Got Meds

I’ve had experiences and phone calls that have tested my patience, pissed me off, bewildered and amazed me in the past week. I have my medication but just to be clear, up to now I haven’t gotten the authorization from the insurance company, so of course it wasn’t filled by my regular pharmacy. In fact, I learned on Friday that the authorization was denied again on Wednesday 29th. I am a member of a Facebook group that consists of women who’ve been diagnosed with MS and sometime last weekend I was scrolling thru and reading one or two posts. I came across one where the person was saying that her insurance denied the same medication and she used Mark Cuban’s drug company and got it. I remembered watching a Daily Show episode where Cuban was the guest and he and Trevor Noah talked about this website that he’d either just started or was about to launch, that offered drugs at little cost to consumers. At the time as interesting as it seemed, I had no use/need for it so, of course I never looked into it. Fast forward to last weekend, I looked it up, saw that the drug was available and read thru the requirements to get it.

Monday started with conversations with my doctor’s office to write a prescription to submit to the site so that I could get my pills from them. On Tuesday I should have known to set my expectation bar very low when it took 4 tries to finally get Freddy on the phone from the patient advocacy group at work. By the time Freddy answered, I was done and laughing to myself at the ridiculousness of the situation – 4tries!! Anyway, Freddy was very helpful, took all my info, the drug info, all the details; I couldn’t ask for a more thorough associate. At the end, he told me that my information was submitted to the advocate team and someone will contact me in 48 hours – not sure when the 48hr clock starts cuz I’m still waiting for a call. On Wednesday, I ordered the pills from Cuban’s site, Cost Plus Drugs. Thursday, I spoke to a rep at my pharmacy, the most helpful person there, who told me that the authorization was denied again the day before and the reason was that my doctor hadn’t sent something they’d requested. Sigh! Later that day, Gilbert’s MA left me a message that said, “Stacey, I’ve given them everything they asked for, they know that you’ve been on this for 12 years and need it. I don’t know what else they want.” Friday, I got an email that the medication had been shipped from Cost Plus Drugs and was scheduled to be delivered on Monday.

By Wednesday or Thursday, I’d started doing a deeper dive into Mark Cuban’s site reading their FAQs and other articles etc. that I found online. What he offers is incredible and EVERYBODY should look into the site to determine if it is a viable option for them. The company was started because “every American should have access to safe, affordable medicines” and that is exactly what they appear to be offering. Now, there is a limited number of drugs available, but it appears that they update and add regularly. You can search for your medicine or you have the option to drill down by “ailment” to find what you need. The first time I accessed, I just searched by drug name but as I started exploring the site, I drilled down by MS and saw that there are 3 drugs available. That’s where you see the costs and the savings for each – and this is where they can blow your mind:

For a 30-day supply:
The retail price of my drug: $1,394.30 Cost Plus price: $11.40
The retail price of MS drug#3: $13,067.14 Cost Plus price: $293.03

Now I always knew that it was all about the money (hell, we all know that and I said so myself in my last post) but how the hell do these people sleep at night?!? How do you in good conscience do this to people??? And guess what? There is actually a 15% markup added to the cost of each drug on Cost Plus- WHAT? It is absolute madness…everybody who can, needs to start using this website. And they don’t even take all insurance right now; they only accept a few plans and mine isn’t one. I had to pay that whopping $53 out of my own pocket. I took my last pill on Saturday and while the feeling of being out of sorts and lethargy eased up, my movements have been quite laboured. I got my package yesterday, took a pill and I’m back on my regular schedule today. I also got a 90-day supply so I’m not even stressing over whatevertheass my insurance company and pharmacy have to say right about now. Big Pharma – it’s just a whole big racket taking advantage of ordinary folk who are just trying to survive!

Go visit the website, see if you can take advantage: Cost Plus Drug Company

hol’ it dong, Stax

Whoa!

I’m not complaining – I swear i’m not (u all know that i of all people am not)…but 70degrees in FEBRUARY!!??!!!  the world is coming to an end – what the?!?!?!  of course, next week it’ll probably snow – such is the weather in Atlanta – steups!! (sorry folks, i have no idea how to translate – it’s a teeth sucking noise that we Trinis do)

Anyhoo, I’ve said before that sometimes i think that insurance is 1 of the biggest ripoffs ever.  But boy am i thankful for it.  My mother is an Executive Agent at Guardian Life and many good things have happened to her since working at Guardian Life and she is doing extremely well there – extremely grateful for that!  Yesterday i got a bill for my last infusion in the mail.  My copay is $40 on the day of and then i normally get a bill for 4.79.  Yesterday when i opened the bill, it was 23.95 – so, of course i needed to understand y it had jumped so much all of a sudden. and i logged onto the insurance co website.

well i discovered that by the time i’d started infusions last year, i’d already met my deductible for the year – hence the low bill (I’d spent so much on my health last year).  Of course i haven’t done anything for this year as yet, so i have to meet my deductible before anything insurance kicks in.  Okay, i can live with that.

Then i saw the actual cost of the infusion – 5032 big ones every month!!  EVER GRATEFUL for the INSURANCE!!!!!!  how do sick people without it deal?  I guess they just deal with their ill health???  There was NO way that i could pay $5k monthly; i’d have to do an infusion a  year or something.  Maybe for sick people, insurance is not a the biggest ripoff afterall
🙂

Ampyra Updates

So, I’ve found out a little more about the new medication.  Remember the last thing i discovered was that it would cost $1056 for a 30-day supply?  Well i was on the manufacturer’s site yesterday and found out that:

  1. Some patients meeting a certain income requirement may be able to get it at no cost! (i can dream on about this – i am almost positive that i won’t qualify)
  2. Other patients who are on Medicare Part D (as opposed to A, B or C?) may be able to get some kind of financial assistance
  3. Yet another subset of patients with private insurance (this is where I fall) may be able to get it for a copay of $40

WOOHOO!!!  I think that i can handle $40 a month for my medication.  The drug is also only going to be available thru specialized pharmacies and will be mailed to patients – it won’t be available at ur local CVS.  I already use one of those pharmacies so here’s hoping that mine will carry it and it won’t be too much of a hassle for me to get it.  Altho, i will say that NOT having to fork out $1K a month is plenty to be happy about even if i have to run around the place like a chicken without a head to actually get it mailed to me.

There is also a Webcast being held on March 17th that i plan on attending; hopefully some of my questions will be answered there.

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