WTF? Does the prescription/insurance field get pricing training from the airline industry?

A 3 month supply (5 vials) of insulin costs $115 through my mail order service, ExpressScripts. The same insulin is half the price ($25 for 2 vials) at my local Walgreens, but they (my insurance) only allows a one month supply from a non-mail order pharmacy. Somehow, a coworker of mine with the same insurance and same medication still gets 3 months worth (5-6 vials) from Walgreens for $25.

The only way I can think that she can pull that off is that her doc put down her 3 month dosage as a one month prescription. I’d consider asking my doc to do the same, but it probably constitutes some kind of fraud.

::sigh::

A great many times... the cash price (Not insurance based) cost of medicines is less. Always ask the pharmacist what the cost is off insurance.

Andrew

And ask your doc for a three month supply on one script.

My doc has done this for non opioid type meds when I've deployed.

I get some of my meds cash instead of insurance because it's cheaper than the deductible. Same with supplies. A box of needles from Amazon-17.50. Deductible-35.00. Wally World proprietary tests strips are HALF what the deductible for name brands is. And five vials for 3 months? That's less than a month for me.

quote:

Originally posted by LS1 GTO:
And ask your doc for a three month supply on one script.

I have a visit coming up shortly. I'm going to bring it up to her. We'll see...

quote:

Originally posted by Fredward:
And five vials for 3 months? That's less than a month for me.

Wow. Are you also Type 1?

quote:

Originally posted by El Cid 92:
A great many times... the cash price (Not insurance based) cost of medicines is less. Always ask the pharmacist what the cost is off insurance.

Andrew

Along with this, download the GoodRx app and see the cash price you pay if you don’t use insurance.

quote:

Originally posted by CoolRich59:

download the GoodRx app and see the cash price you pay if you don’t use insurance.

You don't even have to download an app. You can use a browser and look at the GoodRx website.

$176 per vial at the cash price was what that app gave me.

Yikes.

quote:

Originally posted by flesheatingvirus:
$176 per vial at the cash price was what that app gave me.

Yikes.

Wow. Only caveat I would add is to ensure that you check to be sure the amounts, dosage, etc match your Rx. Whenever I’ve had a big discrepancy, I had plugged in the wrong info.

quote:

Originally posted by CoolRich59:

quote:

Originally posted by flesheatingvirus:
$176 per vial at the cash price was what that app gave me.

Yikes.

Wow. Only caveat I would add is to ensure that you check to be sure the amounts, dosage, etc match your Rx. Whenever I’ve had a big discrepancy, I had plugged in the wrong info.

I plugged in 5 vials for a total of $881. It was $354 when I plugged in 2 vials.

quote:

Originally posted by flesheatingvirus:

quote:

Originally posted by CoolRich59:

quote:

Originally posted by flesheatingvirus:
$176 per vial at the cash price was what that app gave me.

Yikes.

Wow. Only caveat I would add is to ensure that you check to be sure the amounts, dosage, etc match your Rx. Whenever I’ve had a big discrepancy, I had plugged in the wrong info.

I plugged in 5 vials for a total of $881. It was $354 when I plugged in 2 vials.

Ouch. Sorry, doesn’t look like GoodRx is a solution for you.

I was recently prescribed a 30 day supply of Myrbetrig for a bladder issue. It is new enough, that I saw my first TV ad for it the other day. I have no insurance covering medications. When the clerk rang it up, her eyes got big as saucers. " This says $400 !" I said for $400, I'd hold off for awhile. My urologist had no idea it was that expensive as the drug rep had assured him that it was covered by insurance and "was on all the formularies". It proves what I have always said that affordable health will never be reality, as long as the insurance companies and the drug companies are given free rein.

https://www.myrbetriq.com/momentum-program/

Worth looking at to see if you qualify.

I use goodrx and 3 differnt pharmacies. And I check every refill. They often flip flop prices. When they do I move my prescription. Happens more often than not. Too many people getting their drugs paid by insurance and the pharmacies assume you aren't paying attention. Gotta shop smart when you're paying your own way.

quote:

Originally posted by NK402:
It proves what I have always said that affordable health will never be reality, as long as the insurance companies and the drug companies are given free rein.

There should be a law to mandate reasonable prices or set a maximum amount of profit big pharma can make on a new drug. Yes, I’m sure that’s a good solution.

Maybe the government could just buy all the drugs in bulk and then resell them at reasonable prices. The government could also pay big pharma the billions of dollars they spend in R&D as well - it would be like public campaign financing - take the money right out of the equation.

Yep. That will definitely work.

-Rob

Wow! Just check my scrip for Uloric. $323.67 per month. With insurance it is $60, but the manufacturer sent me a coupon code which is logged at my Publix pharmacy and I pay a total of $15.

This stuff has been around for a while. Why is it so expensive?

Here’s a pretty decent discussion of some of the issues which make Rx pricing so complicated:

https://www.uspharmacist.com/a...tanding-drug-pricing

-Rob

quote:

Originally posted by dlc444:
This stuff has been around for a while. Why is it so expensive?

Why is hamburger $5/pound?

quote:

Originally posted by Gustofer:

quote:

Originally posted by dlc444:
This stuff has been around for a while. Why is it so expensive?

Why is hamburger $5/pound?

At leastI can back off my ground beef consumption when it spikes. Insulin could be even worse because demand doesn't typically drop, at least for insulin dependent folks. It worries me that the price could just shoot to $1000/bottle, and I'm not aware of anything that could stop it at the moment.

Cvs bought out a small local pharmacy chain I had been using. Paying cash, they sold me a 90 day supply of Lipitor for $10. Go to cvs to pick up my prescription, he asks for my insurance card, gets my pills and see the bottle is a little empty. I tell him no, the prescription is for a 90 day supply, says right here on the side of my old bottle, please don’t change my prescription without asking me. We can’t provide it as a 90 day supply he says. B.S. I get out a $10 from my wallet, and tell him to charge me the cash price, that’ll be $354 sir. Excuse me? Another fine example of corporate America screwing with me. Will never go to another cvs as long as I live.