Medical Student Seeks Your Help

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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Not all methods posted here will work. These are simply ideas some people have found to be useful.

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Medical Student Seeks Your Help

Postby Depression Diva » Tue Mar 20, 2007 12:03 pm

Hi everyone,
I am posting here because I'd like some assistance in cutting down the cost of my anti-depressants.

I am in my first year of medical school. I was abused and neglected as a child, and despite that-put myself through four years of college and achieved entrance to medical school with scholarship. However, I've recently been plagued by my past, to the point where it is now taking a toll on my future. Consequently I have started to take anti-depressants and have acquired other professional help.

These medications have taken a toll on my paultry medical student budget. I have two part-time jobs to additionally fund my rent and other necessities. I made less than $10,000 last year. I have Aetna for health insurance, my co-pay for medications is $40. This doesn't seem like a lot, however when I was taking three psychotropic medications previously it certainly added up. I additionally have needed albuterol for asthma, an Epipen, and numerous antibiotics which I have not filled b/c, for me, the anti-depressant regimen takes priority. So, if I have a whopping $60, $40 will go for my anti-depressant and the other medications I need get shelfed.

I am currently only taking cymbalta 60 mg, however my doctor just increased my dose to 90 mg once daily. As silly as it sounds, I can't afford my next refill. Most recently before cymbalta I was on lexapro 20 mg (once daily), which essentially had the same effect (a good one, I might add). I'd prefer to return to lexapro.

That about sums it up. I truly appreciate your help and advice. Have a great day!
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Here is the fast response

Postby NoPocketCash » Tue Mar 20, 2007 1:29 pm

I don't know your location but certain chains are now offering antibiotics for free (sounds crazy but it is true).

Take a look at the various topics at Special (possibly time limited) Ways To Save & NEWS!

Your income is below Federal Poverty Guidelines so you should qualify for free drugs using Prescription Assistance Programs (PAPs). Good sites to see if you qualify are www.PPArx.org and www.rxASSIST.org

We will get better specific information to you soon.
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Maybe not

Postby AntiPharm » Tue Mar 20, 2007 2:41 pm

I don't know your age or living situation.

Federal Poverty Guidelines are based upon gross income of the entire household and the number of people in the household. So you do not necessarily fall inside what PPAs require. Typically it is either 150% to 250% of HHS Federal Poverty Guidelines. They are listed at http://aspe.hhs.gov/poverty/07poverty.shtml

Also, it can make a difference if you are listed as a dependent on your parents IRS filings (once again, I do not know your age or living situation.)
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Postby Guest » Tue Mar 20, 2007 3:47 pm

More info:
I'm a 24 year old living independently, my parents cannot claim me.

Thanks for the great avenues to pursue!
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albuterol and antibiotics

Postby GeeWhiz » Tue Mar 20, 2007 5:53 pm

Walmart, Sam
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Initial strikeouts for Cymbalta and Lexapro

Postby NoPocketCash » Tue Mar 20, 2007 6:19 pm

For Cymbalta, the exact site for the drug manufacturer's PAP program is www.lillycares.com/index.jsp Unfortunately you will find out that you do not qualify because you already have prescription coverage.

For Lexapro, the exact site for the drug manufacturer's PAP program is www.forestpharm.com/pap/ Unfortunately you will find out that you do not qualify there either because you already have prescription coverage.

NOTE: A lot of people who have problems at places like free clinics and PAP sites try to hide the fact that they have prescription health insurance (lousy as it may be). This has a much better chance of working if you are dealing with a free clinic where people are often are "vague" about personal information.

Don
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Cymbalta and Lexapro

Postby NoPocketCash » Tue Mar 20, 2007 7:14 pm

Cymbalta and Lexapro are simply too new to be heavily discounted anywhere to be below the cost of your current insurance copay.

If you definitely need to reduce costs (and your doctor will not keep you supplied with free samples) then possibly switching to a therapeutic equivalent might be worth considering.

