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Prescription Madness
Posted by: wave rider
Date: February 03, 2021 02:39PM
Went to the cardiologist yesterday. He prescribed a medication and warned me it was quite expensive. I told him I thought I had good insurance, so off I went with prescription in hand.

Dropped the prescription off at a pharmacy on my way home. They called this morning and said the prescription would be $2,000.

I told them that even though the doctor said it would be expensive, I didn't think it would be that much. Turns out that was the cash price, their system had misplaced my insurance info. They said they would run it past my insurance and call back later.

Call back came, new price is: $60.

I am once again very pleased that I have good insurance, but what are people with less advantageous insurance or none to do?

I sure hope we can fix this system…



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Re: Prescription Madness
Posted by: Lemon Drop
Date: February 03, 2021 03:04PM
Wow, that call from the pharmacy could've caused a second visit with the cardiologist.

Yes, drug pricing is obscene. Everything about it .

30 tabs of xarelto, $600 retail. No generic.
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Re: Prescription Madness
Posted by: GGD
Date: February 03, 2021 03:09PM
My mother takes a heart medication that costs $18,000/month (about $600/pill) and is not available at local pharmacies, there are 9 "specialty pharmacies" in the US that distribute it. Luckily her fantastic health coverage has a $450/year out of pocket maximum for prescription drugs.
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Re: Prescription Madness
Posted by: JoeH
Date: February 03, 2021 03:54PM
Dealing with that run up in drug prices getting insulin for my cat. Retail price is $300+ a vial, can get a coupon that takes off about $15. Coupons are available to get it for just over $200 if the prescription was for a human. Fortunately the vial lasts for about 6 months at the dose needed for my cat. No usable coupon for the boxes of insulin syringes though.

Looked up the estimated cost of producing that vial, and past prices. It used to retail for about $100, and cost about $20-25 to make.
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Re: Prescription Madness
Posted by: wave rider
Date: February 03, 2021 03:55PM
Quote
Lemon Drop
Wow, that call from the pharmacy could've caused a second visit with the cardiologist.
Snip...

smiley-laughing001 I had the same thought!



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Re: Prescription Madness
Posted by: wave rider
Date: February 03, 2021 03:57PM
Quote
GGD
My mother takes a heart medication that costs $18,000/month (about $600/pill) and is not available at local pharmacies, there are 9 "specialty pharmacies" in the US that distribute it. Luckily her fantastic health coverage has a $450/year out of pocket maximum for prescription drugs.

Holy Smokes!



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Re: Prescription Madness
Posted by: Lemon Drop
Date: February 03, 2021 03:59PM
Quote
wave rider
Quote
GGD
My mother takes a heart medication that costs $18,000/month (about $600/pill) and is not available at local pharmacies, there are 9 "specialty pharmacies" in the US that distribute it. Luckily her fantastic health coverage has a $450/year out of pocket maximum for prescription drugs.

Holy Smokes!

Seriously
But if that is what she needs, thank goodness you can get it
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Re: Prescription Madness
Posted by: wave rider
Date: February 03, 2021 04:01PM
Quote
JoeH
Dealing with that run up in drug prices getting insulin for my cat. Retail price is $300+ a vial, can get a coupon that takes off about $15. Coupons are available to get it for just over $200 if the prescription was for a human. Fortunately the vial lasts for about 6 months at the dose needed for my cat. No usable coupon for the boxes of insulin syringes though.

Looked up the estimated cost of producing that vial, and past prices. It used to retail for about $100, and cost about $20-25 to make.

My cats are too old to get the insurance, but if a new kitten shows up in my life, I will get it. It has paid off for a friend that keeps rescuing cats.
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Re: Prescription Madness
Posted by: Ammo
Date: February 03, 2021 04:18PM
I think it’s always worth it to at least try Good RX, WellRX or maybe other drug savings programs to see what the price is with their card. I’ve had a couple of prescriptions that I saved quite a bit of money by using them instead of my normal drug insurance plan (sorry, I’d rather not post the names).



