Prescription costs--outrageous {incoherent rant}

[Amber St. Clare]

This is the time of the month when I have to renew my prescriptions. I have to take several AND have decent coverage thru my husband, but I was looking at my paperwork saw: Cost: $274--my cost $10.07, Cost $45.99-my cost $2.54,Cost $299.97, my cost 23.67. My mail in for three months was $1,200, our cost was $120. and because I am unemployed my Enbrel is free.

What I am OUTRAGED about is the high cost of these item and what alternatives do people who are not a lucky as I am have? Why should people have to chose between medicine and other necessities? Tonite I stood behind an elderly gentlemen who was $10. short for his prescription and didn't want to accept it from me. Why should an older American who has {and here I am supposing} worked and contributed all his life have to be stressed out about whether he can afford his medicine? Why should my friend's husband, who is diabetic, play Russian Roulette with his meds because they don't have insurance? What the hell is wrong with this country, anyway? My friend hasn't had mamogram since we were let go in 2008.


Sorry for the rant. I guess I've been unemployed too long..............

 

[Skippy123]

It is horrible when it is too expensive for the elderly or for people not lucky enough to have insurance have to choose between paying their rent or paying for medicine that is necessary.

 

[DivaDiamond007]

This is the time of the month when I have to renew my prescriptions. I have to take several AND have decent coverage thru my husband, but I was looking at my paperwork saw: Cost: $274--my cost $10.07, Cost $45.99-my cost $2.54,Cost $299.97, my cost 23.67. My mail in for three months was $1,200, our cost was $120. and because I am unemployed my Enbrel is free.

What I am OUTRAGED about is the high cost of these item and what alternatives do people who are not a lucky as I am have? Why should people have to chose between medicine and other necessities? Tonite I stood behind an elderly gentlemen who was $10. short for his prescription and didn't want to accept it from me. Why should an older American who has {and here I am supposing} worked and contributed all his life have to be stressed out about whether he can afford his medicine? Why should my friend's husband, who is diabetic, play Russian Roulette with his meds because they don't have insurance? What the hell is wrong with this country, anyway? My friend hasn't had mamogram since we were let go in 2008.


Sorry for the rant. I guess I've been unemployed too long..............

Here is what's wrong: insurance companies and big pharma are in BUSINESS to make a PROFIT. There is no incentive for them to lower costs for the consumer when it means their bottom line is smaller.

Some people think that access to basic healthcare is a PRIVILEGE and not a RIGHT.

 

[perry]

Here is what's wrong: insurance companies and big pharma are in BUSINESS to make a PROFIT. There is no incentive for them to lower costs for the consumer when it means their bottom line is smaller.

Some people think that access to basic healthcare is a PRIVILEGE and not a RIGHT.

Actually, it is not the insurance companies - they work very hard to pay as little as possible for medicines - which is why they usually insist on generics when available.

The cost of drugs in the US is influenced by two major factors beyond ordinary profit: The very high cost of the R&D cost necessary to gain approval for a new drug, and the fact that the drug companies are subject to unlimited liability if there are problems with the drug later on.

The same drugs from the same companies cost a lot less in other countries (such as Canada) due to a limitation on liability.

Drugs "developed" in many other countries do not need to have all the R&D and approvals that the US FDA requires - so they are cheaper; however, there are a lot more (and worse) problems discovered later on.

Perry

 

[Miss Sparkly]

Geez! Makes me wonder how much mine is regular price

 

[Amethyste]

Oh I know!!! I have Dermatitis and the only thing that works for me is ProTopic.
My insurance Company only allows ONE tube PER year! I usually need 2-3 tube a year. Granted the largest size is 30GRAMS!
There is no Generic form for Protopic.

My co-pay ( once a year ): $65
When I need to get it on my own........: $375!