Major chains are heavily discounting generic antidepressants. The costs at Wegmans for 90 days is $12.99. The cost at Kmart for 90 days is $15. Walmart, Target, and Sam's Club are charging $4 for 30 days ($12 for 90).

All of those chains include these antidepressants in their discounted drug lists. (Brand name equivalents are in parenthesis.)

  • Amitriptyline (Elavil)
  • Citalopram (Celexa)
  • Doxepin (Zonalon, Sinequan, & Prudoxin)
  • Fluoxetine (Sarafem, Prozac) Note: Both Brand Name Drugs are made by the same drug company and are identical. They just market Sarafem for helping relieve PMS symptoms!
  • Nortriptyline (Pamelor & Aventyl)
  • Trazodone
Walmart, Target, and Sam's Club in addition to the top list has:
  • Paroxetine (Paxil)

The FDA has found these drugs just as effective as the newer ones. There is a very large number of antidepressants on the market because people have widely different success rates with even very similar drugs. Also the side effects vary a lot from one person to the next. What may be fine for you, may have bad side effects for someone else.

When sold under their brand label some of these drugs are still quite expensive. Paxil via mail order is over $100 a month. Thirty tablets of Sarafema via mail order is about $150 a month.

If the money you are spending on antidepressants is keeping you from taking the other medications you need then you might consider talking to your doctor about alternatives.
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There are other ways to fight depression!

Postby 1DayAAT » Tue Mar 20, 2007 8:34 pm

Depression is a huge problem that most of society ignores. About 16% of the U.S. population will have a major clinical depressive episode during their lives. Maybe 8% (32 million) have chronic depression that never totally goes away. There are just little vacations between debilitating episodes.

Medication and Therapy work much better as a team than either alone, but more and more studies show that it is necessary to have a total lifestyle of wellness to effectively combat chronic depression.

Many are simple things.

Large muscle exercise is very good for preventing episodes and helping people recover from them. It is very easy to increase the amount of exercise you do. Just a little bit of extra activity goes a long way!

Your brain is only 3 lbs but it consumes 20% of your body's resources. It is not surprising that there is strong evidence that what is healthy for your body is also healthy for your brain. Eat healthy even if you aren't trying to lose or gain weight

More and more information is coming out about getting the correct amount of sleep on a regular schedule being very important with depression. Mommy was right... you need the correct amount of sleep

Many researchers believe that unresolved stress causes quite a lot of depressive episodes. Stress- a primary cause of major physical/mental illness and Deep relaxation releases tension/reduces stressors' effects

It amazes me what studies are showing about how much that having people you are close to can do. One study showed that men returning home to an empty house after having a heart attack were 4 times as likely to die than those returning to a house with family. A lot of studies show that socializing outside the home is very important to reduce problems with depression. People with good friends are healthier

Out of all of these methods to become healthier, it turns out the most important is A New Attitude & Purpose Can Change Your Life!

Remember what I started with; medication and therapy are both important parts of combating depression. I am just trying to show you that many things that cost no money can be just as important.
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Asthma med info and equipment

Postby jimithy » Tue Mar 20, 2007 9:15 pm

Just in case you need more options to reduce the costs of treatment of your Asthma, here are a few links.

The first two are to give you information about equivalent drugs.
AAAAI Allergy & Asthma Medication Guide: Short-Acting Beta Agonists
AAAAI Allergy & Asthma Medication Guide: Inhaled Corticosteroids

This one has equipment that is highly discounted.
Allergy & Asthma Network Mothers of Asthmatics (AANMA)

Finally The American Society of Health-System Pharmacists- Asthma Medications listed with drug maker in order to check out PAPs.

Good luck and PLEASE ask us if there are any more specific things we can do for you. :D
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Antidepressants

Postby dlcnurse » Wed Mar 21, 2007 1:28 am

Being a med student I am sure that you are familiar with the classification of the medications that you take. Cymbalta is a SSNRI/SSRI.
Other medications in this classification are:
Celexa
In a canadian pharmacy these come in 10 mg up to 40 mg tabs and their costs range are the same 59.00 per 100 tabs, regardless of the dosage.
In a US pharmacy The cost is 102.00 to 150.00 per 100 tabs.

