Amir rants about prescription drugs -- again!

amirm

Banned
Apr 2, 2010
15,813
37
0
Seattle, WA
OK, here is another chapter in my "adventures" to fill my prescriptions.

I was out of one of my medications so I ask to have it refilled. It is a small pharmacy and they are only open until 1:00pm on Saturday and I get there at 2:00pm :(.

Was heading to our vacation house and was hoping there would be some of my medication here. I only found a single pill and was out today. Had my doctor call another prescription to the pharmacy close to our vacation house.

They call and it says it is ready a couple of hours ago. I go there and having never filled any prescription, I gave them my insurance card. Immediately I can sense trouble. Two people hovering over the computer and spending 5 minutes on it. And then comes the news: "we can't file this for insurance." I ask why not. They say since I had already "filled" it at the other pharmacy, the insurance company does not pay for it now.

They say I have to pay for it myself. Desperate to have the medication I say sure and ask how much it is. She says $7.95. Normally I pay $15 co-pay for this generic so I am surprised it is this low without insurance. Before I could celebrate the manager stops the person who was helping me and says, "that is not the correct price!" So I get ready: here it comes... A conversation starts with the pharmacist that works in the back and the manager says: "it costs four ninety five cash if he wants to pay for it himself." I am thinking holy cow, nearly $500 for 30 pills??? Before I could spill my guts the person who was helping me comes back and says, "do you want to pay $4.95?" What the heck???? $4.95? Still in disbelief, I give here a $20 bill and she gives me $15.05 back in change!!!

Guys, help me understand this. I have been taking this medication for more than a year. Insurance company forces each refill to be only 30 pills so I am forced to keep paying $15 out of pocket deductible. Now this place only charges $5 for the whole thing???

Just in case you think this was a mistake, I was talking to my neighbor about high cost of insurance and he told me this is the cheapest pharmacy around. The place is called "Cost Less Drugs." The place was super crowded with a ton of people working behind the counter and folks getting a ton of stuff filled. Is it possible that there is some kind of subsidy going on? Or is it the case that there are tons of margins in these prescriptions and these guys, being in a rural area, charge so much less?

I take about a dozen prescriptions. Can't wait to get them all transferred to this place. It would literally save me thousands of dollars/year.
 

rockitman

Member Sponsor
Sep 20, 2011
7,097
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cry me a river. When I was prescribed 20 mg Cialis 6 years ago, they were $15 per tab. They are now $35 per tap. Granted I break them in half per dose:p...Pharmaceutical company pricing strategy reminds me of hi end cable pricing strategy. I get limp thinking about it...lol
 

BlueFox

Member Sponsor
Nov 8, 2013
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Just be glad you aren't using the new hepatitis C drug. The only prescription I had was for Lipitor, and I threw that junk away 9 years ago. While I feel great now, Lipitor was killing me. Every joint in my body ached from that drug.
 

rockitman

Member Sponsor
Sep 20, 2011
7,097
412
1,210
Northern NY
Just be glad you aren't using the new hepatitis C drug. The only prescription I had was for Lipitor, and I threw that junk away 9 years ago. While I feel great now, Lipitor was killing me. Every joint in my body ached from that drug.

I have heard of Lipitor compatibility issues. I was prescribed pravastatin aka zocor I think. I haven't had any side effects I can tell and it brought my LDL from 120 to 85. I haven't changed my diet of loving steak and fat much either. Lipitor is a much stronger statin.
 

MadFloyd

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May 30, 2010
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I lasted a week on Lipitor. Couldn't handle it.
 

FrantzM

Member Sponsor & WBF Founding Member
Apr 20, 2010
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cry me a river. When I was prescribed 20 mg Cialis 6 years ago, they were $15 per tab. They are now $35 per tap. Granted I break them in half per dose:p...Pharmaceutical company pricing strategy reminds me of hi end cable pricing strategy. I get limp thinking about it...lol

ROTFLMAO!!

