Asthma Medication Question

[asta]

I am waiting on CVS/Caremark to open after the weekend to get the real answer but thought it might help with my frustration to see if anyone here can help. After trying to stop a horrible cough that has lasted well over a year my doctor now thinks I have asthma. I am taking every sinus medication available, have been receiving allergy shots for a year, had two chest X-rays and even had surgery last year to open my sinuses and clear out any infection. This still did not help that much with the cough. I don't know why it took so long but the doctor gave me a corticosteroid injection a week ago and the coughing stopped almost immediately. Apparently that told him that my problem is probably asthma and an inhaler is much better at delivering the steroid than an injection. My problem is with the cost of the inhaler. I just picked up my prescription from CVS and the cost was over $120. I have a drug plan and none of my drugs ever cost that much. The steroid shot only cost $35. Anyone else use an inhaler and does this cost seem right? I keep wondering if the drug plan is not covering the asthma medicine for some reason.

 

[BigAlsGal]

It all depends on your insurance. I pay for a 3 month supply at a time for advair. The copay is 25% with a cap of $200 per refill. I pay the cap each time. I calculated each one at $273 for a 1 month supply at full price. They are VERY expensive. With insurance I pay about $66 a month.

I really have no idea about the shot.

I have cvs/Caremark too. If it's the same as mine if you don't get a 3 month supply your cost is 50%. You only get 25% with 3 month supply.

 

[kimblebee]

Yes, that's the correct cost. My suggestion is to look for a REPUTABLE, LEGAL online pharmacy. You can find your meds a lot cheaper and it's all legal. Do your research though..

 

[mjkacmom]

That sounds right. As soon as we reached our deductible last year, my pediatrician prescribed a few for us. The school makes me keep a separate one for each of my twins at the nurse, plus soccer and dance bags.

 

[Kellydelly]

Unfortunately that does sound right. My prescription coverage sucks and I have to pay $50 copay for my asthma inhalers, which I use pulmicort and ventolin. It's a total racket, because there are no generic inhalers that I am aware of, which is ridiculous considering the amount of people suffering from asthma and other respiratory illnesses.

 

[RitaE]

Unfortunately that does sound right. My prescription coverage sucks and I have to pay $50 copay for my asthma inhalers, which I use pulmicort and ventolin. It's a total racket, because there are no generic inhalers that I am aware of, which is ridiculous considering the amount of people suffering from asthma and other respiratory illnesses.

That could likely be the OP's problem. My Mom gets an inhaler prescribed for her breathing problems. The medication itself hasn't changed in decades but a couple of years ago something happened with the inhalers that made it impossible to get a generic version anymore. My Mom's cost over doubled for the exact same medication.

 

[Christine]

OP, does your insurance offer no coverage on these things?

My son gets the ProAir inhalers (rescue inhalers). My doctor presribes a 90 day supply which gives him three inhalers for about $50.

The Advair (which is not a rescue inhaler) goes for about the same, although it is a more expensive drug.

One other thing--don't just assume you have asthma. Quite honestly, you could have had whooping cough which will leave you coughing for a year. Make an appointment with a pulmonogist and go have the breathing tests done. You can work with that doctor to make sure you're on something that's correct for your condition.

 

[Christine]

That could likely be the OP's problem. My Mom gets an inhaler prescribed for her breathing problems. The medication itself hasn't changed in decades but a couple of years ago something happened with the inhalers that made it impossible to get a generic version anymore. My Mom's cost over doubled for the exact same medication.

They took the CFCs out (the inhalers were partly a problem for the hole in the ozone). When they did that, I guess it changes the patents on the formula. One day we will get the generics back!

 

[asta]

OP, does your insurance offer no coverage on these things?

My son gets the ProAir inhalers (rescue inhalers). My doctor presribes a 90 day supply which gives him three inhalers for about $50.

The Advair (which is not a rescue inhaler) goes for about the same, although it is a more expensive drug.

One other thing--don't just assume you have asthma. Quite honestly, you could have had whooping cough which will leave you coughing for a year. Make an appointment with a pulmonogist and go have the breathing tests done. You can work with that doctor to make sure you're on something that's correct for your condition.

That is part of my confusion. I have CVS/Caremark insurance for prescription drugs. I have had this for years and covered drugs have never been this expensive. Just last week I had three sinus medications refilled for about $12 total for all three. The $120 for this single drug just seemed out of line.

The asthma diagnosis kind of surprised me. I have suffered with sinus and histamine problems for many, many years. I have coped by taking every possible medication until this cough started about 20 months ago and it just would not go away. It was so vicious and disruptive I could not sleep many nights and had to stop going places. My ear, nose and throat doctor gave me the corticosteroid injection. The relief from the cough was so instantaneous that both he and my general care doctor said they think it is asthma and want me to inhale the steroids instead of an injection which could cause complications.

