WWYD (re: finding best prescription price)

[sam_gordon]

OK, I'm not sure what to do. I got put on Jardiance (diabetes medication) earlier this year. It was relatively expensive, but I found a "Discount Card" that knocks the monthly charge down to $10/month. Great! That worked for 3-4 months. Then the pharmacy I was at said "we don't accept that any more." I go to a different branded local pharmacy. "We don't accept that". At that point, I was out, so I paid full price ($50/month).

So I tried the mail order my insurance keeps pushing. Again, they wouldn't accept the discount card, but I had to get it filled, had some HSA money, so filled it. Now I'm at the point I have a couple of weeks left of the medicine, get notified by the mail order that it will be $150 for the supply. I call and say "I have this discount card from the manufacturer." "We don't accept that."

I call back to the local pharmacy "how much would this medicine be?"
"We can't tell you without an active prescription."
"Will you accept this card"
"Usually we do, but don't know without an active prescription"
GAH!

How do I find out ahead of time how much the meds are going to cost? I don't want to call my doctor, have them call in a prescription to Pharmacy A, then find out how much it costs, then have the doctor call in a prescription to Pharmacy B, rinse and repeat.

I'm sure $50/month isn't an expensive prescription to many of you. But that's not really the point.

This should be simpler.

 

[ajlsjl]

All you can do is call your prescription insurance company and ask them "I want to fill my Jardiance at XYZ pharmacy, can you tell me my co-pay?" They will tell you to the penny what your co-pay will be. As far as the coupon goes, the pharmacies aren't lying to you. Although it looks like a coupon they'll accept, they won't know that it'll go through until they run it. They need to check to make sure that there's no fine print or back-end issues that aren't immediately obvious. I'm a pharmacy technician, have been for 13+ years, so I speak from experience. You can also try calling the coupon company (there should be a phone number printed on it) and ask them if they can provide more information (i.e. which pharmacies they have contracts with, max dollar amount they'll pay, etc.).

 

[fly girl]

I have no real advice as I have not been down this road. But I will say, this is the problem:

I call back to the local pharmacy "how much would this medicine be?"
"We can't tell you without an active prescription."
"Will you accept this card"
"Usually we do, but don't know without an active prescription"

Why can't they find out how much it would be if you told them your insurance? You'd think they should be able to search and find out. Did you try Good Rx search?

If all else fails, I would actually call your doctor and explain the situation. They may know the pharmacies in the area and could direct you to the cheapest. Worth a shot to ask, they may not know but if they have a sharp office staff there is potential.

 

[kdonnel]

This should be simpler.

Yes!

It's not just prescriptions, it's virtually any medical procedure.

Try to find out how much something is going to cost before getting the bill.

I can't think of any other industry where the consumer has no idea what they are going to pay until after the procedure is completed.

 

[TippyThomas]

I have no real advice as I have not been down this road. But I will say, this is the problem:



Why can't they find out how much it would be if you told them your insurance? You'd think they should be able to search and find out. Did you try Good Rx search?

If all else fails, I would actually call your doctor and explain the situation. They may know the pharmacies in the area and could direct you to the cheapest. Worth a shot to ask, they may not know but if they have a sharp office staff there is potential.

I was going to recommend checking GoodRX as well if you haven't.

 

[sam_gordon]

Thanks for the tips, I'll try GoodRx also.

My doctor wanted to know if I'd be willing to try Ozempic.
Me: "What's the ball park cost"
Doc: "I don't know, we'll call it in and they'll tell you."
Me: "Ok, let's try the mail order." (because again, the insurance 'pushes' mail order)

A week later, the 30 day prescription gets filled, for $150! The mail order never confirmed I actually wanted to prescription filled. AND it's an injection and needs to be refrigerated. Two things, that because of my travel, I really don't want to deal with if I don't have to.

Sorry, just venting.

 

[sam_gordon]

GoodRx is $575+/month.

