retired but need these medicines on daily basis

This is the "cry for help" forum. Provide as much info as you feel comfortable (we do not need your name, address, ID numbers, etc.) and someone will answer within hours hopefully (maximum time 1 day). If you do not wish to disclose any information in a public post you can register using an anonymous email address and then send a private message to dlcnurse, NoPocketCash, or jimithy.

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 WE ARE GIVING "REAL WORLD" COSTS AND IDEAS.
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retired but need these medicines on daily basis

Postby bigjack » Tue Jan 09, 2007 3:16 pm

1. protonix (40mg) - 2x daily
2. lipitor (80mg) - 1x daily
3. toprol (50mg) - 2x daily
4. isosorbide mn (30mg) - 1x daily
5. altace (ramipril) (2.5mg) - 1x daily

any advice on cheapest seller is appreciated!

i have medicare A/B/D.
Last edited by bigjack on Wed Jan 10, 2007 7:07 pm, edited 1 time in total.
bigjack
 

Postby NoPocketCash » Tue Jan 09, 2007 3:33 pm

bigjack,

We really cannot do as much for you without just a little more information. If you could post what is the dose of each of your pills are and how many times a day you take each one, then we can make accurate comparisons.

Dosages and quantities make a very large difference.

Knowing whether you can afford to pay for 90 day supplies would also help.

Thanks! :)

If you do not feel comfortable posting this information then you could send a private message to me.
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Postby jimithy » Tue Jan 09, 2007 8:58 pm

bigjack,

Your post indicates a basic misunderstanding of what we try to do for you. If you look at the other posts in this forum you will see that we show many ways of drastically cutting medication costs. You are simply asking for checking prices. Shopping around for the best prices can help but the other ideas we give out usually save people quite a lot more money than that.

If you are interested in simply shopping around and not trying to use other methods to slash your costs then it is a fairly simple process.

If you do not want to make use of buying 90 (or greater) day supplies via mail order pharmacies then simply calling your local pharmacies can give you a range of prices. My specific experience is that I do not get the lowest prices for a number of medications at a single pharmacy. A decision must be made whether you wish to use more than one pharmacy for your monthly meds. There is an added risk because if your pharmacist does not know all of the meds you are taking then he cannot check for interactions between all of the meds. Often you can eliminate this risk by informing the pharmacist that you have shopped around and his price on certain meds are not the lowest. A great many times he will price match a different local pharmacy (they will never price match mail-order or foriegn pharmacies.)

Surprisingly I have found "Mom & Pop" locally owned pharmacies often have the lowest prices and most often are willing to price match.

Big Box stores and Warehouse Clubs usually have low prices.

Pharmacy chains usually are the most expensive for people without insurance.

Speaking of which... you indicated you are retired but gave no details about Medicare or insurance such as an HMO. This is unusual for a retiree in the U.S. If you live in a different country it is important for us to know if we are going to have a chance to come up with methods of saving money for you.

If you want exact information about shopping for the best prices you might try Shopping for the best prices locally & using the internet

Looking forward to your next post. :D
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Sorry About That! We missed that you edited your post

Postby jimithy » Sat Jan 13, 2007 10:06 pm

bigjack,

I just saw that a couple of days ago you added ALL of the information requested.

This site is new and this Subject was just added so mistakes will happen until we get into the swing of things.

While a detailed response is being done you might want to check out "How to save half when you are not "low income" http://www.slashdrugcosts.org/forum/viewtopic.php?t=62

The numbers there are based upon Medicare Part D for 2006 (2007 has higher numbers). If costs are a problem for you it is my guess that you hit the "donut hole" last year.

To reduce the chance of us missing another post like what happened to you I am going to disable the ability to edit a post after it is submitted. (You can always email or "Personal Message" me to edit it if you want). That way when anyone gives more information (by replying to their post) we will be immediately notified.

