Insurance company

[The Mystery Machine]

$570 for 100 pills would be worth it. My friend had horrible morning sickness with her pregnancy and her meds (zofran) were $700 for TWENTY PILLS.

I would pay if it kept me out of the hospital for sure.

In fact, I would tell you to go shop this med and I am serious. Walgreens, local grocery or drug stores have "prescription cards" you can buy for a single med. I have my dog on Prozac and it is 20 bucks for 180 pills.

If you are close to Canada, I would drive and get the med.

Congrats!

 

[mnrose]

I would pay if it kept me out of the hospital for sure.

In fact, I would tell you to go shop this med and I am serious. Walgreens, local grocery or drug stores have "prescription cards" you can buy for a single med. I have my dog on Prozac and it is 20 bucks for 180 pills.

If you are close to Canada, I would drive and get the med.

Congrats!

Canadian pharmacies will also mail them to you.

 

[The Mystery Machine]

Canadian pharmacies will also mail them to you.

Really? How do you get a legit pharmacy online if you do not know squat about Canadian pharmacies?

 

[mnrose]

https://www.cipa.com

Start here.

And, here:


https://www.pharmacychecker.com


It's not that hard.

It benefits higher priced US pharmaceutical companies to have you believe that it isn't "safe" when in fact the drugs can come from the exact same place. My MIL is a registered pharmacist and worked for many years in US pharmacies. Once she retired, you know where she purchased her drugs? Mexico.

 

[A. Mara Ziwadie]

I have morning sickness issues. Have with each kid. Have had hyperemesis each time. It isn't pretty or fun.

Dr gives me a sample pack of diclegis (only FDA approved morning sickness med). It works! I still feel sick almost constantly, but am able to keep most down. Hallelujah! !

So, I call the doctor to get a prescription. She calls me back. My insurance doesn't cover it and it can cost as much as $570/100 pills. She goes on a tangent all but cursing drug companies and insurance companies and everything. There's an option for preauthorization, but I need to prove I've tried other alternatives first and they still usually do not approve it. She told me to take unisom and Vitamin B6, as that is essentially the make up of diclegis. I intend to try that and hope it works.

I'm just so angry! I have ended up hospitalized multiple times in each pregnancy because of my severe morning sickness. And the insurance company had the cajones to say that a medicine that actually helps me isn't necessary.

Thanks for listening to my angry rant!

I am so sorry to hear that. I had to take something once and need a prior authorization. It was for eye drops. The doctor had to write a letter indicating that I had tried three different OTC eye drops that didn't work. I don't think he was happy about it, though. But hey, he's the doctor. That's what you do. Going on a tangent about insurance companies isn't worth it. That's how she feels, but that's not going to help your problem

What struck me with your post is that it seems your morning sickness is crippling your life. If that's the case, try the alternatives very quickly, and if they don't work, just tell her.

 

[maxaroni]

My moms doctor gave prescriptions to be ordered out of Canada. It wasn't for everything but one of her meds was super expensive in the US and she was in the Medicare "donut hole". The doctor gave her a couple of recommendations, as well.

 

[kimblebee]

If you are going to use an online pharmacy

1- make sure they require a prescription

2- make sure they are certified and follow FDA regulations

3- make sure all prices and pertinent information (drug name, brand name/generic name, originating country) are clearly stated.

I won't give a specific name, but look for the largest Canadian online pharmacy and you won't go wrong..

 

[AquamarineSteph]

I'm so sorry for what you're going through! I hope your new combo works for you! I used to work in a pharmacy, and we would often have to make multiple phone calls to PBM's, doctor's offices, etc., trying to help a patient obtain the medication which their doctor had prescribed for them. It was heartbreaking to hear a person who didn't have a fraction of knowledge about medications (often they couldn't even pronounce the drug correctly) telling you that a person didn't need it because it wasn't on their formulary.

Congratulations on your exciting news, and I wish you nothing but joy and happiness with your baby!

 

[MamaBelle4]

This is my second day taking the b6 and unisom and it *appears* to be working just as well as the diclegis!

Thank you all again for the advice, kind thoughts and well wishes!

 

[mom2rtk]

This is my second day taking the b6 and unisom and it *appears* to be working just as well as the diclegis!

Thank you all again for the advice, kind thoughts and well wishes!

That's great news! I hope it continues and gives you a much needed break.

Your example is why insurance companies make people jump through hoops. The $500+ drug should never have been first line.

 

[MamaBelle4]

That's great news! I hope it continues and gives you a much needed break.

Your example is why insurance companies make people jump through hoops. The $500+ drug should never have been first line.

I really wish I would've known about the B6 and unisom years ago. Would've saved me A LOT.

 

[MamaBelle4]

That's great news! I hope it continues and gives you a much needed break.

Your example is why insurance companies make people jump through hoops. The $500+ drug should never have been first line.

Although that does raise an interesting point. How does a drug company justify charging $570 for 100 pills when I can get the exact same thing over the counter for $15?

That kind of greed is inexcusable.

 

[mom2rtk]

Although that does raise an interesting point. How does a drug company justify charging $570 for 100 pills when I can get the exact same thing over the counter for $15?

That kind of greed is inexcusable.

Part of the cost is what it takes to develop new drugs. If the Unisom/B6 combo didn't work for you, I'm sure you'd be happy to have an alternative available.

Part of the issue is having a 3rd party paying in most cases. If the drug was part of your plan and had a $15 copay, you wouldn't have noticed or cared (nobody would) that the cost was $570.

That said, I won't defend the drug company. I can't defend the indefensible.

 

[SMD]

$570 for 100 pills would be worth it. My friend had horrible morning sickness with her pregnancy and her meds (zofran) were $700 for TWENTY PILLS.

My thought when I saw that price was I was quoted $30/pill for Zofran and my insurance covers it at $7/pill for a max of 5-7 pills at a time. $5.70/pill sounds like a steal. Getting 30 pills at that price wouldn't be so bad.

 

[cabanafrau]

Did the insurance company say it is not necessary or that it is not covered? Each company develops its own formulary of what they will cover and what they won't. This is done to try and keep costs down. Too many new (and expensive) drugs are simply the old ones with a minor change in the chemical composition. If the old one works almost the same as the new one and is half the cost, that's what is covered. If the option your doctor gave you works and is less expensive, I don't see why that's a problem. The cost overruns in the health care system is what drives a good portion of the premiums up. Lower cost alternatives should always be considered first. You do have the appeal process with your insurance company. You can also ask the doctor to contact the manufacturer to see if they have an assistance program for people like you where the drug is not covered by your insurance. Congrats on the pregnancy and I hope you feel better soon.

I think this is a big misunderstanding. Insurance companies don't think they are doctors. Insurance companies only determine what they will or will not cover under their policies. If a drug's not covered and your doctor thinks it is the only option, they can appeal the insurance company, look for manufacturer discounts or you can pay out of pocket. If you end up paying out of pocket, call around (don't forget Walmart) to see where you can get the best price. Prices can vary widely based on articles that I have read in the past.

That's great news! I hope it continues and gives you a much needed break.

Your example is why insurance companies make people jump through hoops. The $500+ drug should never have been first line.

If insurance companies were really trying to look out for the good of their customers and be a part of solving the problem they would reach out to medical providers and/or their insured directly regarding opening a dialogue about some of these more affordable options and why they may or may not be helpful in a particular case. Instead insurers find it more cost effective to simply issue a denial.

 

[cabanafrau]

Solicitations are not welcome here and have been reported.

Legitimate alternatives have already been provided weeks ago for those having issues with medication costs.