Crazy Prescription Prices!! - Its Insane...
- metsfan302
- Posts: 687
- Joined: Fri Oct 09, 2015 9:44 pm
- Location: Dewey Beach, Delaware
Crazy Prescription Prices!! - Its Insane...
I just got prescribed a new inhaler for my copd / breathing - Advair
Its wild the prices big pharma charges insurances/ consumers. I understand there is alot of research, science, yatta yatta but wow!
This new Inhaler Retail Price is - $505.99 for 1 inhaler that's 120 puffs - $4.21 per puff!!!
Yes the insurance covers it and my co-pay's only $3. They have no prob paying for this but wont cover an attended sleep study rejected once again but the sleep dr is appealing it.
So every month they are paying for this inhaler basically what it cost for a new AirSense 10 Autoset (almost)
https://www.cpap.com/productpage/resmed ... idair.html
Its wild the prices big pharma charges insurances/ consumers. I understand there is alot of research, science, yatta yatta but wow!
This new Inhaler Retail Price is - $505.99 for 1 inhaler that's 120 puffs - $4.21 per puff!!!
Yes the insurance covers it and my co-pay's only $3. They have no prob paying for this but wont cover an attended sleep study rejected once again but the sleep dr is appealing it.
So every month they are paying for this inhaler basically what it cost for a new AirSense 10 Autoset (almost)
https://www.cpap.com/productpage/resmed ... idair.html
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This is my Orig Post "The start of my venture to find proper therapy" - http://www.cpaptalk.com/viewtopic.php?f ... &sk=t&sd=a
- ChicagoGranny
- Posts: 14409
- Joined: Sun Jan 29, 2012 1:43 pm
- Location: USA
Re: Crazy Prescription Prices!! - Its Insane...
That's not how insurance works. Your insurance company has a contract with the pharmacy and doesn't pay that much for the inhaler.metsfan302 wrote:They have no prob paying for this
No one pays retail.
Last edited by ChicagoGranny on Wed Nov 25, 2015 12:16 pm, edited 1 time in total.
https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... OSCAR_Help
http://www.apneaboard.com/wiki/index.ph ... ganization
For those not so good with technology: https://home.sleephq.com/
http://www.apneaboard.com/wiki/index.ph ... OSCAR_Help
http://www.apneaboard.com/wiki/index.ph ... ganization
For those not so good with technology: https://home.sleephq.com/
- metsfan302
- Posts: 687
- Joined: Fri Oct 09, 2015 9:44 pm
- Location: Dewey Beach, Delaware
Re: Crazy Prescription Prices!! - Its Insane...
except if I did not have insurance I would i assume?
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Humidifier: DreamStation Heated Humidifier |
Additional Comments: Prior - ResMed AirCurve ASV User |
This is my Orig Post "The start of my venture to find proper therapy" - http://www.cpaptalk.com/viewtopic.php?f ... &sk=t&sd=a
- ChicagoGranny
- Posts: 14409
- Joined: Sun Jan 29, 2012 1:43 pm
- Location: USA
Re: Crazy Prescription Prices!! - Its Insane...
No, you would not pay it. You could not afford it.metsfan302 wrote:except if I did not have insurance I would i assume?
Your doctor should work with you on substitutes. http://www.livingwithasthma.net/3-alter ... or-asthma/
https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... OSCAR_Help
http://www.apneaboard.com/wiki/index.ph ... ganization
For those not so good with technology: https://home.sleephq.com/
http://www.apneaboard.com/wiki/index.ph ... OSCAR_Help
http://www.apneaboard.com/wiki/index.ph ... ganization
For those not so good with technology: https://home.sleephq.com/
- chunkyfrog
- Posts: 34377
- Joined: Mon Jul 12, 2010 5:10 pm
- Location: Nebraska--I am sworn to keep the secret of this paradise.
Re: Crazy Prescription Prices!! - Its Insane...
I suspect that the insurance company may have some kind of (nudge, nudge) "agreement" with the drug company.
Just because such collusion is illegal is not always a deterrent.
Just because such collusion is illegal is not always a deterrent.
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Re: Crazy Prescription Prices!! - Its Insane...
It's not even illegal collusion. The insurers are free to negotiate volume discounts, and I guarantee you they don't pay anywhere near the retail price. Just like CPAP equipment. Our insurers aren't paying the retail prices for CPAP equipment and supplies, they pay a negotiated rate.chunkyfrog wrote:I suspect that the insurance company may have some kind of (nudge, nudge) "agreement" with the drug company.
