I also have a "ton of them"

[bhunt]

There is a lot of them:

Zolpidem 10mg Insomnia
Actos 30mg Diabetes
Lisinopril 20mg High Blood Pressure
Leviothyroxine .075 Hypothyroid
Lyrica 150mg Neuropathy Twice a Day
Alprazolam .05 Anxiety
Lipitor 10mg High Cholesterol
Effexor XR 150mg Antidepressant
Seroquel 200mg Bipolar 200mg Morning 400mg Night
Depakkote ER 500mg Bipolar 1000mg Afternoon
Fluticasone Propionate Nasal Spray 50mcg Allergies
HHF Healthy heart Formula Vitiman Supplement

I have Blue Croos Blue Shield POS, $1500.00 Deductible, Co-pay on Doctors/Therapist $ 40.00/visit, Co-Pay on Brand name $30.00 or $60.00, $15.00 Generic. My husband's policy from his job, he pays over $400.00 a month for this insurance.

Income last year appx. $34,000.00. I do not work, as up till last August I was my son's caretaker. He is on SSI and medicaid for a brain injury, 10 years ago. he now lives with his father.

Hospitalized 4 times since last August. Twice in regular hospital for complications from Diabetes. twicw in Pscy. for attempted suicide.

I appreciate any and all suggestions, and or assistance.

Thank you

[jimithy]

bhunt,

Sorry you did not get a reply yesterday. Everyone must be out enjoying the summer weekend away from their computers!

I definitely see ways that your drug costs can be reduced... right off the bat. It will take more research by all of us here to reduce it as much as possible.

Your Lisinopril 20mg for High Blood Pressure... you did not list how much you are paying for each drug but my guess is that you are not buying the brand name which would be $30/month... you are probably buying the generic for $15/month. Most people do not realize that many drugs are cheaper WITHOUT insurance. You can buy Lisonpril 20/mg (brand name) at Walmart, Sam

[NoPocketCash]

bhunt,

We need more information, please.

You have not given us enough information to be most effective at getting your costs as low as possible.

It is important to know how many pills a month you currently get with each prescription. (It is easy to make assumptions about most of your drugs but the Alprazolam 0.5mg is often taken as needed and we do not know how often you need it.)

What is not critical (but it helps) is to know what you are currently paying for each specific drug per month.

We will work with the information you have given us so far, but if you want the lowest costs then the added information is needed.

It appears from your list that you do not have any issues with taking generic drugs which is good. If you have questions about using generics then you might want to look at Why Generics are just as good as Brand Name Drugs.

We will get you more methods to save as soon as possible.

[NoPocketCash]

Your exact income of last year and current income could be important.

There are some drug assistance programs that have a limit 300% of the HHS federal poverty guidelines and your income easily qualifies under those programs.

Most programs though have lower limits. You are right at the upper threshold of some assistance programs (250% of the HHS federal poverty guidelines) because you are a 2 family household earning $34,000/year and the 250% level is $34,225/year. http://aspe.hhs.gov/poverty/07poverty.shtml

You might qualify for other programs which have a limit of 200% HHS poverty guidelines because your son lived with you for more than half of last year and therefore your last IRS filing would have been for a 3 person household. (200% of 3 person household is $34,340)

Once again you are right on the edge of qualifying so it is important for you to know what your exact last year and current income is when checking to see if you qualify for any of the hundreds of assistance programs. These programs are not handouts. The drug companies get big breaks by promising to support drug assistance programs, so they are making higher profits overall by giving some drugs away for little or nothing. See Prescription Assistance Programs (PAP) This Is Not Charity and specifically The Partnership for Prescription Assistance which gives you a quick way to find out if you qualify for any of over 475 assistance programs.

It is best if you go through this questionnaire online yourself because it asks more private information from you than we like to deal with on this site. If you find some of your drugs can be gotten cheaply or free from any of these programs please post which ones as soon as possible so that we are not spinning our wheels trying to get you lower costs when you might possibly get some drugs for free.

Remember though, you are at the very upper edge of the qualifying income levels for most programs and you have insurance (which disqualifies you from many programs). So this is a "do diligence" effort to see if you possibly qualify with some of your drugs. Do not be too disappointed if you do not. We will still be working on ways to lower your costs.

[1DayAAT]

If you fall within 250% of HHS poverty guidelines then Zolpidem 10mg can be goten for $30 for a 90-day supply though RxOutReach http://www.rxoutreach.com/en/about/AboutUs.aspx

Which would cut your costs from $45 / 3 months to $30 allowing you to pay 66% of what you currently spend using your insurance.

[wandering by]

Leviothyroxine .075mg can be done like Lisinopril and get twice the dosage then split the tablets. Buying in quantity also reduces the price.

If you bought it locally you'd probably pay about $38 for 90 tablets of .150mg strength. Split they would be a six month supply for about $6.33 / month.

You CAN buy mail order safely.

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.

Buying mail order you could probably reduce the six month supply costs to $30 so it would be $5 / month.

It is illegal but there is a FDA web page about how to buy drugs from Canada in the above reference.

