Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I hope they don’t move this to the Health Insurance sub forum, because it has to do with an insurance company that offers Part D coverage. Anyone below the age of 65 may not be interested.
The company I had last year was covering my prescription for my high blood pressure. It was a generic form of Benicar (without the diuretic portion that makes it HCT in the name). I also take a diuretic, when I am in a situation where going to the bathroom repeatedly is not an issue. My medicine was working fine. My blood pressure is under control. Over the last few years I sometimes forgot to take my daily morning regimen of pills for a day now and then, without a major impact on my blood pressure. I had, over time built up a little extra supply of the generic drug, so I did not need to refill until June. When I did finally try to refill it, I found out the company was no longer covering my medicine. They “recommended” my doctor prescribe Edirba, a new drug. I do a little research on the new drug.
Edirba is a new drug. In fact it is so new that it does not have a generic form of it on the market yet. It is more powerful than the drug I was taking. I read a lot of reviews where people were warning that when you first start taking it, be careful because it will lower your blood pressure so much that you could become dizzy and feel faint. Then there was the cost for the medicine. I estimate my share of the cost would have been at least five times what I was paying for my generic drug. Did I say it was working?
Now I started thinking. Why would an insurance company force me to start using a more expensive drug, which, if they were paying their share of the increased cost would negatively affect their bottom line? There is only one answer to that question, and I wish I could prove it. The drug manufacturer of Edirba must be offering the insurance company rebates(kickbacks?), to push their product. Since when has any insurance company required a patient to use a non generic over a generic drug that is working for the patient?
While doing my research I found a website GoodRx, which I was able to use to find pricing on most drugs on the market. It’s a great resource even if you don’t use their service. I was able to print out a coupon for my generic drug, go down to a local Costco and fill my 90 day supply for less than half of what Express Scripts was charging me for the cost of the generic form before the deductible was reached. That doesn’t even account for the monthly premium.
I will keep spending more to maintain coverage with a Part D insurance provider, in case I come down with a condition that requires a super drug at super pricing, but I will not be using Express Scripts once I have the chance to make the switch at the end of the year. I will also be more careful to check the formularies with what ever company I go with from now on.
One word about Costco. You do not have to be a member to use their pharmacy, but the one I went to has to escort you back to the pharmacy, but after dropping off the prescription, I was able to walk around to see if they had the same k-cups I prefer for my coffee. I will switch from BJs to Costco the next time our membership needs renewal. And I will be using GoodRx when the numbers look better, which they do for almost every drug I am taking. If I use GoodRx for the expensive drugs, I may never reach the deductible for the Part D insurer.
At least three of the medicines we (DH and I) use are cheaper to buy the generic without going through our insurance. That's always something worth checking, when filling drug prescriptions.
I will keep spending more to maintain coverage with a Part D insurance provider, in case I come down with a condition that requires a super drug at super pricing, but I will not be using Express Scripts once I have the chance to make the switch at the end of the year. I will also be more careful to check the formularies with what ever company I go with from now on.
Except that as you've discovered, they can change the formulary any time they like.
It's a good reminder for other seniors to never assume you can "set it and forget it" with a Part D provider.
DH just went through this same exercise last month. He's paying about 1/3 the cost for the same medicine by avoiding the on-line pharmacy and going locally.
I started to talk about the diuretic I was taking but forgot to follow through in the OP. The new drug Edirba lists a diuretic as a drug that it has interactions with.
It might be similar to the Benicar HCT that I used to take. When I switched from HCT to plain Benicar, my insurance at the time, through my employers, went from me having to pay a copay to paying zero copay for both a Benicar and the diuretic. A double benefit at the time.
Don't depend on your drug plan to give a valid recommendation for a substitute drug. Mine tried to tell me to take a pain killer when they stopped covering my muscle relaxer. Ask your doctor what to take instead.
And yes, many drugs are cheaper at the pharmacy than your co-pay amount. Everyone should check prices periodically.
And when your drug plan sends you a notice about their formulary changes, pay attention. This is all part of being a senior citizen these days.
Is there any chance you could get your blood pressure under control without using medication, by regularly exercising and modifying your diet? If so, then you wouldn't have to pay anything for a drug. Just a thought.
Is there any chance you could get your blood pressure under control without using medication, by regularly exercising and modifying your diet? If so, then you wouldn't have to pay anything for a drug. Just a thought.
Been trying, but it’s not always that easy, especially at the later stages of life, if you haven’t been doing it all along. That’s a topic or a thread of it’s own, which I think has been done many times.
I switched to using GoodRx exclusively about 6 months ago, mostly through Costco. Usually, GoodRx lists, for example, CVS being even less expensive than Costco, but not always.
I recall having MedcoHealth and it was pretty good, but then it was acquired by ExpressScripts several years ago. ExpressScripts sux.
We are eternally blessed that the VA provides my husband heart meds including the $500 a month Brilanta. I am truly grateful for them.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
