OT: Expensive Prescription

[schoen]

This is somewhat related to Disney for me, because if I can't figure this out, I won't be able to go to Disney!

My doctor prescribed me Nexium for some problems I have been having with acid reflux. While I do have prescription coverage, my insurance will only cover nexium if I have a diagnosis of cancer, which I don't.

The retail is about $250 a month, which is A LOT for me. Do I have any options? Are there programs that could help me?

The drug company will give me a $50 off card for the first 12 months, but $180 is still pretty darn expensive.

any thoughts? suggestions?

 

[starry_solo]

Generic version? Oops, saw there isn't one.

See if the doctor can prescribe the medication that has the active ingredient of Nexium and see if that will work.

 

[sunshine1178]

See below. Not loving my iPhone today.

This is somewhat related to Disney for me, because if I can't figure this out, I won't be able to go to Disney!

My doctor prescribed me Nexium for some problems I have been having with acid reflux. While I do have prescription coverage, my insurance will only cover nexium if I have a diagnosis of cancer, which I don't.

The retail is about $250 a month, which is A LOT for me. Do I have any options? Are there programs that could help me?

The drug company will give me a $50 off card for the first 12 months, but $180 is still pretty darn expensive.


1. Ask your doctor for samPles at every visit.
2. Ask your doctor/pharmacist for less expensive alternatives.
3. Ask your doctor for a 90 day prescription and price that out.
4. Price compare at different pharmacies. SAMs Club is usually the least expensive near me, and I have heard that legally they must also service non-members.
5. Check into mail order. My prescription insurance is significantly cheaper for their mail order pharmacy. ($25 for 90 days mail order or $20 for 30 days retail for one of my Prescriptions.)
any thoughts? suggestions?

 

[Wish I lived in Fl]

I think insurance won't cover it because there are less expensive or OTC drugs for reducing stomach acid. They might cover it if the Doctor is willing to send a letter stating why this drug is preferrred to less expensive options.

My insurance usually won't cover Accolate but after the Pulmonologist wrote a letter why this prescription was necessary rather than Singulair they have covered it ever since, for several years now.
Best of Luck!

 

[Ahrizel]

My suggestion is that you ask your doctor about prilosec instead. The 2 drugs are closely chemically related, and the older, cheaper, and available in generic otc version may work just as well for you. My husband takes it for acid reflux/gerd issues. It would certainly be worth a try. The generic versions run around 18-25 a month.

 

[teacup princess]

Yes. Try the Prilosec first.

 

[fireman26m]

Also ask your Dr. about Dexilant. It's fairly new and expensive but it should be covered and has worked for me whereas all the others have failed to control my Gerd/reflux.

 

[MomRN]

At my hospital if a patient takes Nexium they substitute it for Prilosec. If the patient wants Nexium they have to bring it in from home.

*not medical advice. You should check with your dr to see if the option is available.*

 

[walkdmc]

Talk to your doctor about this issue.

Prilosec and Prevacid are in the same class as Nexium and they are over-the-counter and less expensive than prescription Nexium.

Zegerid is another such med and is OTC. I recently saw some $6 coupons for that floating around. There is a lot of sodium in Zegerid so you have to be careful if you have high blood pressure.

 

[crisi]

I'd recommend figuring out why you have reflux if you don't know and then solving that rather than trying to cover up the symptoms. Mine was gluten intolerance, but a lot of food intolerances/allergies can cause reflux. So can ulcers.

 

[muffyn]

This is somewhat related to Disney for me, because if I can't figure this out, I won't be able to go to Disney!

My doctor prescribed me Nexium for some problems I have been having with acid reflux. While I do have prescription coverage, my insurance will only cover nexium if I have a diagnosis of cancer, which I don't.

The retail is about $250 a month, which is A LOT for me. Do I have any options? Are there programs that could help me?

The drug company will give me a $50 off card for the first 12 months, but $180 is still pretty darn expensive.

any thoughts? suggestions?

my insurance company did the same.

but..

they gave me an alternative. a FREE generic from rite aid. i was on nexium for 4 years. TWO pills a day ( usual dose was one) & was pretty skeptical about the generic, but it works great!!!
& even if you have to pay for it, I think its $24.

don't ignore the gerd.. & if you have it for several years even treated, you need a scope to check for barrets esophagous ( precoursor to cancer)

 

[tigger51276]

I've been on gerd meds since I was 19, so close to half my life and Nexium is by far the one that has worked the best and the easiest for me to swallow as the reason for my gerd is I have no working muscles in my throat so swallowing is not an easy thing. My insurance company BCBS MA gave me lifetime approval for Nexium a bit over 3 years back as they do not normally cover it, well about 6 or 7 months back I got declined when I went to pick up my prescription and when I called they said they had changed their minds as their policies had changed. My doctor has written numerous letters and they refuse to do it. With the generic more than half the time I vomit them up so they are not effective. I have been milking the one bottle of them I have left and my gerd has been getting progressively worse...not sure what to do once I am out completely. You would think that they would rather cover the meds rather than face the large payments when one lands in the hospital because they aren't on meds that actually work for them.