It is possible to drop your cost to about $2.35 by getting it from there.

So depending upon where you buy it. You can drop your costs of this drug to 43%, 33%, or 16% of your current co-pay.

[AntiPharm]

Lyrica interacts with at least one of your other drugs. There are also precautions and important patient information that anyone taking it should have. One of them concerns patients with diabetes. http://www.rxlist.com/cgi/generic/lyrica_pi.htm

There is also a little history behind the drug that some people find interesting. UPDATE: Pfizer's efforts to regain its $Billion pain sales! Pfizer took a VERY minor drug that made them little profits and turned it into a multi-billion dollar blockbuster through illegal means. They ended up paying $400 million dollars in fines for pushing Neurontin as a drug for neuropathic pain management and other uses when it was never FDA approved for such uses and there were no studies showing it helped at all. Pfizer paid people to write stories for publication and then paid doctors to allow their names to be placed as authors of the stories. These stories were then used by drug reps to push the drug. Once it came out what Pfizer had done most doctors stopped prescribing the drug.

Thus a multi-billion dollar profit maker dried up.

Presto-chango... a variation, Lyrica, comes out and is FDA approved using funding from the drug industry. Now with an approved drug they have been able to go after the market niche they had lost.

FDA employees have been put under a new standard in March of this year. To limit corruption, each employee on drug approval committees can only accept $50,000 / year PER DRUG COMPANY. Added up this can greatly eclipse their federal salaries and thus create HUGE conflict of interest problems with drug approvals.

A few months ago a top ranking National Institute of Health employee pleaded guilty of conflict of interest due to Pfizer payments to him of $300,000

A senior government scientist from the National Institutes of Health who took about $300,000 in unauthorized payments from a drug company pleaded guilty Friday to a federal charge that he committed a criminal conflict of interest

The admission by Dr. P. Trey Sunderland III came after years of denials by his attorneys and six months after the scientist had asserted his constitutional right against self-incrimination to a congressional subcommittee.

U.S. Atty. Rod J. Rosenstein told reporters that Sunderland's actions were a breach of the public trust.
"This case is not about an honest mistake," Rosenstein said.

This guy IS NOT a minor employee...

Sunderland, who joined the NIH in 1982 and headed its geriatric psychiatry branch...

Even though the NIH has admitted that they have had a widespread problem with employees accepting large sums from the drug companies they supposedly oversee the actual crime of accepting $300,000 without the NIH's knowledge is only a misdemeanor. There will be no jail time and no fine beyond paying back the money. Sunderland did not even lose his job or get demoted.

Boy... that is REALLY HARSH PUNISHMENT!

the final sentence in the story was...

An NIH spokesman in Bethesda, Md., said Sunderland remained a federal employee.

There is absolutely nothing in ANY of the many stories about doing anything to Pfizer for bribing... Uh, I mean, giving "consulting fees" to a honcho in the NIH.

Doctors are not immune to drug company monies either. Pharmaceutical payments to physicians and the last (bottom) post here Link Between Industry Payments, use of Antipsychotics probed

Drug companies spend about $100 MILLION dollars pushing their products in semi-legitimate ways... because all of their books are closed it is not known how much more is spent in other ways.

Lyrica MIGHT be an effective drug. Unfortunately when you combine the money Pfizer is putting behind it and the placebo effect it can be quite difficult to know for sure.

[GeeWhiz]

Your co-pay for Seroquel is probably $60 a month because it is a very expensive brand name drug.

Below is a slightly modified quote from another post...[quote]Seroquel 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 (called CATIE). 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 an additional major problem not found with the typical antipsychotic. (A class action lawsuit for 700 million dollars has been settled concerning it

[jimithy]

Lipitor is also a very expensive drug and therefore probably has a $60 / month co-pay. Zocor just came out as a generic (Simvastatin).

A large number of insurance companies are requiring patients to switch from Lipitor to the generic of Zocor (Simvastatin) because they do not see enough difference to warrant Lipitor's huge cost. These drugs are called "therapeutically equivalent" which means that they act upon the body in very similar ways. The drug industry calls them "me too" drugs because it is common when one drug company finds a lucrative market then other drug companies patent slight variations in order to cash in on the new market (which is what Pfizer did when they created Lipitor). Simvastatin has a longer history of safety and there are more studies about it.

You can get twice the dosage you need of Simvastatin and split the pills. This would result in a monthly cost of $2.00 / month from Wal-mart, Sam's Club, or Target. Similar or lower prices might be found elsewhere.

If you decide to switch then your costs would drop from $60 / month to $2 / month resulting in you paying about 3.33% as much as you are now for the cholesterol protection you need.

[On SSDI]

If you have not been able to work since August then there is a decent chance you could qualify for Social Security Disability Insurance (SSDI) or SSI (which you are familiar with because of your son.)

Since you did not work for 10 years before that then I have no idea whether you would qualify for SSDI which pays much more.

Either case though could greatly increase your funds because in addition to the monthly payments you would eventually get either Medicare or Medicaid. Either would provide great medication cost savings.