Once again, my apologies :oops:
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Medicare Part D analysis

Postby NoPocketCash » Sun Jan 14, 2007 3:02 pm

You have Medicare Part D so my guess (tell me if I am wrong) is that you are trying to plan now about how to have the lowest costs for the entire year (the
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Proton Pump Inhibitor (PPIs) might be dangerous

Postby GeeWhiz » Sun Jan 14, 2007 6:11 pm

For people who do not know, Protonix is a proton pump inhibitor (PPI) that works by blocking acid production in the stomach. The drug industry primarily promotes PPIs as the treatment of choice for Gastroesophageal Reflux Disease (GERD) although this is typically not a problem for people with acid stomach problems or ulcers (and PPIs are NOT the treatment of choice for those problems). Their TV commercials try their best to scare people with the
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Lipitor Options

Postby 1DayAAT » Wed Jan 17, 2007 3:47 pm

As NoPocketCash indicated previously, the only way to cut your yearly medication costs is to cut your costs in the
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Toprol XL

Postby Just call me friend » Wed Jan 17, 2007 4:05 pm

I saw this posted in one of the other threads (I adjusted the quote for this topic)

[quote]
There are a number of classes of drugs that are used to treat high blood pressure
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isosorbide mn

Postby Just call me friend » Wed Jan 17, 2007 4:17 pm

I do not know anything about what the isosorbide md is being used for but after looking up the drug I believe you are on the controlled release (CR) version because standard isosorbide mn does not appear to come in 30mg dosages.

I do see the drug can be split and that this alone would save you half over what you are paying now.

The less money that your insurance pays now, the longer it will be before you hit the "donut hole".
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Summary

Postby jimithy » Fri Jan 19, 2007 2:38 pm

Well there has been a number of suggestions that I feel should be summarized as various choices.

One choice is to keep exactly the same drugs you are on and split your Toprol and isosorbide mn cr to reduce costs. You could also shop around for the best prices for your particular drug plan. Since you go into the catastrophic coverage of Part D, this could reduce your yearly costs by a little but would have no major effect.

Another choice is to work with your doctor to adjust your medications to alternatives that may be healthier and your would discuss costs with your doctor.

With the potential safety problems with PPIs you might consider
IF you need a drug then you might consider one of the H2 antagonists ( cimetidine, (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine, (Pepcid). All four are available over-the-counter (OTC) without the need for a prescription. They are also available by prescription at higher dosages. There is a VERY long history of safety with these drugs and they are a small fraction of the price of any PPI. (Once again, ANY medication change should be discussed with your doctor.)


Since these drugs take 30 minutes to an hour before taking effect, people often use a common antacid with them. It is best not to use an antacid with Calcium because of their "rebound effect".

Since your Lipitor is virtually the same drug (statin) as the now generic Simvastatin then talking with your doctor about trying the generic drug as a method to reduce costs might be a good idea.

Adding niacin and fiber could possibly allow you to reduce your statin dosage and since Simvastatin can be split that would cut your costs by another half.

Splitting your Toprol and isosorbide mn cr would save you about $37 / month.

But a cheap diuretic can make the Altace and Toprol work better which might let your doctor drop your dosage


My assumption here is that the methods of reducing your dosages of your statin, Toprol, and isosorbide mn cr will not work and therefore not save you money. (For me, when in doubt, I assume most ideas won't work... but they often are worth trying.)

First we need to GUESS what your insurance company has decided your drug costs are. Frequently the insurance medication prices are much higher than actual retail but since I do not know your company I have to use local retail prices.

Protonix - 40mg - 2x daily retails at about $280 / month
Lipitor (80mg) - 1x daily retails at about $135 / month
Toprol XL - 50mg 24 Hour Tablets two times daily at about $60 / month
Isosorbide Mononitrate CR - 30mg 24 Hour Tablets at about $38 / month
Altace - 2.5mg at about $53 / month

This comes to a total of about $566 / month and about $6792 / year.


IF THIS CHANGES to

H2 Antihistamine for about $20 a month
Simvastatin 80mg $50 / month
Toprol XL split to get 60 24hr tablets $45 / month
Isosorbide Mononitrate CR - 30mg 24 Hour Tablets at about $19 / month
Altace - 2.5mg at about $53 / month

This comes to a total of about $187 / month and about $2244 / year.

This means you would never hit the donut hole and your costs would drop from a probable $3948 to a potential $760 / year.

Since there are so many possibilities contained in the various post and we don't have specific information about your Part D insurance; there is no way to get better numbers. :D
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More info on statins (Lipitor, Simvistatin, etc.)