Just because such collusion is illegal is not always a deterrent.
It's the GOVERNMENT which isn't allow to negotiate on behalf of the people. Stupid, stupid, stupid.
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What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm
- chunkyfrog
- Posts: 34377
- Joined: Mon Jul 12, 2010 5:10 pm
- Location: Nebraska--I am sworn to keep the secret of this paradise.
Re: Crazy Prescription Prices!! - Its Insane...
Jan, you clarify this muddle for me, somewhat.
I do know that Medicare may pay doctors between 40-60% of the "normal" price, or even lower,
And hospitals may only get around 10% {based on my benefit statements}. Sweet negotiating! --or lying!
All MC drugs are Part D, taking the gov. out of the equation, (and your fully latched congressperson,
--suckling like mad at the Big Pharma nipple); so my insurer is free to lie as much as they please.
I don't believe for a minute that Humana pays as much as they say they do.
One could only hope that some day the deception will be illegal.
I do know that Medicare may pay doctors between 40-60% of the "normal" price, or even lower,
And hospitals may only get around 10% {based on my benefit statements}. Sweet negotiating! --or lying!
All MC drugs are Part D, taking the gov. out of the equation, (and your fully latched congressperson,
--suckling like mad at the Big Pharma nipple); so my insurer is free to lie as much as they please.
I don't believe for a minute that Humana pays as much as they say they do.
One could only hope that some day the deception will be illegal.
_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Airsense 10 Autoset for Her |
Re: Crazy Prescription Prices!! - Its Insane...
It's not any different than "fantasy billing" for CPAP's. It's what the DME wishes, in it's wildest dreams it could get for a CPAP machine (and sometimes does get if a poor, uninsured sucker walks into their lairs).
Same with drugs, doctor's charges, and hospitalizations.
I love to laugh when big wigs say we need to be better medical consumers and pay attention to costs. HOW???? The prices are pure fiction!
Same with drugs, doctor's charges, and hospitalizations.
I love to laugh when big wigs say we need to be better medical consumers and pay attention to costs. HOW???? The prices are pure fiction!
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: DreamWear Nasal CPAP Mask with Headgear |
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm
Re: Crazy Prescription Prices!! - Its Insane...
Just for kicks I checked Costco's no insurance price on this item.....$340metsfan302 wrote:I just got prescribed a new inhaler for my copd / breathing - Advair
Its wild the prices big pharma charges insurances/ consumers. I understand there is alot of research, science, yatta yatta but wow!
This new Inhaler Retail Price is - $505.99 for 1 inhaler that's 120 puffs - $4.21 per puff!!!
Yes the insurance covers it and my co-pay's only $3. They have no prob paying for this but wont cover an attended sleep study rejected once again but the sleep dr is appealing it.
So every month they are paying for this inhaler basically what it cost for a new AirSense 10 Autoset (almost)
https://www.cpap.com/productpage/resmed ... idair.html
By the way...in case you are not aware...You do not have to be a member to use the Costco Pharmacy.
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Last edited by LSAT on Wed Nov 25, 2015 6:30 pm, edited 1 time in total.
- Wulfman...
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Re: Crazy Prescription Prices!! - Its Insane...
In my opinion, this all started the snowball rolling downhill in the mid-1960s when the government got involved in and created Medicare and regulating medical costs/prices. Over the decades it's gotten progressively worse.Janknitz wrote:It's not even illegal collusion. The insurers are free to negotiate volume discounts, and I guarantee you they don't pay anywhere near the retail price. Just like CPAP equipment. Our insurers aren't paying the retail prices for CPAP equipment and supplies, they pay a negotiated rate.chunkyfrog wrote:I suspect that the insurance company may have some kind of (nudge, nudge) "agreement" with the drug company.
Just because such collusion is illegal is not always a deterrent.
It's the GOVERNMENT which isn't allow to negotiate on behalf of the people. Stupid, stupid, stupid.
Now we have an insurance and medical care nightmare.......created by........ ______________________ (fill in the blank)
Be careful what you wish for.
Den
.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
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User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
Re: Crazy Prescription Prices!! - Its Insane...
You could get it from Canada for $40 or try Costco if you have no insurance.
