I also have a "ton of them"

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Expand view Topic review: I also have a "ton of them"

Re: I also have a "ton of them"

Post by dlcnurse » Wed Sep 21, 2011 11:49 pm

Links updated. Broken links removed. 9/20/11 dlcnurse

Post by parkerlindsey » Fri Aug 28, 2009 4:49 am

Hi jimithy...
Thank you so much for your information. I am now using Lipitor can be bought in the 20mg dosage. It has almost cut off my cost by 40%. Also i have subscribed for the 30 day free supply on www.lipitor.com. Thank you so much for your information.

Post by NoPocketCash » Sat Aug 25, 2007 10:52 am

The following is just for your information and not meant to scare you. We are not here to replace your doctor

Post by dlcnurse » Fri Aug 10, 2007 2:44 am

bhunt
Here are a few suggestions on your medications.

Depakote- this is a medication that has several different generic names and each one is alittle different. Those names are Valproiate Sodium, Valproic Acid, Depakene, Epival.
These can be purchased at lower costs in Canada and India. Many of these are in the Regular Strength of Depakote instead of the Extended Release.
Valproiate Sodium- cost is 42 Cents a pill/12.60 for 30 tablets
Valproic Acid-cost is 50 cents a pill/15.00 for 30 tablets
Depakene- cost is 55 cents to 75 cents a pill/16.50 to 22.50 for 30 tablets
Epival-cost is 173.56 for 100 tablets of the delayed release tabs.
These costs reflect the cost at Canada pharmacies.
Only one Valproic Acid can be purchased for 26 cents a pill/7.80 for 30 tablets in India.

Lyrica is a medication used for neuropathic pain. This medication alone is an expensive drug and there is no generic form currently.
There are some alternative medications that you can ask your doctor about that is also used for this type of pain.
Neurontin or Gabapentin runs about 19 cents a pill to 1.58 a pill depending on the dosage. Dosages range from 100mg to 800mg in this medication.

Other medications are Cymbalta (duloxetine), Dilantin (Phenytoin). Cymbalta is a rather new medication on the market also so this one may not be any cheaper for you.
Effexor XR
A alternative medication that is of the same classification (has the same actions as Effexor) is Wellbutrin (Bupropion) which is more cost effective than Effexor. It does have a extended release tablet and also has a XL that is a once a day dose. I will have to obtain the prices for you on this one.

These are some suggestions for you. I will take a look at your other medications as well and see what I may be able to help you with. Do talk to your doctor when you return to him about alternative medications that have the same effects but are cheaper in cost.
Also, since you have insurance coverage, you may want to check with your benefits administrator to see if they would consider drug coverage from outside the US in mail order.

In regards to your hospital bills... do make an appointment with the accounts department of your hospital and discuss the balance after insurance. Many times that balance can be written off and they will accept what payment your insurance makes. You will need to have a work sheet with you showing all of your expenses per month, including food, clothing, medications, etc. And the last paycheck stub. (The way it is done is that they deduct your living expenses from the gross income and base your ability to pay on that amount, if it falls below a given poverty level for your size household, they will write off the balance owed. They will also set up payment plans if that is what you desire to do.
I will look into some other programs out there to see if I can help you. I do have one question that I will need in order to find the programs for you and that is the state/area that you live in. You can send a private message if you wish to have that remain confidential.

Co-pays
There are some programs out there that will help you with co-pays, one is http://www.patientadvocate.org/ which is a non-profit organization that assists by being a liaision between the patient, the insurer, and the physician and working out a solution that will allow you to remain financially stable, ensure that you recieve medical care etc.. They do work through your physician to to help you figure something out. If you prefer to call them the number is 1-800-532-5274 for further information.

Another foundation that may be of some help is http://www.healthwellfoundation.org They can provide some assistance for patients with certain illnesses and insurance premium, co-pays etc... I don't know what their terms are though.

Post by jimithy » Thu Aug 09, 2007 4:07 pm

bhunt,

I noticed that you removed these from your original medication list:

Actos 30mg Diabetes
Fluticasone Propionate Nasal Spray 50mcg Allergies
HHF Healthy heart Formula Vitiman Supplement

and you added:

Glipizide

Is this accurate? Did you drop the Actos and add Glipizide based upon our concerns and the most current study comparing it to older drugs - was it for some other reason?