Where is there dignity unless there is also honesty? - Cicero



Edited 1 time(s). Last edit at 02/03/2021 04:19PM by Ammo.
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Re: Prescription Madness
Posted by: GGD
Date: February 03, 2021 04:31PM
Quote
Lemon Drop
Quote
wave rider
Quote
GGD
My mother takes a heart medication that costs $18,000/month (about $600/pill) and is not available at local pharmacies, there are 9 "specialty pharmacies" in the US that distribute it. Luckily her fantastic health coverage has a $450/year out of pocket maximum for prescription drugs.

Holy Smokes!

Seriously
But if that is what she needs, thank goodness you can get it

This is what she's taking (Vyndamax), it's only been available for about two years and is THE most expensive heart medication.
[www.tctmd.com]

It can stop the progression of Heart Failure in patients where there's a certain specific cause. She was tested for it, and has the trait that this drug can treat, and it was caught early enough. There were also tests done to see if it was genetic and if me and my siblings might develop it as we age, but those were negative.

Since it "stops the progression", it's difficult for us to observe if it's really doing anything for her because everything remains normal, but tests that the cardiologist has run show that it's not getting worse.
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Re: Prescription Madness
Posted by: S. Pupp
Date: February 03, 2021 04:49PM
There is a medication that I've been told might stop me from going through hell and back on an almost daily basis, hell that has robbed me of my career. The med didn't work for me six years ago when it cost me $20/mo, but I agreed to give it another go.

$2200/mo with my current insurance, $1000/mo with coupon. That's for 8 doses of a medication that has been around since the end of WWII. Combined with $1000/mo in other medical care... At least I've just paid off expenses accrued due to health problems in the 1990's. There's that.

Healthcare in the US is hell to those on both sides of the stethoscope.
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Re: Prescription Madness
Posted by: voodoopenguin
Date: February 03, 2021 05:01PM
I just cannot imagine the worry, heartache and dilemmas you lot have to go through to get your health sorted.

Paul
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Re: Prescription Madness
Posted by: S. Pupp
Date: February 03, 2021 05:11PM
Quote
voodoopenguin
I just cannot imagine the worry, heartache and dilemmas you lot have to go through to get your health sorted.

Paul

I'm reminded of an episode of "The New Statesman," where ultra-conservative Alan B'Stard mourns for the "good old days" before the UK's National Health Service:

"You see, in the good old days, you were poor, you got ill, and you died. And yet these days people seem to think they've got some sort of God-given right to be cured. And what is the result of this sloppy socialist thinking? More poor people. In contrast, my policies would eradicate poor people, thereby eliminating poverty. And they say that we Conservatives have no heart."



In the US, "poor people" would mean the bottom 98% of the population.



Edited 3 time(s). Last edit at 02/03/2021 05:19PM by S. Pupp.
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Re: Prescription Madness
Posted by: p8712
Date: February 03, 2021 05:22PM
The HIV meds I was on were 50 bucks a pill. Every day.
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Re: Prescription Madness
Posted by: deckeda
Date: February 03, 2021 05:37PM
If $2K is the retail price, then the insurer is getting stiffed for even more, which helps explain why healthcare in America costs so much. We all subsidize Big Pharma.
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Re: Prescription Madness
Posted by: Ombligo
Date: February 03, 2021 05:40PM
My mom uses an inhaler that is not in her formulary. The brand name is $1200/month - the generic is $950. GoodRx drops it to $100, except that is for three inhalers rather than one.

She had a ER visit that was $15000 before insurance reduced it to $41.40.

The medical system in the US needs to be fixed, something that isn't going to happen anytime soon.