 

[cm8]

Also ask your Dr. about Dexilant. It's fairly new and expensive but it should be covered and has worked for me whereas all the others have failed to control my Gerd/reflux.

DId you know that Dexilant was first named Kapidex when it first came out , The name was changed due to the mix ups that use to occur when it was prescribed to patients

OP, I have tons of Nexium where I am at. We give them away all the time. I wish that I could help you out. I would ask your Doctor to get you some samples and lots of it. We sometimes use the samples to see how our patients will react before we write a script. I usually load my patients up if it is a drug that I like and know that it will help them in the long run. I also prescribe the generic form too if they have to get it out in town because we don't have it in our formulary Priolosec was the original purple pill. I would try that if you have too

 

[pampam]

I'm not sure if this is the kind of help you were needing or not but I thought I'd throw it in anyway.

I too had acid reflux and was on prescription for it. I was told it was caused by a hyatius hernia. I also had Chrones disease. They were not connected. I went on the Specific Carbohydrate Diet (SCD)for the Chrones and it fixed it, but also cured the acid reflux, as well as stopped my arthritis. I now am on no medication for these things. It's something you might want to look into.

 

[mjkacmom]

My suggestion is that you ask your doctor about prilosec instead. The 2 drugs are closely chemically related, and the older, cheaper, and available in generic otc version may work just as well for you. My husband takes it for acid reflux/gerd issues. It would certainly be worth a try. The generic versions run around 18-25 a month.

I complained about the price of Nexium to my GI, and he told me that his patients have had great success with prilosec, and even the generic costco version. I switched over, and the costco ones works GREAT. The problem now is that I will only use costco's, because it's so much cheaper, so I have to time it right (if I go without, by day 3 I feel horrible!).

 

[SYDCOLEMOM]

At Costco the cash price for a 30 day supply of Nexium is $186.60. You could use the $50 off card you mentioned to bring it down to $136.60 a month. Thats assuming you have a Costco nearby. Sams club should be pretty close as well. Not great but it helps. I agree , try some other alternatives first.

 

[princessmom29]

I'd recommend figuring out why you have reflux if you don't know and then solving that rather than trying to cover up the symptoms. Mine was gluten intolerance, but a lot of food intolerances/allergies can cause reflux. So can ulcers.

and some cases are medical and need to be treated with medication. You cannot fix everything by changing your diet.

 

[Mrs. Bradbury]

I agree with the PPs who have suggested Prilosec. When Nexium first came out I was on a program to get it for free for a year; the maker ended that with no reason given after 6 months or so. My doctor suggested Prilosec; he said that since the drug company was losing their patent on Prilosec they changed one molecule and "voila!" they now had a new drug they could patent and make more money on. According to him there is very little difference.

I'm sure many are different, but it appears most doctors are herded like sheep by the drug companies these days. An example - my husband had a severe allergic reaction just recently and went to the doctor and got a steroid shot. Then he was told to get some Allegra and take it as needed. My husband didn't ask but I immediately thought it was odd, considering benadryl is a much more effective antihistamine and is cheap to boot. Yes it makes you drowsy but he wasn't going anywhere in his condition anyway! Why Allegra? Because it's new. What do the drug companies do for the doctors so that they will suggest particular OTC meds, I wonder?

 

[2disneyboys]

I was diagnosed w/ GERD last year and a SCOPE showed that I have barrets esophagous. My insurance wanted to fight over Nexum. My Dr put me on prilosec (the OTC strenght 2 x a day) and that worked fine. I asked him to give me a prescription for it as it would be even cheaper for me.. I think I was paying around $30 a month for the OTC, and now thru my insurance mail in program, I get a 90 day supply (180 pills) for $10.00

I would ask your Dr if there is anything else he can try first (assuming you haven't already been through all the other versions) and if not, can he write a letter to your insurance company (and in the meantime hook you up w/ lots of samples!)

 

[crisi]

and some cases are medical and need to be treated with medication. You cannot fix everything by changing your diet.

ABSOLUTELY, but you also don't want to cover up symptoms if what there really is is a problem that can be solved by something like a dietary change. Or something that needs to be corrected with something like surgery.