BTW you can buy 10mg Glipizide and split them. Several Big Box stores ( www.slashdrugcosts.org/forum/viewtopic.php?t=221 ) offer it at 90 tablets of 10mg for $12. Split this would be $2 / month. Comparing that to your current costs it would be 33% of what you currently pay.

Post by jimithy » Thu Aug 09, 2007 3:12 pm

bhunt,

You indicated that your providers cost you 75% as much as your drug bill. We do not normally give advice about reducing other costs so you can look at www.nbgroup.org/reducing_costs.htm and possibly some of their ideas can drastically reduce your provider costs.

Post by jimithy » Thu Aug 09, 2007 3:08 pm

bhunt,

You said you take:

Alprazolam 05mg $3.35 30 tabs

I am sure you meant

Alprazolam 0.5mg $3.35 30 tabs

Either way... I find no retail pharmacy that can beat that price no matter what methods are used to reduce costs.

Since this does not appear to a copay. It would add to our knowledge if you could tell us how you got such an EXTREMELY low price on 30 .5 mg tablets. (are you sure you are not quoting the price for each tablet instead of your monthly costs?)

A very minor reduction in price would be IF this drug can be split (ask any pharmacist) then getting the 1 mg tablet and cutting it in half would drop the price to $1.68 / month.

Post by jimithy » Thu Aug 09, 2007 3:02 pm

bhunt,

Your lisinopril 20mg can be gotten as Lisinopril 40mg and split in half. The cheapest I can locate the Lisinopril 40mg tablets is a KMart where 90 are $15. That would be a six month supply when split. So the cost per month would be $2.50 versus the $7.32 you currently pay so you by paying about 35% as much.

Post by dlcnurse » Thu Aug 09, 2007 12:21 am

bhunt,

So sorry to hear that you were hospitalized. I do hope that things get better. Seeing 4 different docs is difficult when the co-pay is $40.00 each time.
Question in regards to your medications. The cost you stated, is that for the total supply you need of each med per month?

So your total cost per month for your meds is roughly $213.00 per month currently?
Are you currently purchasing any medications that are over the counter, such as vitamins, minerals, etc.. that you are taking on a daily basis?

The lisinopril you can purchased cheaper at the Big Box stores for $4.00 for the 30 day supply. Or $15.00 for a 90 day supply. I will need to go back and take a look again at your other medications to offer other suggestions.

Thanks for replying

Post by jimithy » Wed Aug 08, 2007 11:53 am

bhunt,

Sorry you had to go into the hospital.

Thank you for all of the more specific and added information. We will see what we can do with it.

I also have a UTI, and am taking Clindamycin 300mg twice a day for 7 days, $15.00.


Various drug store chains (with pharmacies) now give away up to 14 days of antibiotics for free (see http://www.slashdrugcosts.org/forum/viewtopic.php?t=217 and http://www.slashdrugcosts.org/forum/viewtopic.php?t=315 ). Check the websites of major chains close to you to see if any of them do. If so, copy the list and bring it to your doctor whenever he MIGHT prescribe an antibiotic. A lot of antibiotics have "therapeutic equivalents". Basically this means that another drug can also treat the same problem with similar effectiveness.

Also, most Big Box stores such as Wal-Mart, KMart, Target, and Sam's Club have some VERY inexpensive generic drugs (see http://www.slashdrugcosts.org/forum/viewtopic.php?t=221 and http://www.slashdrugcosts.org/forum/viewtopic.php?t=300). If you have a printer (because the lists are long) you can print those out and ask your doctor about whether any of those drugs are therapeutic equivalents of what you now take. Also ask whether the pills can be split (If so then ask for double the dosage per pill) and many times that can lower your costs to $2/month.

Also taking Amitiza, for severe constipation, 24mcg once a day, free pack of 8, insurance does not cover, if I have to take more.


If your doctor had one free pack then he can get more. Call his office exlain your lack of money and request that they call the drug rep for the Amitiza and then request they call you when it comes in. You can do this WITHOUT incurring the costs of another doctor visit and just pick it up from the office staff.

Also, it will not help you now but many times this problem can be prevented by taking the generic equivalent of Metamucil (psylium fiber) EVERY DAY. If you get the version that you spoon out and stir into a liquid then your costs would be only a couple of dollars a month.

So far this year thru 08/01/07 he has made


Most assistance programs will not accept pay stubs indicating what you are currently making. They want to know your gross income of the year before that you filed with the IRS. That information is much more useful to us.

