When insurance won't pay for generics---

[femmocrat]

Last edited Mon May 11, 2015, 04:43 PM - Edit history (1)

What are we supposed to do?

I went to pick up a $5 generic drug yesterday. It now costs $150!!! I did not accept it, and the pharmacy told me to call the doctor.

Today, I called the doctor's office and asked for him to recommend an alternative .... The doctor himself called me back, rather annoyed, and told me to call the pharmacy back. (Did he think I was making it up?)

I called the pharmacy back. They told me to call the insurance company (for alternatives.)

The insurance company checked. Nope... not covered. Told me to call the doctor's office for an alternative. (I did that in the first place.... sigh.....)

So here we are..... huge runaround, no results, lots of frustration.

This is a lousy $5 item that if taken correctly can prevent all kinds of major and expensive complications. This country's medical-pharmaceutical complex is really f*cked up. That is what I told the insurance person.

[yeoman6987]

1. 5 dollars is too low and 150 is too high

What needs to be done is find a price that will work for consumer, insurance company and pharmaceutical companies. Or allow some to buy pills directly from the pharmaceutical company. What about 30 dollars for every perscription. If that were to happen problems would disappear.

[femmocrat]

2. That is too logical. :)

Of course, there are people who cannot afford $30.

My point was that for the cost of a $5 preventative (it could be more now--- that is what the doctor thought it was), all kinds of expensive complications could be avoided in the future. That is the part that is f*cked up, IMO.

[Vincardog]

3. On what evidence do you base that assessment? $5 is too much for WHAT?

[Warpy]

4. Making a lot of drugs OTC is also shifting costs away from insurers and onto customers.

Most of the drugs that have gone OTC are much cheaper than they were as prescription drugs, even if they were available as generics. However, it is evidence of more cost shifting onto patients.