“No persons are more frequently wrong, than those who will not admit they are wrong.” -- François de La Rochefoucauld

"Those who cannot accept the past are condemned to revise it." -- Geo. Mathias

The German word for contraceptive is “Schwangerschaftsverhütungsmittel”. By the time you finished saying that, it’s too late
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Re: Prescription Madness
Posted by: JoeH
Date: February 03, 2021 05:59PM
Quote
wave rider
Quote
JoeH
Dealing with that run up in drug prices getting insulin for my cat. Retail price is $300+ a vial, can get a coupon that takes off about $15. Coupons are available to get it for just over $200 if the prescription was for a human. Fortunately the vial lasts for about 6 months at the dose needed for my cat. No usable coupon for the boxes of insulin syringes though.

Looked up the estimated cost of producing that vial, and past prices. It used to retail for about $100, and cost about $20-25 to make.

My cats are too old to get the insurance, but if a new kitten shows up in my life, I will get it. It has paid off for a friend that keeps rescuing cats.

Mine is 13, diagnosed with diabetes back in early June. Will have to consider pet health insurance when/if I get a new cat in the future.
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Re: Prescription Madness
Posted by: Dennis S
Date: February 03, 2021 06:04PM
For a couple years, 2018 and 2019, I took Jakafi at $12,680 a month. Express Scripts paid it all.
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Re: Prescription Madness
Posted by: Ca Bob
Date: February 03, 2021 06:52PM
We're kind of in an in-between era where we are learning a lot about specific diseases and we have ways of (rapidly) screening hundreds of thousands of compounds in silico (that's biology jargon for using computer programs to look for molecules that fit with each other) and out of that, screening for workable drugs -- first in cultured cells, then with animal testing, and finally in human tests. The companies that grab the patents don't have a lot of shame when it comes to pricing.

Forty years from now, things will be different and the overall consumer costs for drugs will probably be less.
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Re: Prescription Madness
Posted by: bfd
Date: February 03, 2021 07:57PM
Quote
wave rider

I am once again very pleased that I have good insurance, but what are people with less advantageous insurance or none to do?

I sure hope we can fix this system…

MediCal if they're indigent - and they live in Cali. It's more of a problem for those in the middle, those who don't have or can't afford insurance but still make too much to qualify for assistance. While some states are more progressive in covering that group, many still aren't. And that group truly suffers the consequences.

And yes, that needs to get fixed across the land. The only thing keeping the right thing from happening is a bunch of bureaucrats, insurance and health care executives, and big Pharma wonks who continue making millions of dollars a year off the current system of haves and have nots.



Edited 1 time(s). Last edit at 02/03/2021 07:59PM by bfd.
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Re: Prescription Madness
Posted by: davester
Date: February 03, 2021 09:28PM
This is utter madness. I grew up in the UK, with medical care taken care of by our taxes. That we have to worry about how much a giant corporation might charge for a drug, or be faced with the insane dilemma of giant corporations charging uninsured people full freight while giving mega discounts to corporate insurance companies literally makes my blood boil. Why the populace doesn't insist on single payer healthcare is completely beyond my ken.



"In science it often happens that scientists say, 'You know that's a really good argument; my position is mistaken,' and then they would actually change their minds and you never hear that old view from them again. They really do it. It doesn't happen as often as it should, because scientists are human and change is sometimes painful. But it happens every day. I cannot recall the last time something like that happened in politics or religion." (1987) -- Carl Sagan
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Re: Prescription Madness
Posted by: NewtonMP2100
Date: February 03, 2021 10:32PM
......some of the psoriatic arthritis drugs like Humira, Stelara, etc..........without insurance are like $8,000-$12,000 per shot........

....even with insurance can cost a few hundred, unless you use company discount card......



_____________________________________

I reject your reality and substitute my own!
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Re: Prescription Madness
Posted by: space-time
Date: February 03, 2021 10:58PM
It’s less expensive to die.
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Re: Prescription Madness
Posted by: bfd
Date: February 03, 2021 11:22PM
Quote
space-time
It’s less expensive to die.