Once, again... I hope you are feeling better now and thank you for your reply. We will get back to you.

jimithy

new meds

Post by bhhunt » Wed Aug 08, 2007 10:20 am

I appreciate all of your assistance. I have not answered back, as I was hospitalized again. My meds were changed, here is the new list plus cost:

Lisinopril 20mg $7.32 30 tabs
Effexor XR 150mg $30.00 60 tabs
Depakote ER 500mg $30.00 1000mg PM 60 tabs
Seroquel 200mg $30.00 800mg PM 120 tabs
Lyrica 150mg $60.00 150mg AM 150mg PM 60 tabs
Zolpidem 10mg $15.00 30 tabs
Lipitor 10mg $30.00 30 tabs
Levothyroxine .088mcg $7.48 30 tabs
Geodon 40mg $30.00 40mg AM 40mg PM 60 tabs
Glipzide 05mg $6.16 30 tabs
Alprazolam 05mg $3.35 30 tabs

Blue Blue Shield of Ga. Doctor co-pay $40.00, each and every one. I have appointments with Primary, Therapist, Pdoc, and new neurologist. That is $160.00, and my Primary wants to see me again on next Monday for bloodwork, as my sodium level is 128, which is very low, and I have severe edema in my feet, ankles, legs, face, and arms. I also have a UTI, and am taking Clindamycin 300mg twice a day for 7 days, $15.00. Also taking Amitiza, for severe constipation, 24mcg once a day, free pack of 8, insurance does not cover, if I have to take more.

SSI or SSDI, is out for me, as I spent last 9 years taking care of my son who was on SSI for a TBI. Husband makes too much so no help there either. So far this year thru 08/01/07 he has made $28,800.00.

I really do appreciate all your feedback from each and every one of you.

Actos is ineffective

Post by NoPocketCash » Wed Jul 18, 2007 12:05 am

The Annals of Internal Medicine (established by the American College of Physicians in 1927) just published a federally funded (Health and Human Services) report on Monday (July 16, 2007) comparing all diabetes medications.

The results do not surprise me.

The newest medications, Avandia and Actos, for which in May, 2007 the FDA requested their most extreme "black box" warning were shown to be less effective than older, cheaper, safer drugs.

216 controlled trials and cohort studies and 2 systematic reviews that addressed benefits and harms of oral diabetes drug classes available in the United States were identified and analyzed.

Besides being just as effective as newer drugs with blood sugar control, Metformin (Glucophage) had another positive effect.
Metformin decreased LDL cholesterol levels by about 0.26 mmol/L (10 mg/dL), whereas other oral agents had no obvious effects on LDL cholesterol levels. Most agents other than metformin increased body weight by 1 to 5 kg. Sulfonylureas and repaglinide were associated with greater risk for hypoglycemia, thiazolidinediones with greater risk for heart failure, and metformin with greater risk for gastrointestinal problems compared with other oral agents. Lactic acidosis was no more common in metformin recipients without comorbid conditions than in recipients of other oral diabetes agents.

Conclusions: Compared with newer, more expensive agents (thiazolidinediones, {alpha}-glucosidase inhibitors, and meglitinides), older agents (second-generation sulfonylureas and metformin) have similar or superior effects on glycemic control, lipids, and other intermediate end points.
www.annals.org/cgi/content/full/0000605 ... 80-00178v1

Basically this extremely extensive government sponsored study published by a very respected journal says that Metformin (Glucophage) is better and safer.

This is an important study and you should review the results with your doctor (especially considering you take medication for cardiovascular problems which the FDA "black box" warning of Actos concerns).

The costs for the extended time-release version of Metformin (Glucophage) from the "drug war" stores is $4 / month. You are probably paying a $60 / month co-pay but even if it is only $30 / month you would still pay only 14% of what you currently spend using your insurance.

Another run through PPArx.org

Post by jimithy » Tue Jul 17, 2007 5:52 am

You might want to input data again at www.PPArx.org and indicate that you have no insurance for medications just to see the results.

You can then find out how many of your meds can be had for free or at greatly reduced prices if you are not insured.

Since your insurance costs are so high ($1500 deductible + $4800 premiums + expensive co-pays most of the year) it might be worth dropping off your husband's policy. (maybe he could just drop your prescription coverage?)