Funniest post of the month .. !!

Made my day !!
 

Johnny Vinyl

Member Sponsor & WBF Founding Member
May 16, 2010
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Phelonious Ponk

New Member
Jun 30, 2010
8,677
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0
Your copay can often be more than the street cost of generics. if you're interested in watching your pennies closely, you should find out what an aggressive discount price is for every generic you take. Paying the insurance company $15 is probably a bad deal. Start here:http://www.walmart.com/cp/1078664?adid=22222222330213494370&wmlspartner=wmtlabs&wl0=e&wl1=g&wl2=c&wl3=43023272514&wl4=&veh=sem

Walmart has a long list of generics and over-the-counter drugs they sell for $4 for a 30 day supply, $10 for a 90 day supply. I'm a capitalist, and I expect the insurance and drug companies to make money. But calling something a "co-pay" in this case is just dishonest.

Tim
 
Last edited:

mojave

Well-Known Member
Oct 29, 2010
251
0
321
Elkhorn, NE
Normally I pay $15 co-pay for this generic so I am surprised it is this low without insurance.
A lot of people don't understand how much cheaper medical care, prescriptions, etc. can be when you don't use insurance. Dental insurance is one example, at least for me. I can get my teeth cleaned for 10 times (5 years) for what it costs to pay for one year of dental insurance. At the University of Nebraska Medical Center you can pay directly and get an MRI for $500. Go through insurance and it is several thousand!

Walmart has a long list of generics and over-the-counter drugs they sell for $4 for a 30 day supply, $10 for a 90 day supply. I'm a capitalist, and I expect the insurance and drug companies to make money. But calling something a "co-pay" in this case is just dishonest.

Tim
My wife recently had to get two antibiotic prescriptions for cellulitis. Each was only $4 at Wal-Mart. We also checked at Walgreens and they were about $28 each for the same generic drug.
 

Phelonious Ponk

New Member
Jun 30, 2010
8,677
23
0
A lot of people don't understand how much cheaper medical care, prescriptions, etc. can be when you don't use insurance. Dental insurance is one example, at least for me. I can get my teeth cleaned for 10 times (5 years) for what it costs to pay for one year of dental insurance. At the University of Nebraska Medical Center you can pay directly and get an MRI for $500. Go through insurance and it is several thousand!


My wife recently had to get two antibiotic prescriptions for cellulitis. Each was only $4 at Wal-Mart. We also checked at Walgreens and they were about $28 each for the same generic drug.

Yep. There is little price consistency in healthcare, much less prescription drugs. It should be the ultimate "buyer beware" industry, but unfortunately, illness, injury and shopping around for the best price don't go together well. The industry - from insurance to the doctor's office - takes advantage of that fact too often. I know we don't like regulations in this country, but if there is anyplace where serious regulation is needed, it's healthcare. I guess someday it will become enough of a drain on the economy that even Congress might do something.

Tim
 

Garth

Member Sponsor
Feb 23, 2014
299
0
0
OK, here is another chapter in my "adventures" to fill my prescriptions.

I was out of one of my medications so I ask to have it refilled. It is a small pharmacy and they are only open until 1:00pm on Saturday and I get there at 2:00pm :(.

Was heading to our vacation house and was hoping there would be some of my medication here. I only found a single pill and was out today. Had my doctor call another prescription to the pharmacy close to our vacation house.

They call and it says it is ready a couple of hours ago. I go there and having never filled any prescription, I gave them my insurance card. Immediately I can sense trouble. Two people hovering over the computer and spending 5 minutes on it. And then comes the news: "we can't file this for insurance." I ask why not. They say since I had already "filled" it at the other pharmacy, the insurance company does not pay for it now.

