Single with a medium income but my med costs make me poor

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Single with a medium income but my med costs make me poor

Postby Must Cut Costs » Tue Dec 26, 2006 3:19 pm

Hello... I am at a loss how to pay for hundreds of dollars a month for my meds because although I have a decent job, I also have the same living expenses everyone else does. :(

My meds are:
Geodon: 40 mg in am; 160 mg in pm
Wellbutrin: 300 mg in am
Lamictal: 100 mg in pm (soon to be 200 mg)

Any help would be appreciated.
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Here is a decent start at reducing your costs - more to come

Postby jimithy » Tue Dec 26, 2006 7:08 pm

FIRST, THE SPECIFIC IDEAS PRESENTED SHOULD NOT BE FOLLOWED BLINDLY. YOU SHOULD MAKE YOUR OWN CHOICES AS FAR AS TREATMENTS, PHARMACIES, MEDICATIONS, ETC.

ANY SPECIFIC EXAMPLE GIVEN IS JUST THAT... AN EXAMPLE TO SHOW I AM GIVING "REAL WORLD" COSTS AND IDEAS.

IT IS BEST TO "SHOP AROUND" WHENEVER POSSIBLE... WHETHER YOU BUY YOUR MEDICATIONS LOCALLY, FROM AN ON-LINE AMERICAN PHARMACY, OR FROM A FOREIGN PHARMACY. THE ONES IN THIS EXAMPLE WERE CHOSEN BECAUSE THEY ARE COMMONLY USED... USUALLY YOU WILL FIND BETTER PRICES ELSEWHERE.

Now... on to answering your question...

Well there are a number of things that can help.

First, when asking a question like this it is good to provide as much information as possible about your meds, your income, the state you live in, how many people live in your household (you said you are single but that does not mean you do not live with other people.), where you are currently getting your drugs, etc.

You said your current meds are…

Geodon: 40 mg in am; 160 mg in pm
Wellbutrin: 300 mg in am
Lamictal: 100 mg in pm (soon to be 200 mg).

An assumption here is that these are drugs that you will be taking for a long time. This means you have a chronic condition that requires them AND you are fairly sure that the doctor will not be changing the drugs you will be taking for this condition in the near future.

A few things missing is the specific type of Wellbutrin (immediate release, 12 hour, or 24 hour.) and how your Lamictal dosing will be when you finish ramping up to 200mg.

It is best if you can be very flexible in the possible ways to reduce your costs. The whole idea is to end up with more available cash to spend each month. The specific (as long as they are legal) methods should not matter. For an instance, if some of that cash comes from government programs it should be ok (considering how much taxes how have paid... and will pay throughout your life... if other people use YOUR TAX MONEY... you should use it too.) But we are not even to that point yet.

The quickest way to slash your costs is to get free drug samples from your doctor. The drug reps are really pushing Geodon and Lamictal right now (and both of those drugs are VERY expensive). Your doctor is only supposed to give you enough to get you started on them but most doctors will help you IF you tell them about how difficult affording them is to you (and they realize how bad it will be if you stop taking your drugs because you can\'t pay for them). Sometimes the doctor will give you stickers that go on the back of prescriptions that allow you to fill them at your pharmacy for free. That is just as good as getting the sample drugs themselves.

Wellbutrin is not being pushed by drug reps in this way so you have to use other methods with it.

Checking out the Wellbutrin you are taking I found different ways to reduce the cost. I think you will like the answers.

You are currently taking Wellbutrin: 300 mg in am

Here is some of the issues about Wellbutrin and its generic form Bupropion. There is an increased risk of seizures when taking immediate release versions of the pill in high dosages. Therefore it would probably be best if choosing immediate release versions that 75mg four times a day be used rather than 100mg three times a day.

It is important to talk with your doctor about the possible variations in the drugs you take. Possibly your doctor may be skittish about immediate release versions but IF he feels you will remember to take the drug twice a day then he probably won\'t have a problem with the 12 hour release (SR) version.

NOTE: Most time release versions of drugs cannot be split so those options are not shown here.

NOTE: The generic version of Wellbutrin XL (24hr sustained release) has just become available. The first generic drug company that overcomes the hurdles to qualify their drug is given a 6 month monopoly on the generic market. Therefore they price the drug much higher than normal until they have competition. Their prices are usually set by choosing the highest price possible that still makes it preferable over the name brand. This industry practice is known as "shadow pricing". Other industries call it "Price fixing" and the government sues them for doing it.