The cost of your doctor and therapist visits could be minor in comparison to your drug bill.

This would be especially true if you qualified for SSDI or SSI where the doctor and therapist visits (and other health expenses) could be covered.

Split Lipitor

Post by jimithy » Tue Jul 17, 2007 5:41 am

Lipitor can be bought in the 20mg dosage and split to cut the cost in half. Adventuresome people sometimes cut pills into quarters with a GOOD pill splitter and reduce costs even more.

Also, a free 30 day supply can be gotten at http://www.lipitor.com/resources/home.j ... s/home.jsp

If your doctor indicates that you take the 20mg dosage then it would be a free 60 day supply (when split).

Post by dlcnurse » Tue Jul 17, 2007 3:01 am

bhunt,

I am assuming that the $1500.00 is your hospitalization deductable. Your doctor visits are $40.00 a visit, and your co-pay for prescriptions is $30.00 or $60.00 depending on the tier level of I,II or III, and $15.00 for generic medications.

I don't know what your cost of medications are currently and what you are actually spending on them so am unable to ascertain whether this will be a savings for you.

For your list of medications, here are some costs that you might want to think about in comparison to your actual costs.

Zolpidem for 100 tablets the cost is on average about $40.00

Actos for 90 tablets in brand name the cost averages from $289.00 to over $500.00 depending on where you purchase them.
A generic form of Actos can be purchased online from Canada at a lower cost of 145.00 for 100 tablets

Lisinopril can be purchased also online for less, The stores mentioned in the above posts also has it for $4.00 for a 30 day supply. You can actually purchase this at http://www.costco.com A 100 tablet supply for $10.00 You do not have to join their site to obtain medications from their pharmacy.

Levothyroxine (the generic version) can also be purchased in Canada for $14.05 for a supply of 100 tablets. it also is available at the above mentioned stores for the $4.00 for the 30 day supply

Lyrica, which you take twice a day, for a 60 day supply it runs from $152.00 on the average cost, 100 tablets = $194.00 and 120 tablets =$333.00 in the brand name.
Lyrica, does have a generic brand available in Canada called pregabalin; for a 90 day supply the cost is $109.00. It does come in a 300 mg dosage also, which may be able to be split. These come in a hard gelatin capsule and if they are scored, it is possible to split them, if there is no signs of a score mark, then they can not be split. But that is a option to purchase in the 300 mg dosage and split them. Ask your pharmacist to be absolutely sure before trying to split the pill. (To ensure that you are not getting too large of a dose over a short period of time)

Alprazolam can be purchased also at Costco.com for $10.00 for a supply of 100 tablets. Canada is still cheaper. The cost is $9.22 for a 100 tablet supply. For a dosage of 3 times a day, the cost would be approximately $30.00. (this is usually the maximum dose prescribed).

Lipitor is purchased in the US by Brand name for a cost of $128.00 for a 90 day supply. In Canada the cost is $89.00 for the 90 day supply.
It also comes in a generic brand called Atorvastatin which for 100 tablets is 78.00 in the US and $50.00 in Canada

Depakote ER does not have a generic equivalent. For a 100 day supply the cost in the US is $252.00, $175.00 in Canada.
Depakote in the regular dosages does come in a generic form called Valproic Acid. The cost is much cheaper in this. You can purchase 100 tablets for $45.00 in Canada and $50.00 in the US.
You may want to talk to your doctor about using the regular Depakote versus the ER form.

Effexor XR 100 tablets of the 150 mg strength in Canada is $193.00 compared to the US which for the 100 tablets the cost is $370.00.
This also comes in a generic form named Venlafaxine XR and the cost for the generic is $110.00 for 100 tablets in Canada, $139.00 in the US

Seroquel in the 200 mg tablets the cost for 100 tablets is $306.00 and in Canada $275.00. The generic form named Quetiapine it is $179.00 in Canada and $199.00 in the US

this will give you some idea of what you can save, but not knowing what your costs actually are, I have no idea of how much it will be of help to you.

Do talk with your doctor before making any kind of changes in your medications, ask about other medications that may be of lower cost to you, and talk to him/her about applying for you through the office to the pharmaceutical companies on your behalf. Many pharmceutical companies will provide medications through the doctors office for little or no cost when it is a hardship for you. Don't be afraid to talk to your doctor about it. They can be a big help in supplying the necessary medications you need.

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