They say I have to pay for it myself. Desperate to have the medication I say sure and ask how much it is. She says $7.95. Normally I pay $15 co-pay for this generic so I am surprised it is this low without insurance. Before I could celebrate the manager stops the person who was helping me and says, "that is not the correct price!" So I get ready: here it comes... A conversation starts with the pharmacist that works in the back and the manager says: "it costs four ninety five cash if he wants to pay for it himself." I am thinking holy cow, nearly $500 for 30 pills??? Before I could spill my guts the person who was helping me comes back and says, "do you want to pay $4.95?" What the heck???? $4.95? Still in disbelief, I give here a $20 bill and she gives me $15.05 back in change!!!

Guys, help me understand this. I have been taking this medication for more than a year. Insurance company forces each refill to be only 30 pills so I am forced to keep paying $15 out of pocket deductible. Now this place only charges $5 for the whole thing???

Just in case you think this was a mistake, I was talking to my neighbor about high cost of insurance and he told me this is the cheapest pharmacy around. The place is called "Cost Less Drugs." The place was super crowded with a ton of people working behind the counter and folks getting a ton of stuff filled. Is it possible that there is some kind of subsidy going on? Or is it the case that there are tons of margins in these prescriptions and these guys, being in a rural area, charge so much less?

I take about a dozen prescriptions. Can't wait to get them all transferred to this place. It would literally save me thousands of dollars/year.

In Canada the land of free health care I could not get into see a specialist for at lest 6 months so I flew to the Mayo Clinic best eye specialist is their no wait. The drug I needed and it did help was listed as experimental in Canada but if you wanted to pay for it no problem . So I payed $1,900.00 a month to have some one put a needle in my eye for a year. I also had to be driven their and back an hour each way. So much for free health care . USA cost like hell but you can get care when you need it. Take a number and wait is hard on the mind because most f the time you do not know if it is a real problem or not. USA is better health care but not cheaper. When you pay some of the highest taxes in the world then get asked for 23,000 dollars for drugs in a country with free health care that is a eye rolling moment.
 

carolkoh

[Industry Expert] Member Sponsor
Sep 17, 2010
907
226
955
Seattle, WA
www.genesisloudspeakers.com
Target, Walgreens and Costco all also have the same $4 prescriptions but you have to join Walgreens' Prescription Savings Club for $20 a year / $35 for a family to get that, and Costco, of course has a yearly membership fee.

However, what I've found out is that you have to tell them NOT to run it under your insurance. They will run it by default.
 

audio.bill

Well-Known Member
May 27, 2013
547
79
340
Chicago suburbs
Target, Walgreens and Costco all also have the same $4 prescriptions but you have to join Walgreens' Prescription Savings Club for $20 a year / $35 for a family to get that, and Costco, of course has a yearly membership fee.

However, what I've found out is that you have to tell them NOT to run it under your insurance. They will run it by default.
I have my prescriptions filled at Target, where they have always filled generics under my insurance and have given me the $4 per month or $10 for 90 days pricing when available. However since January when I changed insurance policies due to the change in health insurance requirements, even though it's still a Blue Cross Blue Shield policy those same prescriptions are now filled for me at NO COST! They just hand me all of those refills for 90 days and the invoice shows a charge to me of $0.00.
 

Greg_R

New Member
Jan 25, 2012
95
0
0
The company I work for uses ExpressScripts/Medco as both the insurance provider *AND* the pharmacy. If we use anyone besides ExpressScripts to fill prescriptions with our insurance we get charged. 1st time prescription fills are exempt from the rule.
 

GaryProtein

VIP/Donor
Jul 25, 2012
2,542
31
385
NY
A lot of people don't understand how much cheaper medical care, prescriptions, etc. can be when you don't use insurance. Dental insurance is one example, at least for me. I can get my teeth cleaned for 10 times (5 years) for what it costs to pay for one year of dental insurance. . . .

