope, no generic available.

Any other thoughts?

 

[LuvOrlando]

If you pay $110 for 2 meds could you tell me how much they cost out of pocket without insurance.

I've had a hard time with our Ins for my DD because they are trying to FORCE, yes FORCE me to go with an alternative. My DD takes Flovent for Asthma and because it isn't on a list they like they are making me pay %50, $65 a month as a penalty. So what, its my money and my business right? If I'm willing to pay for our medicine who are they to tell me no. In fact, I have a right to pay out of pocket for a medication I want even if my Insurer disallows it don't I? I don't even have to use insurance if I don't want to. Case closed I thought.

Well Medco went so far as to call my Dr's last month and have an invasive conversation with OUR DR with privileged information they only have access to for processing our claims. These people have my info ONLY so they can process stuff like a bunch of accountants, the ONLY legal way they are SUPPOSED to use the privileged and confidential info on their desks is to make sure my prescriptions meet the criteria outlined in the plan, they ARE NOT allowed to evaluate my care. After talking to the Dr, THEN they called the pharmacy and had them switch to a generic. Without my permission, this company dared to step in between me and my kids' Dr AND sent me a letter telling me they did it. I called and I screamed at them for acting as a representative on my behalf without my permission, and they tell me my DH's employer gave them permission to do so. I flipped because since when does my DH's employer have the right to act as my agent?!? They have a contract to provide services to me, but it is ultimately my decision to accept those services or reject them at any given time for any given reason. I called my DH's Human Resources Dept and again, chewed an ear off. I KNOW what they did isn't legal and am still incredible ticked over it because I can only imagine how many other people they've done this to who had no idea it was a breech of Dr-patient confidentiality.

I get paying more than we want to pay for a medicine stinks, but if we want what we want that's just the way it is and nothing is going to change that. I have been toying with the idea of calling Flovent like AllyandJack did, but a part of me feels really guilty that I might be bumping someone else off the 'ok to help' list if they accept me. As long as my DD's medicine helps her I'll bite the bullet and pay, I won't like it but I'll do it.

OK, my minivent is over. THe point is I understand how frustrating things can be. THis original post is to make people aware that sometimes there might be help out there that people do not know about. Readers Digest won't help everyone, sorry it can't help you Forevryoung, but it can't help me either. Even so, if it helps anyone I think it has value and that's why I posted it.

 

[DisneyBamaFan]

If you pay $110 for 2 meds could you tell me how much they cost out of pocket without insurance.

I've had a hard time with our Ins for my DD because they are trying to FORCE, yes FORCE me to go with an alternative. My DD takes Flovent for Asthma and because it isn't on a list they like they are making me pay %50, $65 a month as a penalty. So what, its my money and my business right? If I'm willing to pay for our medicie who are they to tell me no. In fact, I have a right to pay out of pocket for a medication I want even if my Insurer disallows it don't I. I don't even have to use insurance if I don't want to. Well Medco went so far as to call my Dr's last month and have an invasive conversation with OUR DR with privileged information they only have access to for processing our claims. THEN they called the pharmacy and had them switch to a generic. Without my permission, this company dared to step in between me and my kids' Dr AND sent me a letter telling me they did it. I called and I screamed at them for acting as a representative on my behalf without my permission, and they tell me my DH's employer gave them permission to do so. I flipped because since when does my DH's employer have the right to act as my agent?!? They have a contract to provide services to me, but it is ultimately my decision to accept those services or reject them at any given time for any given reason. I called my DH's Human Resources Dept and again, chewed an ear off. I KNOW what they did isn't legal and am still incredible ticked over it because I can only imagine how many other people they've done this to who had no idea it was a breech of Dr-patient confidentiality...

If you are paying 100% out of pocket, this is not acceptable, or understandable. Why would an insurance company intervene in a stiuation in which you are paying 100% out of pocket.

