Stupid expensive prescription meds!

[Jennasis]

So I went to refill my migraine medication today. 8 little pills and it cost me $35 My insurance company refuses to allow me more than 1 refill per month of that prescription. However, I have had refills of Xanax (anti-anxiety) and Untracet (pain meds that I could probably sell on the street) at 30 pills for practically nothing (like $5) . How can they justify charging me $35 for 8 pills for a migraine medication but a potentially addicting "street" drug is cheap and handed out willy-nilly...Sheesh! I guess they've never had migraines at blue-cross.

 

[Rafiki Rafiki Rafiki]

The medical community seems to believe that if you're taking more than a couple of migranes a week that you need to be on a prophylactic medication for migranes. I tend to agree...especially because of the side effects of many of those drugs.

Is that prescription your cost share for the medicine? My migrane medication was significantly more expensive than yours...

Do you know what causes your migranes? For many women, it's hormonal. For me, it was allergies to milk and eggs. I was reluctant to take my Relpax because I didn't want to accept from the neurologist that I just had migranes without a cause...and give in to take these drugs that brought my day to a screeching halt.

OK, and here's my last thought on the subject. The high cost of prescription medications keeps many of us from being well, and that's a shame. I think we need to stand up to the drug companies and make some changes about the way they do business....

 

[cepmom]

can you fill it by mail order? I know I can have my Dr write the prescription for 90 day supply, mail it away to our mail order pharmacy and get 3 months worth for one co-pay. We have BC/BS too.

 

[beckmrk04]

I totally sympathize- I have had the worst go-rounds with my insurance companies about my migraine meds.

Can you have your Dr. prescribe you more pills- I found out that no matter what # of pills I was getting, I still paid the same amount.

I'm sorry!! I know how it feels, literally, and it sucks.

 

[aprilgail2]

I have to pick up a prescription for my mom tomorrow....its for 16 pills and its 300.00+ ...so much for the great medicare part D plan that the government is shoving down our throats as a "great" plan!! and that is just ONE of them..she has 3 or 4 others that are over 200 each month too!

 

[HaleyB]

Yeah, I fill pain RX's that have a street value over $800 every month (I am guessing based on internet prices) with no problem, but my darn Thyroid meds get rejected by insurance. At least they are cheap.

Is it Ultracet (the OP pain med?) you are filling? That is one I take a lot of.

 

[Feralpeg]

I totally sympathize. I just took my DD off an antibiotic that her dermatologist prescribed. The generic version would cost me $200 a month. My insurance will not cover it because it is considered cosmetic.

 

[Talking Hands]

I just paid $152 for a months worth of Zocor. that's about $5/pill. And I pay all of it as I don't currently have insurance. And that is only 1 of 7 medications I need daily. Having chronic illness is not easy and is definately expensive.

 

[laurie31]

Our insurance changed its prescription coverage this year and we just had DH's stuff filled for the first time (we do the 90 day mail order thing). His anti-inflammatory went from $40 to $150 because it wasn't on the "approved" list.

I immediately called the company to see what was comparable that was on the list. They had two similar drugs that were only $20 - so he will call his doc to see if he can switch. It's pretty sad when insurance co. instead of the physician can choose which drugs a patient can have.

Laurie

 

[beckmrk04]

Our insurance changed its prescription coverage this year and we just had DH's stuff filled for the first time (we do the 90 day mail order thing). His anti-inflammatory went from $40 to $150 because it wasn't on the "approved" list.

I immediately called the company to see what was comparable that was on the list. They had two similar drugs that were only $20 - so he will call his doc to see if he can switch. It's pretty sad when insurance co. instead of the physician can choose which drugs a patient can have.

Laurie

That is sad. My ins. co. wouldn't approve my migraine meds (maxalt) because, "I hadn't tried anything else." WHAT?! They had only been my ins. co. since I had been married. I had all my previous paperwork faxed from my other dr's and my neurologist to show them all the different meds I have tried, and finally they agreed to pay for it, but it was a total hassle.

I think it is so wrong, though, that they can tell you what you can take, ESPECIALLY when you are lucky enough to find something that works!!!