Lexapro
varies in dosage from 10 mg to 40 mg tabs cost in a canadian pharmacy is 110.00 for 90 tabs
US pharmacy cost range is 150.00 to 190.00 for 90 tabs

Cymbalta
generic form available from canadian pharmacy cost is 98.00 for 50 tabs in 30 mg, 110.00 for 60 mg tabs/ per 50 tabs.
Us pharmacy- you already know the costs

Paxil, Seroxat, Aropax, Pexeva
cost ranges from 115.00 per 100 tabs to 160.00 per 100 tabs for 40mg tabs. (it comes is 10,20,30, 40 mg tabs)
US cost for the same dosages is 130.00 to 140.00


Prozac or Sarafem
Canadian pharmacy comes in 10, 20 mg. cost is 39.00 per 100 tabs
US pharmacy- cost is 50-80.00 depending on dose

Zoloft or Lustral
Canadian pharmacy cost per 100 tabs is 65.00 to 112.00 in doses range from 25 mg to 100 mg.
US pharmacy cost ranges from 67.00 to 130.00 per 100 tabs

Desyrel
Doses range from 50 mg to 300 mg and the cost per 90 tabs is 50 mg tabs 24.00, 100 mg tabs = 29.00 150 mg tabs = 39.00 and 300 mg tabs = 344.00
US Pharmacys for the 50 mg tab to the 150 mg tabs runs from 33.00 to 83.00

Most of these drugs have a generic form. One other drug Effexor is also in this class but does not come in a generic form. The cost is 130.00 to 200.00 per 90 tabs in a canadian pharmacy. I did not look up for US pharmacies.

Since you have taken Lexapro which is a SSRI and Cymbalta which is the SSNRI, you might ask your doctor about switching to one of these cheaper medications. Prescribing anti-depressant medications is not like prescribing any other medication. It is very much individualized per patient. And if you have good control with the medications you are presently taking, changing them could mean starting all over to achieve that same control. But sometimes, the cost can be a major deterent on whether to purchase or not to purchase the necessary medications.

Talk with your physician and ask about using something in the same classification. Hopefully, this will help you in approaching him in regards to the high cost of the Cymbalta, and possibly avoid some of the initial side effects associated with changing to a complete different class of anti-depressants. Good luck.
Last edited by dlcnurse on Wed Mar 21, 2007 11:27 pm, edited 1 time in total.
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Pricing Mistake

Postby NoPocketCash » Wed Mar 21, 2007 9:30 am

Depression Diva,

dlcnurse said:
Being a med student I am sure that you are familiar with the classification of the medications that you take. Cymbalta is a SSNRI/SSRI.
Other medications in this classification are:
Paxil, Seroxat, Aropax, Pexeva
cost ranges from 115.00 per 100 tabs to 160.00 per 100 tabs for 40mg tabs. (it comes is 10,20,30, 40 mg tabs)
US cost for the same dosages is 130.00 to 140.00

Prozac or Sarafem
Canadian pharmacy comes in 10, 20 mg. cost is 39.00 per 100 tabs
US pharmacy- cost is 50-80.00 depending on dose

She must not have noticed from my earlier post but Paxil, Sarafem, and Prozac are part of the "price-war" drugs and can be bought locally for $4 / month instead of the prices she quoted.

That is one of the difficulties of shopping around. No matter how many places you check prices, the one you did not check could be much better. :D
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Oops... missed that one

Postby dlcnurse » Wed Mar 21, 2007 11:54 pm

By all means do take advantage of the price wars on these particular medications. I totally missed it in NoPocketCash's post.

Also, a site that may help you with questions on dealing with depression is http://www.helpguide.org/mental/depression_tips.htm

The site has some resources that may help.
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