Neighborhood Drug Store (Note: Mom & Pop Drug stores & "Big Box" store pharmacies are often somewhat cheaper)

Walgreen’s on Black Horse Pike in NJ

Wellbutrin XL 300mg (24hr sustained release) 30 tablets = $181.99 x 3 (90 tablets) = $545.97 (better prices if you shop around)

Bupropion HCl 300mg (24hr sustained release) 30 tablets = $136.99 x 3 (90 tablets) = $410.97 (better prices if you shop around)



Online Drugs – With online drugs it is almost always best to go with at least a 90 day supply. They price it better and shipping costs are reduced or free. NOTE: It is not a good idea to buy 3 month supplies of drugs unless you are quite sure you will be taking the drug for that long.

http://www.DrugStore.com (people have called it very reliable)

Wellbutrin XL 300mg (24hr sustained release) 90 tablets = $437.71 (better prices if you shop around)

Wellbutrin SR 150mg (12hr sustained release) 180 tablets = $419.96 (better prices if you shop around)

Wellbutrin (immediate release ~ 4hr) 360 tablets = $490.64 (better prices if you shop around)


Generic Wellbutrin is Bupropion HCl

Bupropion HCl 300mg (24hr sustained release) NOT AVAILABLE

Bupropion HCl 150mg (12hr sustained release) 180 tablets = $199.98 (better prices if you shop around)

Bupropion HCl 100mg (immediate release ~ 4hr) 270 tablets = $181.98 (better prices if you shop around)

Bupropion HCl 75mg (immediate release ~ 4hr) 360 tablets = $182.63 (better prices if you shop around)


Foreign Drug Stores

One Canada drugstore\'s (This is one that the state of Wisconsin uses) prices. NOTE: There is a wide variance, a friend uses http://www.candrugstore.com regularly because of reliability and good prices.


http://www.canadadrugs.com

Wellbutrin XL 300mg (24hr sustained release) 90 tablets = $222.35 (better prices if you shop around)

Wellbutrin SR 150mg (12hr sustained release) NOT AVAILABLE

Wellbutrin (immediate release ~ 4hr) NOT AVAILABLE


Generic Wellbutrin is Bupropion HCl

Bupropion HCl (12hr sustained release) (effectively) 180 tablets = $147.39 (actually must buy 2 x 60 bottles @ $110.54 (better prices if you shop around)

Bupropion HCl (immediate release ~ 4hr) (effectively) 360 tablets = $259.38 (actually must buy 4 x 100 bottles @ $72.05 (better prices if you shop around)


NOTE: Here is a good example of why you check ALL the prices in a pharmacy. The generic immediate release version should be the cheapest. It is actually more expensive than the brand name 24 hour release.

The end result is that strictly by shopping, using the generic version, and switching from the 24 hour to the 12 hour release versions (since there is only a minor savings to use the generic immediate release); you spend about 36% as the local pharmacy I checked ($545.97 versus $199.98 ) without using a foreign pharmacy. If you did use that foreign pharmacy then you would be spending about 27% as much ($545.97 versus $147.39).

Now... how about saving 95% of the cost instead? ($545.97 versus $30) without using a drug company Prescription Aid Plan (PAP) (many can be hard to qualify for because of income and other restrictions.).

Xubex® www.xubex.com offers assistance to qualified individuals for generic medications through its innovative program. There is no cost to join and no monthly fees. For a one person household, the monthly Gross income cannot exceed $2056.17. Bupropion HCl is available for $30 for a 90 day supply (NOTE: Most of their drugs are $20 / 90 days).

Then again possibly you could get Wellbutrin XL brand name drug for free using the GlaxoSmithKline "Bridges to Access" program http://www.bridgestoaccess.com The patient must have no prescription coverage for the medication and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident. For a one person household the monthly Gross income cannot exceed $1,633.33. This is where it can get weird. If by chance you were making $1730 / month and asked your employer to lower your pay to $1630. Your actual take home pay would not drop by $100 because of all of the deductions they take out. Your actual money to pay bills would go up by $100 to $400 though because you\'d be getting your Wellbutrin for free. It would probably go up even more because other drugs you take might fall within the same $1633 / month limit which would allow you to get them for free as well.