 

[Miss Sparkly]

Yikes, that's expensive. I use Nasonex for my allergies and one time I filled it 3 days early. There are 120 sprays per bottle, you have to prime the pump with 6 sprays and use 2 sprays per nostril that leaves me 28.5 days. Fred Meyer put an "overuse" warning on my perscription so now I have to fill it on the day or insurance won't pay for it My other favorite was when I called to try to find a cheaper alteternitive to Nasonex as their only generic in that class gave me nose bleeds. The gal gave me the name of the drug and when I researched it I found it that it was an inhaler for lung cancer patients. I called insurance back and asked them what the heck they were thinking! She said, "I don't know, it's on the piece of paper. Can you use it instead?" Sure, because lung cancer drug will help my nasal allergies Such a love hate relationship

 

[Imdanny]

This is the time of the month when I have to renew my prescriptions. I have to take several AND have decent coverage thru my husband, but I was looking at my paperwork saw: Cost: $274--my cost $10.07, Cost $45.99-my cost $2.54,Cost $299.97, my cost 23.67. My mail in for three months was $1,200, our cost was $120. and because I am unemployed my Enbrel is free.

What I am OUTRAGED about is the high cost of these item and what alternatives do people who are not a lucky as I am have? Why should people have to chose between medicine and other necessities? Tonite I stood behind an elderly gentlemen who was $10. short for his prescription and didn't want to accept it from me. Why should an older American who has {and here I am supposing} worked and contributed all his life have to be stressed out about whether he can afford his medicine? Why should my friend's husband, who is diabetic, play Russian Roulette with his meds because they don't have insurance? What the hell is wrong with this country, anyway? My friend hasn't had mamogram since we were let go in 2008.


Sorry for the rant. I guess I've been unemployed too long..............

Here is what's wrong: insurance companies and big pharma are in BUSINESS to make a PROFIT. There is no incentive for them to lower costs for the consumer when it means their bottom line is smaller.

Some people think that access to basic healthcare is a PRIVILEGE and not a RIGHT.

I agree with the OP 100%.

BTW, insurance companies are a cartel, not a "business." They received in the 1940's and still have an exemption from the Sherman federal anti-trust act. As a cartel, they are free to price gouge, and they do.

Anyone who thinks insurance companies represent "the free market," should research this subject thoroughly.

Drug companies in the US don't compete in "the free market," either. There is no drug reimportation allowed in the US, as there is in other countries. Furthermore, threre is no price negotiation with Medicare. Taxpayers are gauged continually.

The privilege vs right debate oversimplifies a rigged system, one that entails many people in the US not receiving adequate healthcare. It is a disgrace.

 

[LGK]

Seriously. I work with an older woman and she's been dealing with some awful, awful health issues lately. She developed psoriasis on her hands so badly they look like raw meat. Literally skinned and bleeding all over her palms and fingers. So she's in constant pain and can barely do her job. She's tried a zillion different treatments and the only thing that worked was this topical lotion that was developed for cancer treatments. It worked really well and her hands finally, finally healed. Cost? Well over $1K per small tube.

Medicare only covers up to $4K annually in prescription costs. (Or something thereabouts- I could have the numbers slightly wrong.) So of course she topped out that allowance pretty quick in a matter of a few months. Apparently there's some sort of emergency coverage that you can get through Medicare but only if you're up to something like $6K spent on prescriptions. So, in order to get the emergency coverage she'd need to find $2K out of pocket to spend to get her there. Of course she doesn't have anything remotely like that or any family to fall back on.

She couldn't get her medicine, her hands returned to raw meat condition and it was just agonizing for her, and all of us, to see.

Finally her doctor went to bat for her and somehow talked the manufacturer of the lotion into providing it to her for free. Thank god. It was heartbreaking to see how elderly people on low incomes are just utterly screwed sometimes by the medical coverage in the US.

(She didn't have insurance of course, just Medicare.)