Postby Guest » Sat Jan 20, 2007 2:17 pm

1DayAAT,

There is more of a difference between statins than you indicate.

There are three statins (pravastatin, simvastatin, and lovastatin) that are derived from natural sources and have similar chemical structures. These statins have been shown in large studies to actually decrease heart attacks. Pravastatin also cuts down the number of strokes. In addition, simvastatin and pravastatin have both shown the ability to extend lifespan.

All of the other statins are completely synthetic and chemically are much different from the natural statins. They have not shown these advantages that the natural statins have.
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Check the reasons why you are taking these medications

Postby dlcnurse » Sun Jan 28, 2007 1:12 am

Cost reduction in medication is very important. Changing the classification of medication is not always in the person's best interest. For example: PPI's to H2 antagonists.
Nexium is one of the most expensive meds which in the same classification meds such as protonix, aciphex, prilosec are cheaper than the nexium. A point of interest here is that there have been several studies that indicate that H2 antagonists are not the best choice of these medications in older adults 65 or older who require a greater degree of acid suppression that younger adults. Why? As we age, many anatomical changes occur in our bodies, decrease motility of the gut, relaxed sphincter control of the stomach/esphogus, altered metabolism of drugs are some of these changes.
Many older adults also are at risk for many more side effects. Antacids for example cause an increased risk of toxicity of some medications such as coumadin, lanoxin, beta blockers, etc... also many antacids will increase risk for salt overload, hypercalcemia, constipation, diarrhea, and they interfere with absorption of drugs.
H2 antagonists such as tagament, pepcid, zantac in older adults increase the risk for renal, liver, and hepatic dysfunction in older adults taking ace inhibitors. Ace inhibitors work in regards to blocking angiotension I to angiotension II, which also effects the kidneys, adrenal glands (renal system) to promote diuresis (get rid of excess fluid in the body). So H2 antagonists are not a drug of choice for you.
Betablockers come in many different medications used to treat high blood pressure, angina, and status post heart attacks. There is a big difference in the choice of beta blocker that your doctor places you on... Toprol XL is a cardioselective beta blocker that works are cardiac muscle( beta1 and beta2 cells), The meds listed in previous posts are all examples of beta blockers but one important factor is that some of these are non-selective beta blockers, they do work on the beta cells but are not cardio-selective thus would not give you the same benefit. splitting the toprol is a very good suggestion, if you are able to do that. Most doses available in this medication is the 25 mg tab and the 50 mg, and 100 mg tab. Which splitting this medication does not cause any problems, so this would be a good choice to do.
Imdur which is a nitrate, can be split, although they don't recommend it because it alters the efficiency of the drug, especially if you are taking the CR. Also, a note here: another point in the use of the PPI vs the H2 antagonists is that the nitrates cause relaxation of smooth muscle in the heart and also relaxes the esphogeal sphincter which is also smooth muscle and one of the reasons why PPI's are a better choice.
You may need to ask your doctor to possibly increasing the dose of the Imdur to 60 mg in order to obtain the availability of splitting it. Imdur splitting as I said is possible but if you notice that you are experiencing more chest pain, the medication is not working as well for you then you may need to think about going back to the original dose of 30 mg.
The statin drugs such as lipitor, zocor, prevacholol are the natural statins and have been proven to be much more effective in persons who have had heart problems such as a heart attack, hypertension, cardiomyopathies in extending life expectancy over the synthetic statins. Niacin is a possibility but if you are a diabetic, this medication can cause a rise in blood glucose levels.
The reasons why you take a medication is as important as the cost.
I am not trying to discourage you, but encouraging you to talk with your doctor and explore the options available to you in regards to switching medications, asking why you are taking that particular medication, what can you do to lower the cost, etc... Knowing all about your medications is essential when trying to decide how to cut the costs. The options that you have may be more limited due to your own health issues/conditions.
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Postby dlcnurse » Tue Feb 06, 2007 4:50 pm

Toprol XL now comes in a generic form that came out this month. It is called Metoprolol ER. This may also lower your costs by asking your pharmacist to fill your prescriptions with the generic form of Toprol XL.
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