If you are slightly over that then it could be good to keep an eye on "Rx Outreach" http://www.rxoutreach.com that specializes in higher incomes ($2041.67 / month - higher in Alaska & Hawaii). They are tied with about 55 assistance programs. Unfortunately they do not currently handle Wellbutrin.

For even higher incomes ($2500 / month - higher in Alaska & Hawaii). There is TogetherRxAccess http://www.TogetherRxAccess.com They represent 275 name brand prescription drugs and a wide range of generic drugs as well.

Remember the income limitations shown here are based upon a one person household. (More people in the house means more income is allowed. Astra Zeneca allows incomes of $60,000 in some cases.) :D
Last edited by jimithy on Wed Jan 10, 2007 12:02 pm, edited 2 times in total.
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Ways to save on Lamictal

Postby AntiPharm » Tue Dec 26, 2006 8:50 pm

Lamictal usage information indicates that is used alone or with other medications to prevent or control seizures (epilepsy) or to help prevent the mood swings of bipolar disorder.

Based on the other drugs you are taking it appears that you probably take Lamictal to help control Bipolar Disorder.

One common way to reduce costs is to buy higher dosage drugs (which often have almost the same price of lwwer dosage pills. Then use a pill splitter to make the correct dosage at half the price. Unfortunately Lamictal cannot be split (or crushed or chewed) so that is not an option here.

A common way to save money on drugs is to use generics (which is not available for Lamictal) or a patient who cannot afford one drug can be switched to what is called a therapeutic equivalent. Basically this means that another drug can also treat the same problem with similar effectiveness.

There are various drugs that are used to treat mood swings but only one other drug has the same property of helping swings both up and down and that is Lithium.

Lithium has definitely the longest history (50+ years) by far in treating Bipolar Disorder and nothing has shown to be more effective at controlling mood swings. The key though is that it does not matter how effective it is overall for a large group of people. What counts is what drug is effective for the person taking it. Bipolar Disorder has a high mortality rate. A doctor and patient must carefully weigh the risks versus the benefits when switching to a different drug in order to save money.

With all of this said IF you and your doctor agree that Lithium might be worth trying then there could be major cost savings.

When you have ramped up on Lamictal to 200mg (since you did not say my guess is you will be taking 2 doses of 100mg - one am and one pm) and you shopped around then you might get a decent price of something over $200 a month.

Lithium is commonly prescribed as a time-release tablet (Eskalith Cr). A common lab test indicates the serum levels in your blood to determine the correct dosage (and it is critical that it be monitored periodically for as long as you are on the drug). A typical monthly cost of using Lithium can be about $50 (or a generic from a good Canada drug store can drop that to about $13 a month). That is 1/4 or less of the cost of using Lamictal.

This might not be an acceptable choice for many people. For people who are facing not being able to afford $200 a month, then possibly an alternative at $50 could be appealing.
Last edited by AntiPharm on Wed Dec 27, 2006 2:13 am, edited 1 time in total.
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Ways to save on Geodon

Postby AntiPharm » Tue Dec 26, 2006 11:21 pm

You can shop around for Geodon and might get a decent price of something about $150 for thirty 40mg capsules + $325 for sixty 80mg (BTW Some of the newer drugs have new marketing methods to prevent foreign drug stores from undercutting U.S. prices. Geodon is not cheaper in Canada).

Geodon is also one of those drugs whose price is not determined by the cost of manufacture. The 20mg capsules sell for approximately the same price as the 80mg capsules. With a cost of about $5 per capsule I know someone who actually went out on eBay and bought 1000 empty gel capsules for about $10 and then very carefully divided each of his 80mg capsules in two equal parts in order to make 40mg capsules. He said the capsules come apart very easily simply by twisting them. He was on two 40 mg capsules a day so he saved about $75 a month this way. I do not think it is a good idea because there is always going to be somewhat more or less than 40mg in each newly created capsule this way.

Since your cost for Geodon is probably going to be about $475 a month then cutting that down to $400 using a questionable (and time consuming) practice is not very worthwhile.

Of course there is another way.

Geodon is called an atypical antipsychotic which is a new class of antipsychotics that started major use about 10 years ago. They replaced what are now called typical antipsychotics because the drug companies said that they should not have the bad (often irreversible) side effect of Tardive Dyskinesia (TD). TD is basically involuntary movements often of the mouth.