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Re: Crazy Prescription Prices!! - Its Insane...
I always suggest that if people need to buy medications without insurance that they check GoodRx to find the best prices:
http://www.goodrx.com/advair-diskus?dru ... air+diskus
Here's the story on GoodRX - started by a couple of early Facebook employees:
http://techcrunch.com/2012/02/18/goodrx ... ion-drugs/
This is a very legit site that costs nothing. You can access it on your home computer or using their phone apps. It keeps track of lowest prices and gives you codes you can print out to get the reduced prices. Like many medical things, the "list prices" pharmacies charge are often outrageous. But if you have the right discount codes, you get a much better price.
When I have been off insurance, I used GoodRX to compare if I got better prices at walmart, costco, target, etc. The other nice thing is that you can see how the price changes with different quantities. Often, by buying a larger quantity, you can pay less per pill. I made a spreadsheet to calculate the per pill price for different quantities and found that the highest price was usually for a 30 day supply. And doctors are usually happy to write the prescription for the amount you want to buy. You can also often save money by buying pills that are double the dosage you need and then cutting or breaking them in half.
http://www.goodrx.com/advair-diskus?dru ... air+diskus
Here's the story on GoodRX - started by a couple of early Facebook employees:
http://techcrunch.com/2012/02/18/goodrx ... ion-drugs/
This is a very legit site that costs nothing. You can access it on your home computer or using their phone apps. It keeps track of lowest prices and gives you codes you can print out to get the reduced prices. Like many medical things, the "list prices" pharmacies charge are often outrageous. But if you have the right discount codes, you get a much better price.
When I have been off insurance, I used GoodRX to compare if I got better prices at walmart, costco, target, etc. The other nice thing is that you can see how the price changes with different quantities. Often, by buying a larger quantity, you can pay less per pill. I made a spreadsheet to calculate the per pill price for different quantities and found that the highest price was usually for a 30 day supply. And doctors are usually happy to write the prescription for the amount you want to buy. You can also often save money by buying pills that are double the dosage you need and then cutting or breaking them in half.
_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Additional Comments: January 2015 Sleep Study Results: Apnea/Hypopnea Index (AHI): 80.2, Sleepyhead |
Re: Crazy Prescription Prices!! - Its Insane...
How does this work if you have Medicare Part D?yaconsult wrote:I always suggest that if people need to buy medications without insurance that they check GoodRx to find the best prices:
http://www.goodrx.com/advair-diskus?dru ... air+diskus
Here's the story on GoodRX - started by a couple of early Facebook employees:
http://techcrunch.com/2012/02/18/goodrx ... ion-drugs/
This is a very legit site that costs nothing. You can access it on your home computer or using their phone apps. It keeps track of lowest prices and gives you codes you can print out to get the reduced prices. Like many medical things, the "list prices" pharmacies charge are often outrageous. But if you have the right discount codes, you get a much better price.
When I have been off insurance, I used GoodRX to compare if I got better prices at walmart, costco, target, etc. The other nice thing is that you can see how the price changes with different quantities. Often, by buying a larger quantity, you can pay less per pill. I made a spreadsheet to calculate the per pill price for different quantities and found that the highest price was usually for a 30 day supply. And doctors are usually happy to write the prescription for the amount you want to buy. You can also often save money by buying pills that are double the dosage you need and then cutting or breaking them in half.
Can I use GoodRx for one or 2 medications and then my Medicare Part D plan for the rest?
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Re: Crazy Prescription Prices!! - Its Insane...
http://www.bloomberg.com/news/articles/ ... ric-advair
Generic Advair is close!
But as has been said, the list price of $500+ is NOT what your company had to pay... no even close!
Generic Advair is close!
But as has been said, the list price of $500+ is NOT what your company had to pay... no even close!
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- metsfan302
- Posts: 687
- Joined: Fri Oct 09, 2015 9:44 pm
- Location: Dewey Beach, Delaware
Re: Crazy Prescription Prices!! - Its Insane...
But if I did not have insurance i would have to pay that
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Machine: DreamStation BiPAP® Pro Machine |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Humidifier: DreamStation Heated Humidifier |
Additional Comments: Prior - ResMed AirCurve ASV User |
This is my Orig Post "The start of my venture to find proper therapy" - http://www.cpaptalk.com/viewtopic.php?f ... &sk=t&sd=a