Also, you might be able to drop off your husband's health insurance which could lower the premiums significantly. Also, if your husband does not require maintenance medications then you may not have to pay the $1500 deductible every year. A best case guess of the savings possible if you got off his insurance would be the $1500 deductible plus maybe $150 / month savings in premiums. (totaling $3300 a year)

Medicare Part D premiums can be quite low with much lower co-pays and deductibles than you currently pay.

Just a thought.

[dlcnurse]

I will have to take a look at all of your medications more closely but for now, a generic form is available for the Actos (Pioglitazone), Zolpidem is a generic drug for Ambien, depending on what you are using, levothyroxine may already be a generic for brands such as synthroid, levoxyl, levothyroid etc.. Unithyroid is another generic name, Lipitor does have a generic equivilant called by its trade name Altorvastatin, the Alprazolam may already be the generic alternative for Xanax. Depakote also comes in a generic brand called Valproic acid.

One thought you might consider is purchasing your medications at different locations near you such as Kmart, Walmart, Sam's Club, Target. Some of your medications such as the thyroid, lisinopril, you can purchase them for a much lower price by not using your insurance/drug card. The cost is $4.00 per med for 30 day supply or 15.00 for a 90 day supply at Kmart.

The generic brand of Depakote can actually be purchased online for a much lower cost. Especially since you are taking a minimum of 3 500 mg tabs a day. You can actually purchase 100 tablets of the 500 mg for a cost of 45.00. In comparison to spending 233.00 for a 100 day supply.

The generic form of Seroquel is called Quetiapine. The cost for 300 tabs is 170.00. This is not available in the US market as of yet but can be bought from outside of the US.

Check out the site Free Medicine Foundation to also find more information on assistance programs. http://freemedicinefoundation.com

Another great site to answer alot of questions you may have about PAP's is http://ashp.org/pap/
The site is called American Society of Health-System Pharmacists.

A site that you should bring to your doctor's attention is

http://www.Rxassist.org/

This website offers your doctor a searchable database to assist him/her in locating the correct patient prescription assistance program. It will allow your physician to search by company, brand or generic name, and also by class of drug. This would be a big help in gaining assistance with medications as most of the programs listed require your physician to apply on your behalf.
I will look into your medications more closely to see about costs, generics, etc.. on how we may help you.

[GeeWhiz]

Effexor XR does not come in a generic form in the U.S.

Even at a Canadian pharmacy the price of the generic ($133 / month) would be far above your current copay.

Many drug companies introduce time release versions of their drugs simply to get additional time with patent protection. Often if a patient is willing to take pills more than once a day there is little difference in the medication's effectiveness.

If you switched to the generic non-time release version the cost can be reduced to around $44 / month at a Canadian pharmacy. If you are currently paying $60 a month then this can provide some savings.

The generics of 2 other newer antidepressants; Zoloft (Sertraline) and Celexa (Citalopram) have just been slashed in price by the"drug war stores" to $4 / month. (Depending upon your dosage both meds may be split to cut those costs in half.) Effexor is a SSNRI and these other drugs are SSRIs therefore they may not work for you. The warnings about switching drugs when treating depression that I listed above still apply.

So it should be a thorough discussion with your doctor before 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 deterrent on whether to purchase or not to purchase the necessary medications.

NOTE: There are numerous other antidepressants of various classes that are available as very cheap generics. Most people do not know it but NO antidepressant approved since the Tricyclic antidepressants of the 1950's have been shown to be more effective at reducing depression than those older drugs. The newer drugs are pushed because many are SUPPOSED to have fewer side effects but that is not always true either. The brand new MAOI patch has very significant difficulties associated with taking it. I have taken the oldest antidepressants without any more side effects than the newest (NOTE: Personal anecdotal evidence is not worth much :lol:).

What is important is what works for you. NOT how new the drug is.

If you did switch to Sertraline or Citalopram then your costs would be reduced to 14% (or if split the pills then 7%) of what you current pay for Effexor.

[jimithy]

bhunt,

We could really use some more information about the HHF Healthy heart Formula Vitiman Supplement you listed. It seems that there are a number of products from different manufacturers with that name.

Could you tell us the manufacturer of that specific supplement? Also, it would be good to know whether they are prescribed and therefore part of your insurance plan, over-the-counter by doctor's orders, or over-the-counter because you believe it is important for you to take them.

Most of the products I found contain some level of CoQ10 which could be important for you. Lipitor and other "statin" drugs deplete natural levels of CoQ10 and therefore some replacement is usually advised when taking those drugs.

The University of Maryland Medical Center website at http://www.umm.edu/altmed/articles/coen ... 000295.htm contains extensive information about CoQ10 including the amounts suggested for adults who take it. (The amounts vary with the reasons you take it.)

Thank you,

jimithy

[Guest]

No one has mentioned yet that your doctor can help by supplying brand name drug samples in quantity.

If you let your doctor know that you are having trouble affording your drugs (and which drugs you need help with) usually they are happy to help by requesting additional samples from the drug reps. You can even ask to have someone in the office to give you a call when samples are dropped off in order to get them before they are given away elsewhere.

[dlcnurse]

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.