Anyway, anecdotal evidence started mounting up that the newer drugs still had the same problems. Finally the National Institute of Mental Health (NIMH) did the biggest longest study of antipsychotics ever done. There have been a lot of studies analyzing the results and they indicate the newer drugs cause TD just as much as the older drugs. There was no significant improvement for the patient to be on an atypical versus a typical antipsychotic. In fact the most popular atypical antipsychotic was shown to cause definite problems. (A lawsuit for hundreds of millions of dollars has been settled concerning it
Last edited by AntiPharm on Mon Jan 01, 2007 4:32 pm, edited 1 time in total.
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Utilize your physician for help

Postby dlcnurse » Tue Dec 26, 2006 11:26 pm

Many of the programs that Jimithy mentioned are excellent resources to apply for. One other source is to utilize your physician. Make an appointment and go talk to him/her in regards to the cost of your medications and ask them for assistance in applying for the assistance. Sometimes physicians can obtain the medications for you that can be sent directly to their office for you. One site that is strictly geared to the physician is http://www.indicare.com which requires them to register and apply on your behalf for the medications. For many persons the medications that you take are for a permanent condition that is not going to go away and you are not able to function a normal lifestyle without them. Be sure and ask your doctor if there is a effective alternative to what you are taking currently. Different medications such as other mood stabilizers such as Tegretol, Depakote, Lithum are other alternatives for Geodon. Antidepressants such as Prozac, Paxil, Zoloft which are classified as SSRI's, Zyprexa, Seroquel, Risperdal, Abilify are other medications. It may be that your doctor has tried some of these other medications as well and they don't work for you. Prescribing medications for bipolar illness is quite different than prescribing medications for a heart condition, or diabetes, and other illnesses. The goal of treatment in mental illness is to have "successful maintenance treatment program". Be sure and ask your doctor questions such as Is this the right choice of drug for me? Are there any alternatives that will provide the same treatment modality? Is it really needed? Unfortunately, changing medications in these type of medications can mean starting over in having your symptoms fully controlled. It can make a big difference in making a decision on whether to change or not, regardless of the cost. Pharmaceutical companies usually will provide the medications at a reduced cost and some times free. I am sure that your physician would be more than happy to assist you knowing that it is causing you hardship in affording them. Some times having the documentation of the necessity of using these particular medications is essential for life and also the documentation of the hardship of cost to you, pharmaceutical companies will reduce the cost or give the medications for free. The only stipulation to these programs is that the medication has to be sent to your physician, and not to you directly. It is very important that you share your concerns regarding the cost, needing help with that cost with your physician.
TogetherRx.com is about the largest program that many of the pharmceutical companies participate in. The medications you take are available through this program. One problem though is that you would have to be without any drug coverage. Not knowing if this is the case for you, I would recommend applying but even this can be done through your physician's office.
Copy the IP address or go to the page for the physician assistance and copy it and take it to your physician's office when you see him/her to steer them in the right direction to assist you. Good luck. dlcnurse
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Postby jimithy » Thu Jan 04, 2007 11:28 pm

You indicated that you are about to be ramped up to 200mg of Lamictal. It is very understandable if you desire to stay on this drug despite its cost because of the inherent danger of changing medications when you have Bipolar Disorder.

There is a major price advantage by buying Lamictal online.
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Cribbing an answer again...

Postby GeeWhiz » Fri Feb 02, 2007 5:47 pm

I just noticed that I do not believe anyone posted concerns about mail order drugs. So I am (once again) going to crib and modify one of jimithy's posts.

Done wisely internet or foreign pharmacies can be an effective method for some medications. Without knowing what you are doing it can be a recipe for disaster. Counterfeit medications are everywhere (including local pharmacies) but internet, mail order, and foreign pharmacies have substantially greater problems with them. Not all mail order services are bad. Several cities and states use foreign pharmacies and the FDA gives advice about finding reputable foreign pharmacies. Please read Shopping for the best prices locally & using the internet if you plan to mail order your medications. (Such as the suggestion for Lamictal)

Thats all! :D
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Re: Single with a medium income but my med costs make me poo

Postby jimithy » Sun Aug 21, 2011 11:26 am

Updated text and links 8/21/2011 by jimithy
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Re: Single with a medium income but my med costs make me poo

Postby dlcnurse » Wed Sep 21, 2011 11:53 pm

Broken links noted on 9/21/11 and removed. dlcnurse
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