I don't know how you get your teeth cleaned ten times for the cost of one year's insurance, but dental insurance ISN'T a good investment. I tell all my patients NOT to buy dental insurance if they ask me. If they get it as a perk, OK, but no one should buy it. If you need MINIMAL and SIMPLE work, with co-pays and other fees, you'll break even--maybe. I tell them to set up their own "health fund" (a bank account) for non-catastrphic, known regular exams and preventive health expenses. If you need a lot of work, (1) the yearly cap on dental benefits won't even get you underway if you're not in one of several types of pre-paid plans, and they provide the very lowest quality of care and in many cases you will get very poorly executed over-treatment because practitioners are only paid well for certain procedures that you may not need, (2) also because the yearly cap is so low, if you need even a moderate amount of work and are seeing a good practitioner who has fees commensurate with the time, skill and ability to excellently perform each particular service, your insurance will never come close to touching your actual treatment fees. Under many pre-paid plans, the dentist is paid whether they see you or not, so it is best for them to do as little treatment as possible or to perform more costly procedures you don't need, when a simpler one is actually preferred.

In medicine, many of us have experienced the difference between the internist who spends a lot of time listening to your concerns and problems and carefully examining you in contrast to the physician or other type of practitioner who does a "drive by exam" and gets you in and out in five minutes. In dentistry, you tend to get what you pay for because beautifully executed treatment takes time to perform and if the work is being paid for at a low rate by an insurance company (and lets not forget that the insurance company also has to approve the treatment you are to receive and they DON'T like paying benefits), the practitioner has no choice but to speed things up to increase their volume and production. Believe me, you want someone who works methodically and obsesses over every detail.
 

amirm

Banned
Apr 2, 2010
15,813
37
0
Seattle, WA
Just an update on my situation. I happen to run out of a couple of our medications so I thought I give the new place a try. I was very interested in Nexium as that has a $50 deductible due to lack of generic version. I had my doctor call in both of them to the new pharmacy. I go to check out and they want $60. I asked for the breakdown and they said it was $50 for Nexium (so no savings) and just $5 off from my normal $15 deductible.

So I thought I had saved $5 only to find out it cost me $30 more! I get home and realize that the Nexium they gave me was at half dose. Nexium has over the counter version now with half the amount at $20. I call the place and ask them who screwed up. They said the doctor had called in the wrong amount. I asked them why they would charge me $50 deductible instead of recommending the OTC for just $20. She said, "we do what we are told!" In contrast, my normal pharmacy always asks me if I want the OTC including this Nexium. So I went there and filled in another prescription for yet another $50 deductible.

All in all, a bum deal and no great discount. Not sure how or why the first visit was such a bargain.

I am part of Costco's drug prescription service. So I might give them a try but boy, do I hate going there. Just like Safeway drugs near us, I rather have my teeth pulled than dealing with the people behind the counter. I go there for one medication that has no insurance coverage and their price is lower than any place including online.
 

treitz3

Super Moderator
Staff member
Dec 25, 2011
5,459
961
1,290
The tube lair in beautiful Rock Hill, SC
Hello, Amir. There's just something very wrong with that story. Sounds like Costco or Safeway is your best bet and I would never again step foot into the store that told you, "we do what we are told!". They are obviously not looking out for your best interests.

Tom
 

MtnHam

Industry Expert
Jan 12, 2014
275
50
335
Nothern California Wine Country
Proper diet and exercise can eliminate the root cause of many ailments that are regularly treated with expensive medications. Modern medicine as practiced in the U.S. often fails to educate the individual of the necessity to take responsibility for their own health. Obesity, smoking and alcohol abuse with their litany of subsequent diseases are prime examples. I am a 70 year old who previously was diagnosed with rheumatoid arthritis and prescribed numerous drugs I was told I would take for the rest of my life. Finding the drugs to be toxic and damaging, I searched for alternatives. A complete change of lifestyle resulted in losing 80 lbs. and complete remission, something my doctors told me was impossible. Today, 15 years later, I have no symptoms, am in the best shape of my life, and take no drugs!
 

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