Well, once someone has finished their useful worker life, that's kind of the grand plan, isn't it?
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Re: Prescription Madness
Posted by: Pam
Date: February 04, 2021 04:51AM
Pharma executives make around 122 million dollars a year. They get bonuses when they raise profits without raising costs. One cancer drug tripled in price and gave executives millions in bonuses. No change to the med. it’s obscene!
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Re: Prescription Madness
Posted by: pdq
Date: February 04, 2021 08:32AM
How else is big pharma going to pay for all those ads they run?

Seriously, during the national evening news, it must be a third of all commercials, if not a half...
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Re: Prescription Madness
Posted by: mrbigstuff
Date: February 04, 2021 12:17PM
Quote
pdq
How else is big pharma going to pay for all those ads they run?

Seriously, during the national evening news, it must be a third of all commercials, if not a half...

No @#$%&, this is a prime example of where legislation is needed to restrict ads from pharma cos. How? Not sure if it's inhibiting free speech (probably), but 100s of millions in ads comes from somewhere.



Mischievous and Deceitful
Chicanerous and Deplorable



Edited 1 time(s). Last edit at 02/04/2021 12:18PM by mrbigstuff.
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Re: Prescription Madness
Posted by: lost in space
Date: February 04, 2021 12:18PM
The drug price madness is one thing; medical treatment is at least as bad. My provider billed insurance for $189K US last year. Plan only had to pay $43K. That's a 500% markup for "retail."



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Re: Prescription Madness
Posted by: DeusxMac
Date: February 04, 2021 12:25PM
Quote
mrbigstuff
Quote
pdq
How else is big pharma going to pay for all those ads they run?

Seriously, during the national evening news, it must be a third of all commercials, if not a half...

No @#$%&, this is a prime example of where legislation is needed to restrict ads from pharma cos. How? Not sure if it's inhibiting free speech (probably), but 100s of millions in ads comes from somewhere.

There was a time when prescription drugs were NOT advertised/marketed to the general public; only OTC.

But then, “Ask your doctor about...” became a way to circumvent doctors as the sole decision makers and increase sales.
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Re: Prescription Madness
Posted by: davemchine
Date: February 04, 2021 03:23PM
I required medical assistance during a four month period of time where they charged $18,500/mo. So my total bill was $74,000. After adding other charges it topped $126,000. My insurance negotiated an end price of $27k. There's a lot of corruption in the medical industry and I can't imagine what a private payer would have to do since they have no leverage.



Ukulele music I couldn't find anywhere else.
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Re: Prescription Madness
Posted by: wave rider
Date: February 04, 2021 05:06PM
I qualified for Medicare halfway through my R-CHOP chemo for lymphoma in 2016. I remember looking at my Medicare explanation of benefits, which shows the retail price.

If I remember correctly, the bag of Rituximab retails for $34,000 and I used six of them during my course of chemo. Don't remember the cost of the other chemo ingredients.

I remember being very pleased at the time with my insurance.



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Re: Prescription Madness
Posted by: RgrF
Date: February 04, 2021 11:53PM
An aneurysm leading to a MERSA infection leading to an aorta replacement. A MERSA relapse 8 years later followed by months of rehab.

Total billings ran into 7 figures, no idea what or who was actually paid or how much. These days if you can't own a casino, grab a piece of the medical/pharmaceutical market and then spend your time clipping coupons.
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Re: Prescription Madness
Posted by: Speedy
Date: February 05, 2021 02:40AM
Glad you folks are still with us.



Saint Cloud, Minnesota, where the weather is wonderful even when it isn't.
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Re: Prescription Madness
Posted by: Bill in NC
Date: February 05, 2021 02:45PM
Thankfully the VA (I don't know why) covers the most expensive anti-rejection meds for a close relative who received a kidney transplant a few years ago.
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Re: Prescription Madness
Posted by: Speedy
Date: February 05, 2021 11:23PM
Quote
Bill in NC
Thankfully the VA (I don't know why) covers the most expensive anti-rejection meds for a close relative who received a kidney transplant a few years ago.

As will Medicare no matter your age. Medicare also covers dialysis.



Saint Cloud, Minnesota, where the weather is wonderful even when it isn't.
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