Monday, December 28, 2009
Copaxone Price Shock
Presently, I cannot complain with how much I pay for prescription medication, but it is just a matter of time I will have huge out of pocket deductibles for my medications. I am fortunate to have the benefit of getting most of my prescriptions filled at a Military base pharmacy at no charge. However, I noticed prescriptions I take are slowly being phased out and I have no choice but to go to an outside pharmacy. In the past my co-pays use to be $3.00 generic and $9.00 brand. My co-pays are now $3.00 for a generic, $9.00 for a brand formula drug and $22.00 for a brand non-formula drug. If you are thinking most of my drugs are now brand non-formula...ding ding you are correct!
I made a conscious decision to not become dependent on the many drugs MS'ers are prescribed for every nuisance the disease bring our way. Yes, my neurologist did not like me taking most of my drugs as needed. My rationale to her dislike is...I am the one living with MS and I know my body better than anyone. I am not trying to play doctor, but I do know that I feel a lot better taking medication as I need it than taking it every day when the MS symptom or symptoms are no longer present.
However, Health Care Reform is definitely needed in America. Although, IMO what is being called Health Care Reform is a bunch of BS...KO eloquently tells you WHY! Washington needs to stop the RAPE of American citizens from the fraud and abuse of the Health Care and Big Pharma Industry...AND Washington needs to stop the BS political games at our expense! We are being raped with higher deductibles and co-pays because of the bullshit I just discovered. It is a damn shame how one pharmacy chain can charge almost twice as much for Copaxone and not be held accountable to WHY they are charging more than another reputable pharmacy chain.
Case and point, for years I have been filling my Copaxone prescription at the grocery chain Kroger Pharmacy, until December of 2008, I decided to have my Copaxone filled at Walgreens. Now I know how Walgreens can afford to have a pharmacy on every corner in about every state. I always assumed my insurance was paying Walgreens the same as they did Kroger after my co-pay until today. Express Scripts never sent me an Explanation of Benefits before today. They were not doing me any favors, what they were doing was soliciting me to mail order my Cymbalta through them; Which I plan to do because I can receive three months supply for $22.00 a month. Duh, who would not want to save $44.00? The SHOCK on the EOB was the amount TRICARE was paying Walgreens after my co-pay; I thought it had to be some sort of mistake. Therefore I went and pulled my 2008 prescription profile to see if Copaxone had a 100% price increase.
I discovered in November 2008, after paying my $9.00 co-pay at Kroger's for my Copaxone, my insurance paid them $1,783.00, which was an increased from 1,666.97 three months prior. However, in December 2008, I discovered after paying my $9.00 co-pay at Walgreens for my Copaxone, my insurance paid Walgreens $2,806.00 that is a freaking $1,023.00 difference. ..WTF!
Here is the industry BS according the EOB from Express Script I received today. Walgreens submitted a bill of $3,005.51 for my Copaxone, my insurance allowed amount is $2,562.19, I paid my $9.00 co-pay and TRICARE paid Walgreens $2,554.53. That amount is still MORE than what Kroger charges. Walgreens is pricing their drugs pass the allowable amount, knowing they will get paid the maximum amount allowed by my insurance...I have a bridge to sell you if you do not think the system is broken! It does not take a rocket scientist to see what the eff is going on with the industry.
Hell, its just a matter of time I will be paying for this fraud and abuse. It does not make any freaking sense how one monthly disease modifying drug cost $30,746.28 a year...at that rate a cure will never be found. TRICARE should have never paid Walgreens that much money. TRICARE would have been more cost efficient and proactive in their efforts of informing ME the drug I depend on daily to slow the progression of my MS cost them $21,396 a year at Kroger Pharmacy.
TRICARE listen up, I am going to save you $9,350.28 a year...I am switching my Copaxone prescription BACK to Kroger Pharmacy. How about a THANK YOU!