 

[barkley]

i've got 3 meds for migranes-1 if it starts during the day (has major caffiene as one of the componants so if i take it after around 3pm i can count on NO sleep all night), 1 for late day/evening use (vicodin-but i don't find it does much but somewhat dull the pain), and my "big gun" a morphene based supposotory which i can only get 6 per perscription 4 times per year.

the insurance company did'nt want the doctor to give me a perscription for more than 1 at a time, and then wanted to charge something like $35 for that 1. my doctor pointed out that sometimes (thankfully rarely) i might need as many as 2 during a few day period and since the perscription can't be called in to a pharmacy (triplicate copy because it's considered a "controlled medication") and the alternative was for me to go to the e/r and get the same meds at several hundreds of dollars for the e/r visit (and he pointed out the dates this had happened wherein they did pay that much out). insurance company finaly gave in and said they would allow it as "cost effective"-so i get 6 and pay around $35 total (and they still get off cheap cuz i rarely need to refill as often as i am eligible).

meds are horribly expensive, i'm very thankful for good perscription coverage (and a proactive doctor who knows the nuances of negotiating with my insurer). i feel tremendous sympathy for those without perscription coverage, or those (like some parents of friends) whose coverage has been slashed such that their co-pays have gone up 500% this year as well as having the majority of their maintainance drugs removed from coverage (but their coverage is still considered better than medicare part d so they can't take advantage of that either).

my mother in law ended up in a wierd perscription delemia a couple of years ago-she had a surgical procedure that required some drugs to be perscribed for her to use upon release. none of her insurance company's contracting pharmacies permitted one of the drugs to be given directly to a patient (had to be medicaly supervised)-despite her surgeon and her doctor arguing that she was entirely capable of self administering (she's a retired r.n.) they would'nt budge. the insurance company would not reimburse if she went to an uncontracted pharmacy (some of which routinly did via perscription), so when she found out it would either be a couple hundred dollars of unreimbursed co-pays for the drug vs. a $10 co-pay for her to go to the e/r and receive it-she opted to go to the e/r...twice a day for the 5 or 6 days until her insurance company realised what it was costing them (over 10K at that point) and made quick arrangements for one of their non-contractors to provide the meds and bill them directly.

seems like more often than not-money talks more effectivly with regards to "bending the rules" in these matters

 

[stacy347]

Jennasis ~ I can completely relate to what you are saying!!

I am on Nexium daily (can NOT use anything else...they've tried me on all of the others to no avail). Now, the co-pay on this one is currently $10 BUT we were just notified recently that DH's employer is no longer going to cover Nexium as of June 2006 ~ one month's supply is over $130 and I can not use anything else so of course I'm stuck.

Also, I was down at my sister's and forgot to take my Nexium with me ~ so I called her local branch of my pharmacy to just get one refill transferred over (I seriously can't eat anything without my meds) and they said it was too soon and they put a flag in the system that I was a possible abuser of the meds, LMBO ~ it's NEXIUM for crying out loud ~ not sure what kind of kicks they think people are getting off of an acid reducer
Anyway, they did let me buy 2 of the pills but it was $15 for those 2 pills!

 

[nliedel]

I am with the OP. If it was not for my prescription plan I would not be able to afford my meds.

 

[Jennasis]

I should clarify..Thanks to a very good nuerologist, I am on a "profylactic" medication for my migraine (Topamax) which so far has been quite effective at controlling the majority of my migraines and is covered by my insurance thank God (though is a 3rd tier drug and still an expensive co-pay at $35 a refill). But I do still get an occassional migraine and need the "rescue" med (my Axert)...which I am only entitled to 8 pills of, according to my insurance conpany...at $35 a refill.

The Ultracet was a pain med my primary doc had prescribed WAY back last summer before I found the nuerologist and had the migraines diagnosed. I was desperate to get the pain to stop and begged the doctor to give me SOMETHING to help (the ultracet didn't touch the migraine pain). What I am amazed at is why they are practically hoarding the migraine pills like they are gold, but are handing out a huge bottle of Ultracet or percocet, or oxycodon or other pills that people could really abuse???

 

[Christine]

The Xanax and Ultracet are so cheap because they have been around forever and have gone generic a LONG time ago. The stuff is dirt cheap now. The migraine meds (you sound like you're talking about Imitrex) are still in brand name form. Even when they go generic, they will still be pricey at first. In about 20 years, they may be cheaper.

 

[Jennasis]

Not Imitrex. I said it was Axert.

Maybe we'll just move to Canada....

 

[puffkin]

I was on Zofran for extreme morning sickness at the beginning of my pregnancy. It was approx. $33 a pill, and I took 3 pills a day. Thank god my prescription plan covered it because it was a true lifesaver for the few months I needed it. My copay was $27 for each refill (every 5 days) but that was a lot better than the actual cost. I would not have been able to use it if I didn't have insurance and there is no generic for it yet.

The drug was initially intended for chemotherapy patients to help with naseau from their treatments. It is a shame that such a great drug that could help ease the pain of so many is so expensive. I am sure many insurance companies would not cover it, so I feel pretty lucky.