 

[longboard55]

ok here is my too much information story. I had the slightly high PSA found out it was a little prostate cancer and had surgery, so afterwards Viagra is your best friend, which is very expensive and hard to get thru insurance. Like all things today we get support on the internet message boards, reading from the guys you find out I would say just about everyone goes the India pharmacy route. Price goes down from like $30 to 50 cents, SO now I also get inhalers there and those disk things, plus anything else we need. The sell most things but not any kind of sleeping pills or depression meds. Its called Alldaychemist. They are a little sticky with credit cards but the echeck things work. Asthma is about their biggest product

 

[lvillotta1]

I am a nurse at an Allergy asthma office. INHALERS in general are all wicked expensive!!!! My first recommendation is to call the drug makers of the inhaler and ask if they have a co-pay assistance card. Most all companies have these. We give them out all the time to our patients. Some are pay as little at $15 for a year etc. The Proair now comes in a respiclick and at our office we have a copay card that will give a patient a free one every year. Each drug company has their own copay cards. We as consumers must become much more educated on how to get our meds cheaper. If you call these companies you can also ask about financial assistance to afford the med and she what they have to offer. But you must do the work. One last thing I will say is if you are fillings meds at Walgreen's,CVS,grocery store chains they are the HIGHEST priced places in the city and the 1 reason is for CONVENIENCE!!!!! Sams and Costco are the cheapest places to get you meds. The cost difference is substancil often times saving over $50-100 per drug. You do not need a membership to use the box bog clubs. Yes you do have to go in and wait for your first prescription,but after that you can call in the refill and will be ready for you when you arrive. They will take all copay cards and insurance. Please spread this message to all of your friends and families. We as consumers are being eaten alive with healthcare costs and prescription costs to the point of not being able to have insurance or afford our meds. A $200 inhaler would be grocery money for a family of 4 for 2 weeks.

 

[Christine]

I am a nurse at an Allergy asthma office. INHALERS in general are all wicked expensive!!!! My first recommendation is to call the drug makers of the inhaler and ask if they have a co-pay assistance card. Most all companies have these. We give them out all the time to our patients. Some are pay as little at $15 for a year etc. The Proair now comes in a respiclick and at our office we have a copay card that will give a patient a free one every year. Each drug company has their own copay cards. We as consumers must become much more educated on how to get our meds cheaper. If you call these companies you can also ask about financial assistance to afford the med and she what they have to offer. But you must do the work. One last thing I will say is if you are fillings meds at Walgreen's,CVS,grocery store chains they are the HIGHEST priced places in the city and the 1 reason is for CONVENIENCE!!!!! Sams and Costco are the cheapest places to get you meds. The cost difference is substancil often times saving over $50-100 per drug. You do not need a membership to use the box bog clubs. Yes you do have to go in and wait for your first prescription,but after that you can call in the refill and will be ready for you when you arrive. They will take all copay cards and insurance. Please spread this message to all of your friends and families. We as consumers are being eaten alive with healthcare costs and prescription costs to the point of not being able to have insurance or afford our meds. A $200 inhaler would be grocery money for a family of 4 for 2 weeks.

Some of us have insurance that mandates we go to CVS/Caremark. I know that's what I have to do. It doesn't matter to me because I have a very straightforward copay and it is the same no matter where I go. When I buy my pet's meds (that are human meds) you can bet I'm doing it at Costco, Walmart, etc.

 

[asta]

Some of us have insurance that mandates we go to CVS/Caremark. I know that's what I have to do. It doesn't matter to me because I have a very straightforward copay and it is the same no matter where I go. When I buy my pet's meds (that are human meds) you can bet I'm doing it at Costco, Walmart, etc.

Likewise my insurance company mandates CVS/Caremark. I do definitely need to become more educated. It appears that I may be able to buy this medicine out of pocket cheaper than with my insurance. I intend to find out.

Thanks for the information everyone. I will be able to have a much better conversation with Caremark tomorrow.

 

[mommysaurus]

Yes, that seems right. My son has serious asthma and I have to leave one at school and one at daycare. I also keep one with me and keep one at the house for babysitter,etc. it's crazy!!!!

 

[mom2grace]

Some of us have insurance that mandates we go to CVS/Caremark. I know that's what I have to do. It doesn't matter to me because I have a very straightforward copay and it is the same no matter where I go. When I buy my pet's meds (that are human meds) you can bet I'm doing it at Costco, Walmart, etc.

I have CVS/Caremark but can get my meds filled anywhere. For a long time I assumed I had to use CVS, I don't. YMMV.

 

[disfan07]

I have CVS Caremark and I take xoponex HFA, symbicort inhaler, pulmicort flexhaler, pulmicort nebs, and xoponex nebs. None of my asthma inhalers have ever cost us that much.

CVS will allow 1 initial prescription and 1 refill at somewhere other than CVS. But if it's a maintenance med, they will not pay for it through anyone but CVS.

But honestly, unless you have like minimum prescription coverage, that price sounds like CVS trying to rip you off. We've had a lot of issues with them trying to overcharge us. Honestly, I despise CVS.

 

[Optimouse Prime]

I've actually been through this a few times, so hopefully this information will be helpful!

I'm not sure about the details of your drug plan, but most insurance plans have what's called a formulary list. Long story short, drugs that aren't on the formulary list tend to cost more. I've switched medications twice in the last few years because the drugs I'd been using went off that formulary list for one reason or another. Most customer service reps with insurance companies are really good about helping you find alternatives that are on the formulary and will cost you less money. Right now I use an inhaler called Symbicort and it runs about $63 for a three month supply on my plan, and from my understand it's pretty common on most formulary lists at this point, but your plan might have something different. Let your doctor know what's going on, and I'm sure they'll be more than happy to help you find a solution that works for you.

Hopefully you'll find a medication that works for you and won't break the bank. I got a surprise adult onset asthma diagnosis several years ago so I know how difficult it can be. I'll be keeping my fingers crossed that you can get this all sorted out!

 

[Christine]

I have CVS/Caremark but can get my meds filled anywhere. For a long time I assumed I had to use CVS, I don't. YMMV.

If I only need a short supply of something (antibiotic, painkiller, prescription antihistamine) and it is not a recurring med, I can also go anywhere. The minute I get a second supply, I get a letter from them saying that if it will be a recurring prescription, I must use mail order or long-term order through CVS/Caremark. I cannot go to Target for my Synthroid, my son's asthma meds, etc.