However, if the insurance company is picking up any of the expense, they are going to try to intervene. They have many, many people on staff with a single role - lower their costs. If there is an option that is less expensive for them, they will push their consumers toward those options for understandable reasons.

I am not sure if any HIPPA laws were violated here. Something worth looking into...

 

[LuvOrlando]

Oh yeah, this was wrong. Not only were all sorts of HIPPA laws broken, but even before HIPPA, it was illegal for anyone to #1, intercede on behalf of an adult as if they had power of attorney without permission #2, use privileged and confidential information for any purpose other than it's intended use.

 

[LuvOrlando]

If you want less expensive drugs, order them on-line from Canada. Over 12 million Rx filled per year at tremendously lower prices...

Isn't this illegal though? I mean, I know lots of people do it, and I know some feel they have no choice but for me, I'd be worried that the safeguards we have here don't exist there. What about the fact it's transported through the mail. Doesn't that make it a felony? Or is it ok as long as you have in your possession a US Dr prescription?

I'm not judging or telling anyone what to do, I'm just wondering about our laws. Of course, if I was ever denied being able to get what I want here I'd be the first one to take medical trips out of the US for my Asthmatic son no matter what the cost. I predict a new kind of tourism probably to Mexico but maybe to Europe where the big Pharmas are as as our hospitals & Dr's drift over the borders so don't take this as a criticism. It would be the next BIG thing, move over dotcoms... I see an emerging industry in the making.

Right now the Walmart $4 program (too bad they outlawed the $4 Albuterol though- now you need to pay $50 or more for the 'new' formula), and these outreach programs cited in Readers Digest are a help. I hope they are expanded.

 

[DisneyBamaFan]

Isn't this illegal though? I mean, I know lots of people do it, and I know some feel they have no choice but for me, I'd be worried that the safeguards we have here don't exist there. What about the fact it's transported through the mail. Doesn't that make it a felony? Or is it ok as long as you have in your possession a US Dr prescription?...

Here is an article that discusses it - link...

But is it legal to buy medications from Canadian pharmacies? The answer is, technically no, but U.S. officials are allowing it to happen.

Under the Prescription Drug Marketing Act of 1987, it is illegal for anyone other than the original manufacturer to bring prescription drugs into the country. However, federal officials have decided to exercise "enforcement discretion" in dealing with prescription drugs brought across the border, provided the drugs are not narcotics or other controlled substances. This means that as long as a person brings back no more than a three-month supply for personal use, border officials generally look the other way, Thomas McGinnis, director of pharmacy affairs for the U.S. Food and Drug Administration (FDA), told the Milwaukee Journal Sentinel in March 2001. Patients generally may order refills in amounts up to a three-month supply without interference.

What about ordering over the Internet? Prescription drugs cannot be legally mailed into the United States by foreign "e-pharmacies." But here again officials are employing "enforcement discretion," preferring to use limited resources to crack down on large commercial drug supplies and narcotics, not prescription-drug shipments for personal consumption. Thus, customs officials allow the companies to mail up to 90-day supplies of medications.

Canadian drug retailer RXNorth.com recently told a Wall Street Journal reporter that only 1 percent of the 1,500 prescription drug orders it ships to the U.S. each day is confiscated at the border and returned to the company. The firm simply repackages the shipment and resends it.

Congress thought it had cleared up some of this legal ambiguity in 2000 by passing the Medicine Equity and Drug Safety Act, which allows prescription drugs from certain foreign countries to be sold to American consumers. However, Secretary of Health and Human Services Tommy Thompson has refused to implement the act, saying it would increase public health risks.

In the meantime, the FDA is being realistic. "We urge people not to import foreign drugs,” the Wall Street Journal quoted a “senior FDA official” as saying. “That said, if people are going to go ahead and order drugs outside the U.S., they''re better off getting them from Canada than from a country like Thailand or Mexico. At least Canada has drug regulations and testing systems that are comparable to ours in the U.S., which makes it a little safer."