 

[Steel]

Seriously. I work with an older woman and she's been dealing with some awful, awful health issues lately. She developed psoriasis on her hands so badly they look like raw meat. Literally skinned and bleeding all over her palms and fingers. So she's in constant pain and can barely do her job. She's tried a zillion different treatments and the only thing that worked was this topical lotion that was developed for cancer treatments. It worked really well and her hands finally, finally healed. Cost? Well over $1K per small tube.

Medicare only covers up to $4K annually in prescription costs. (Or something thereabouts- I could have the numbers slightly wrong.) So of course she topped out that allowance pretty quick in a matter of a few months. Apparently there's some sort of emergency coverage that you can get through Medicare but only if you're up to something like $6K spent on prescriptions. So, in order to get the emergency coverage she'd need to find $2K out of pocket to spend to get her there. Of course she doesn't have anything remotely like that or any family to fall back on.

She couldn't get her medicine, her hands returned to raw meat condition and it was just agonizing for her, and all of us, to see.

Finally her doctor went to bat for her and somehow talked the manufacturer of the lotion into providing it to her for free. Thank god. It was heartbreaking to see how elderly people on low incomes are just utterly screwed sometimes by the medical coverage in the US.

(She didn't have insurance of course, just Medicare.)

I was so glad to read that LGK. I know she will be in a minority of people who can't afford meds but are able to source them, still I'm really happy for her. Her Dr. & the Drugs rep. should feel pretty good about themselves too. I know, it is a single case, but for her it makes all the difference.

 

[Maisie]

I don't have to pay for my prescriptions. Even if I did the NHS charge a standard price for most medicines. And its not too expensive. I am so grateful that we don't have to pay the prices you do over there.

 

[Gailey]

Heck, if we ever lose our insurance in Canada, I'm headed back to the UK. God Bless the NHS!

 

[that_someone_special]

medicare prescription drug plans are outrageous!!! has anyone looked at those? they cover a handful of meds under different categories. then those are broken down into tiers for payment. if your meds don't fall into tier one, someone needs to ask themselves if the meds are actually necessary as everything else is expensive. its so sad!

 

[Amber St. Clare]

Oh I know!!! I have Dermatitis and the only thing that works for me is ProTopic.
My insurance Company only allows ONE tube PER year! I usually need 2-3 tube a year. Granted the largest size is 30GRAMS!
There is no Generic form for Protopic.

My co-pay ( once a year ): $65
When I need to get it on my own........: $375!

Amy--I'm just shaking my head in bewilderment and disgust................

 

[atroop711]

I'm so with you. My parents have prescription coverage which is part of their retirement agreement. There coverage has a CAP on it. With both of them needing meds every month, they usually reach their cap by end of October BUT this yr with the increased med prices, they reached their cap at the end of Aug. My mother is a heart patient (she has congestive heart failure), lung patient and diabetic. My dad also has diabetes and is on other meds. Their out of pocket monthly co-pay expense for meds is $500 before the cap. NOW on a small pension and social security, their new expense for meds because they hit the CAP is about $1250...that's almost the entire amt of money my dad gets from soc. security. Without these meds my mother would die so they have no choice. I hate that they've worked their entire life and cannot afford to buy the meds to keep them going. If it wasn't for their children, they wouldn't be able to buy these meds once they meet the cap.

 

[diamondringlover]

This very topic came up the other day when I was picking up yet another prescription....I am pretty lucky to have good insurance, my husband works for a very good company that believes in excellent medical insurance for a reasonable monthly fee...on the other hand I work for a large insurance company and they choose to have crappy insurance for their employees, its very expensive with very high deductibles, if I had the insurance that I work for I would be broke in no time at all.....however, I am seriously worried about what happens once we retire, how will we afford our medicines, we both have a host of medical problems that we take many pills for every day..I am not sure yet, but it sure scares me. The price of medicines in the united states is just freaking crazy. My heart goes out to all the elderly people who cant afford the medicines that need to keep them alive. I wish there was something that can be done...maybe one day, hopefully before I retire this issue will be resolved in the US.

