Rx question (was gonna post in Health but those forums are not active): COPD meds

[CurtEastPoint]

When I was on Cigna private insurance, I got 3 30-day inhalers (Breo Ellipta) for $50. Now that I am on Medicare and have a smaller income, the same supply is gonna run me $300.

So instead of $16.66 per month, it's six times that, or $100 per month. (Don't get me started on insurance, big pharma, etc. Grrrr...)

So here's my question: this med seems to help me breath easier. Have any of you found a med that helps with COPD or asthma (which is what it is marketed for) that might be less expensive?

Thank you all in advance!

[Eliot Rosewater]

1. Check your Part D plan and see if you can find one that pays better on that drug.

http://www.medicare2017.org/get-quotes/?CID=27068&SRC=mp_goog_d&bw_state=0&bw_type=Medicare+Part+D+Options&bw_brand=0&Sub_ID=medicare%20part%20d&bw_keyword=medicare%20part%20d&google_network=g&creativeid=190973566289&position=1t2&matchtype=b&mobile=&gclid=CjwKEAjw3KDIBRCz0KvZlJ7k4TgSJABDqOK7fXetM5Qpcq_lVuMLY_lfP6fbz5Je9JTLn-noJjG6SRoCE_Tw_wcB

You may find a plan that does better than the one you are on

[CurtEastPoint]

13. On Aetna Advantage. Did some calling and it's $600/year so better but still....

[Eliot Rosewater]

16. Did you use the tool and then call them to see the amount? Isnt there more than

one option?

[CurtEastPoint]

18. Yes, I called. There are several and we went over it. It's all so damn complicated.

No sense in this. But it's lower than I thought. Thank you!

[Eliot Rosewater]

23. Welcome, and each time your needs change, do this exercise.

[still_one]

2. Just curious, which Medicare part D plan did you choose? The price you are quoting

is almost as much as if you went through goodrx.com without going through Medicare Part D:

https://www.goodrx.com/breo-ellipta?drug-name=Breo+Ellipta

So that leads me to believe that either you choose a less expensive Part-D plan, and or the plan you are under are trying to push you to take an alternative.

If your physician contacts Medicare, and says this drug is necessary for your treatment, you should be able to get the Medicare insurance part D to cover a larger portion of it. You need something like a pre-authorization from your doctor to the Medicare Part D insurer stating this.

Either call Medicare or your Medicare provider and ask them about the procedure.

Good luck

[Solomon]

3. You can download and sign up for a coupon from the breo

Website which makes it free for a year.

[still_one]

4. Here is an example of a prior authorization form for a durg not covered from BCBS

http://www.bcbsm.com/medicare/help/understanding-plans/pharmacy-prescription-drugs/prior-authorization.html

but most of them have something like that

[notadmblnd]

5. You might be able to get a coupon for a free year of Symbacort

Ask your primary care or pulmonary Dr. They usually have coupons your local pharmacy will honor. Forget ordering it via Express Scripts, they don't accept coupons.

[WillowTree]

8. I hated Symbicort.

I started generating lots of phlegm in my chest and throat that made my voice gravelly (people were always asking me if I was sick) and, unlike the non-steroid, dry inhalers I've used, it was less convenient to use. Dr. took me off that after the first 90 day supply was exhausted.

[The Wielding Truth]

6. Found this online. Maybe it could work. Ask your doctor.

http://www.mybreo.com/asthma/savings-and-offers.html

[CurtEastPoint]

12. Thanks. Not for medicare. Of course!

[Runningdawg]

7. Advair

runs me 50.00 per month on Blue Cross in OK but I am thinking of trying a Canadian pharmacy and see if its cheaper.

[JenniferJuniper]

9. My mother's doctor

told her to always check out Canadian pharmacies for her ridiculously expensive COPD medications.

There is a website out there that lists a bunch of them with various drug prices.

[csziggy]

10. Check with GoodRx.com and see if they can get you a discount

There is another company now advertising the same kind of thing but I don't have any experience with it and don't remember their name.

GoodRX does give discounts for a lot of drugs, but not all. What is nice is that you can check from their website with no obligation. They will show you the prices with their coupon at most pharmacies in your area. If you sign up and get one of their cards, you don't have to mess with coupons.

I had two drugs that were over $250 a month each WITH my insurance. With GoodRx I could go to a different pharmacy and get one for under $30. For the other one I got a coupon for a year to discount it to $25 a month until I changed insurance and have been on a plan that covers both for $40.

On the other hand a drug my sister uses that is over $400 a month is not discounted at all with GoodRX and it is not covered under her current insurance. The only way you know is to go look.

GoodRX does not spam you and they pretty much leave you alone. I haven't used them for over a year - my current health plan covers my drugs without the need for the discounts - and get an email maybe once a month updating me on the prices for the drugs on my list.

[Break time]

11. Good Rx

they are pretty good with the coupons, I have been using Healthwarehouse.com, the require a prescription but beat most others for price. Unfortunately I use an inhaler also and they are not any cheaper there.

[CurtEastPoint]

15. THANK YOU ALL!!

[LeftyMom]

17. Both your pharmacy and your doctor's office staff should help you with this.

Your doctor's office might be able to submit paperwork showing why you need Brio Elipta and not a cheaper/older/generic drug. You might need to demonstrate that you've tried a formulary drug first or that you have a unusual case that makes a cheaper alternative less suitable.

Do you qualify for Extra Help or state assistance for your medical expenses? Could you apply for the assistance program with the company that makes your drug? Can your doctor get you samples?

I hate that this stuff is such a complicated pain. My dad's waiting on an organ transplant and if he didn't have me to handle all the hoop-jumping, listening-to-hold-music and paperwork I genuinely don't know what he'd do. Maybe die. It's been touch and go a few times.

[CurtEastPoint]

19. Thank you for these ideas. And best to you and Dad. It is all so crazy complicated and it should

NOT be. Especially for some older folks and/or those who are not that savvy. Ridiculous.

[Ninsianna]

20. Have you talked to your doctor about other options?

Breo Ellipta seems to be 100mg fluticasone (corticosteroid) and 25mg vilanterol (Long acting Beta agonist)

Advair seems to be a similar formulation, with Fluticasone and salmeterol (which is chemically similar to Vilanterol so it should work the same), this is an older drug and the combination is off patent, so it should be a little lower in price.

I hope that helps, I don't know much about pricing, but I hope the pharmacology is helpful

[CurtEastPoint]

21. I am seeing him in June and will certainly ask! Thank you! I just checked and the prices

are exactly the same as Breo. Waaah!

[Ninsianna]

22. You're welcome, and please keep us updated! Might be helpful to others in your situation as well.