 

[TiggerTrigger]

Just for the heck of it, I checked GoodRX in our area and it's extremely expensive. $580 seemed to be the lowest price on there for Jardiance at pharmacies in our town. Ouch!

I would also speak to your doctor about alternatives. I have been through some of this with my daughter's epinephrine injectors. The base price of the name brand med is extremely high and the coupon discounts often don't work or don't deduct as much as they say they can. In my case, it's supposedly due to some coupon conflicts with my insurance. Some hinges on whether or not there are generics or cheaper options that would have similar results. GoodRX could still come in handy if you find a cheaper generic option. My insurance will only cover the name brand, which is significantly more expensive, but the GoodRX coupons for the generic make my daughter's meds much more reasonable. Good luck!

 

[Rogue1677x]

Yeah, I feel your pain. Even with the prescription discount card, I have an injection medication for migraines that costs me $60 per month. If I want my rescue medication, which my insurance won't cover at all because it's the same class at the injection, that will be another $1500....ha, ha.

 

[kdonnel]

GoodRx is $575+/month.

Have you been prescribed Metformin ER?

It is free or close to free from almost every pharmacy.

 

[sam_gordon]

Have you been prescribed Metformin ER?

It is free or close to free from almost every pharmacy.

Yup. On Metformin too.

 

[Dan Murphy]

For your mail order insurance, Sam, you should be able to go online to their website and price the Rx. You then know that part. Then, use GoodRx, online or app, and price the pharmacies around you. Some meds I get through my mail order insurance, others, much more expensive through my mail order, I get from local Rx's, much less expensive. And the GoodRx prices that come up online or the app are very accurate. Generally not to the penny, but really close. Another similar to GoodRx is SingleCare. Give that one a look also, sometimes less than GoodRx.

Generally though, those discount apps, like GoodRx, are not too helpful on the brand name meds. If one of my doctors gives me a new Rx, they'll ask where I want it sent. I will generally give them the name of the pharmacy I have had the most luck in pricing. Once I leave the doc's office, I will price it with my mail order (if a maintenance med) or GoodRx. If I find a better pricing, worth my time, I will go online and transfer the Rx to the lesser cost place.

Good luck.

 

[EACarlson]

Go to CVS. As long as you have commercial insurance, the price should certainly be $10/mo. That's what I pay for my Jardiance there. I've gone down that road with another medication and for a while had all of my prescriptions except one at CVS, but had one at an unbranded local pharmacy because the price was that much better.

 

[Cadiewampus]

Yup. On Metformin too.

Me as well. What dosage is the Jardiance? I was on 25 mg and my copay was $50. I had such good luck with it my doctor though we could bump it to 50mg. Co pay on that was $12.00

 

[sam_gordon]

Me as well. What dosage is the Jardiance? I was on 25 mg and my copay was $50. I had such good luck with it my doctor though we could bump it to 50mg. Co pay on that was $12.00

Just 10mg.

 

[barkley]

you might try checking with costco. we had one script for ds that the copay was more than i wanted to pay but at costco it was much less (and they do accept good rx as well).

 

[sam_gordon]

you might try checking with costco. we had one script for ds that the copay was more than i wanted to pay but at costco it was much less (and they do accept good rx as well).

Good idea, but not a costco member.

 

[Moliphino]

Good idea, but not a costco member.

You don't need to be to use their pharmacy.

 

[sam_gordon]

You don't need to be to use their pharmacy.

Really? OK. I'll give them a call. Thanks!

 

[Pea-n-Me]

Was the $150 for mail order for a three month supply? Or just one month.

I suggest talking to your endocrinology team, they deal with this all the time.

But also, if you’re considering changing medications for cost, one considerations should be making sure they’re ones that decrease your chance of heart attack and stroke as a diabetic. (Priceless.)

https://www.diabetes.org.uk/about_us/news/type-2-diabetes-medications-can-also-protect-heart-health