 

[aliciagirl]

Seriously. I work with an older woman and she's been dealing with some awful, awful health issues lately. She developed psoriasis on her hands so badly they look like raw meat. Literally skinned and bleeding all over her palms and fingers. So she's in constant pain and can barely do her job. She's tried a zillion different treatments and the only thing that worked was this topical lotion that was developed for cancer treatments. It worked really well and her hands finally, finally healed. Cost? Well over $1K per small tube.

Medicare only covers up to $4K annually in prescription costs. (Or something thereabouts- I could have the numbers slightly wrong.) So of course she topped out that allowance pretty quick in a matter of a few months. Apparently there's some sort of emergency coverage that you can get through Medicare but only if you're up to something like $6K spent on prescriptions. So, in order to get the emergency coverage she'd need to find $2K out of pocket to spend to get her there. Of course she doesn't have anything remotely like that or any family to fall back on.

She couldn't get her medicine, her hands returned to raw meat condition and it was just agonizing for her, and all of us, to see.

Finally her doctor went to bat for her and somehow talked the manufacturer of the lotion into providing it to her for free. Thank god. It was heartbreaking to see how elderly people on low incomes are just utterly screwed sometimes by the medical coverage in the US.

(She didn't have insurance of course, just Medicare.)

This is the case for every.single.person who has Medicare Part D coverage in the US. It's called the "donut hole" and it's something that many of our seniors are facing at this very moment - it truly is so sad. Luckily, the new health care coverage will close this gap. I am lucky to be a pharmacist for a privately owned family company who has decided to give away free antibiotics and free diabetic medications so that people who are really in need can get the care that they need (for full disclosure, it is mostly cheaper older drugs like amoxicillin and metformin but for many of our patients they are very, very appreciative!)

Something to keep in mind - maybe just because I am faced with rude, very angry people on a daily basis - it's not your pharmacists fault, it's usually your insurance's fault! And as much as we would like to give you that $300 medication for free, well we can't (no matter how much you yell at us!) I know a lot of times most people don't have a choice as far as their insurance coverage goes, but I always recommend requesting a formulary and comparing to the medications that you are currently taking to make sure everything will be covered.

In the case of the insurance not covering enough or needing refills early, there are usually ways around this - like prior authorizations (the doctor filling out forms with the insurance to let them know why you need more than than pre-approved amount) or having your doctor write the days supply on the prescription (like on the case of the nasal spray - if the MD wrote on the RX that it would only last 20 or 25 days.)

What most people don't realize is that all pharmacies get audited by insurance companies - they come in and try to find where we misbilled a prescription (maybe by saying it would last 30 days when it actually lasts 50 days) or they try to find errors that we've made (like we aren't allowed to say "use as directed" for instance) and if there are any of these mistakes they take back ALL the money that they paid out for the prescription. They say this is fraudulent. So not only do they make tons of money from your copays, they make thousands more from these audits. I have one on Tuesday - oh joy!

 

[DivaDiamond007]

I'm so with you. My parents have prescription coverage which is part of their retirement agreement. There coverage has a CAP on it. With both of them needing meds every month, they usually reach their cap by end of October BUT this yr with the increased med prices, they reached their cap at the end of Aug. My mother is a heart patient (she has congestive heart failure), lung patient and diabetic. My dad also has diabetes and is on other meds. Their out of pocket monthly co-pay expense for meds is $500 before the cap. NOW on a small pension and social security, their new expense for meds because they hit the CAP is about $1250...that's almost the entire amt of money my dad gets from soc. security. Without these meds my mother would die so they have no choice. I hate that they've worked their entire life and cannot afford to buy the meds to keep them going. If it wasn't for their children, they wouldn't be able to buy these meds once they meet the cap.

....and what I find even more sad is that I have paid into Social Security my entire adult life, will continue to pay into it, but will never be able to collect any of the benefits since it will be bankrupt long before I am old enough to collect benefits. What are people in this situation supposed to do in old age? Can't save money since wages are stagnant and prices are rising so won't be able to retire or collect Social Security and will probably die with nothing but a mound of debt I get depressed just thinking about what is happening in our country these days, especially with healthcare. I hope things are better for my children.

 

[Yimmers]

I agree, prescription costs and health care costs are insane. My company recently changed their PPO health care plan. My prescription, once $25/month, went up to $63 before dropping to $45. That is just for birth control. I have been fortunate enough to be in good enough health to avoid other monthly prescriptions, but I hate to know what has happened for others who may need more costly ones under our plan. And my co-pay has gone up as well. And to cover my husband under my plan, it would cost an additional $800 per month. So, he may go under cobra once his old employer stops paying for his medical benefits.

Of course, for my friend who had cancer and lupus...she is practically uninsurable unless she works for an employer who offers a HMO, or for another 8 years or so (when insurance basically stop considering her cancer as a liability to them). People argue about NHS...I'm all for it because people like my friend live in limbo if they cannot get insurance.

 

[TooPatient]

Here is what's wrong: insurance companies and big pharma are in BUSINESS to make a PROFIT. There is no incentive for them to lower costs for the consumer when it means their bottom line is smaller.

Some people think that access to basic healthcare is a PRIVILEGE and not a RIGHT.

Actually, it is not the insurance companies - they work very hard to pay as little as possible for medicines - which is why they usually insist on generics when available.

The cost of drugs in the US is influenced by two major factors beyond ordinary profit: The very high cost of the R&D cost necessary to gain approval for a new drug, and the fact that the drug companies are subject to unlimited liability if there are problems with the drug later on.

The same drugs from the same companies cost a lot less in other countries (such as Canada) due to a limitation on liability.

Drugs "developed" in many other countries do not need to have all the R&D and approvals that the US FDA requires - so they are cheaper; however, there are a lot more (and worse) problems discovered later on.

Perry

Thank you for pointing this out Perry.

There needs to be a balance between regulations to prevent problems and keeping the process lower cost so there are more options (and less expensive all around) available to people.

Simply putting everyone on a government health plan won't fix the problem. There needs to be competition between insurance companies (across state lines), lower costs for R&D, and limitations on law suits.
Without actual changes in the system, all we will do is shift the cost from individuals to the government (who shift back to individuals) and have, at best, a short term solution.

 

[Astra]

First - sorry about my english...

Second - I have to get this out of my system

So, In Croatia you have free health insurance for everybody. Free my ASS!

Average salary in my hometown is around $1200. Last month doctors suspected I have some heart problems, so I had to do heart ultrasound and wear holter monitor. Ok, no problem. So, if I wanted to do heart ultrasound free of charge I had to wait for it 6 months... holter as well...
I said I'll do it privately and paid for it - I spent around $220. Plus $10 for heart RTG.

Now, my gyn wants me to do some blood check-ups, of course I have to do it privately again, free health insurance won't pay for it..., thats $150. Plus $120 for ovary ultrasound (privately of course, again, no need for ultrasound if you look healthy).

And of course almost every prescription you have to pay extra,,, sometimes is just few dollars, and sometimes its $30-40.

God bless free health insurance .

Ok, I feel slightly better now.

 

[Lynnie]

I recently took care of a lady who had to get her leg amputated because she couldn't afford Plavix for her Peripheral vascular disease. It's a terrible shame that people are losing body parts (and their lives) because their script is unaffordable!!! It makes me so angry, just thinking about it... I don't know what the solution is, or even who's at fault, but it *is* ridiculous, and very, very sad.

I work for a hospital, and have pretty decent insurance. But it blows my mind when I get my $20 copay bill for an ultrasound that took 10 MINUTES and insurance covered the other $2500. Incredible.

Oh, and I have to get my scripts filled at my hospital, or pay crazy copays. DH quit smoking last year, and used Chantix. The copay at the local pharmacy was $125... at my hospital, it was $5. Just doesn't make sense to me!! It seems everything's just all about business and $$$.