Written By: Anna Holness
Wouldn’t it be wonderful to be able to concentrate all of your energy on getting well instead of having to deal with finances and other problems when you are ill? Certainly anyone who has had a stem cell transplant has first-hand experience of being prescribed a multitude of often expensive medications throughout the transplant journey.
Having worked in the healthcare field for more than 30 years I thought I was reasonably savvy about being aware of economical ways to purchase medications. I purchased generic whenever possible, ordered long term medications via my medical insurance pharmacy home delivery plan, and ordered a 90-day supply for long-term medications instead of constantly reordering every 30 days. However, there was an incident that left me feeling quite ignorant.
Approximately eight months after an allogeneic transplant, I developed a viral infection, which irreversibly affected my thyroid and added yet another medication to my regimen. Levothyroxine (generic Synthroid) is a common medication, not known to be exorbitantly priced. I began ordering it via the pharmacy plan offered by my medical insurance at a price of $37.50 for a 90-day supply. One day, approximately one year later, I noticed a medication search feature on the pharmacy insurance website. I began comparing the price of levothyroxine at various pharmacies. To say that I was surprised, astonished – even incredulous – would be an understatement. I was happy paying $37.50 for a 90-day supply, yet the same 90-day supply cost $10 at a nearby pharmacy in a national retail store. It occurred to me that perhaps the national retailer had more buying power and I should start ordering all my medications via their pharmacy. One-by-one I searched each of my medications and the national retailer was not less expensive for all my medications. In fact, a 30-day supply, one bottle of latanoprost eye drops cost $5.32 at the local supermarket pharmacy, $15.00 at the national retailer and $16.50, if I ordered from the medical insurance pharmacy plan.
How could this be? Isn’t the pharmacy plan affiliated with our medical insurance plan supposed to provide the lowest available prices for its members? I now pay for a year’s supply of levothyroxine what I had previously paid for a 90-day supply. This was a game changer for me. I now routinely compare prices at big box stores such as Costco and Sam’s Club, national retailers such as Walmart and Target, local and supermarket pharmacies.
Many pharmacies have greatly discounted prices for common generic medications. These are not cancer medications, but are commonly used to treat diseases such as diabetes, cardiac and blood pressure, thyroid, cholesterol, gastrointestinal, mental health and even some vitamins. Prices are approximately $4 for a 30-day supply and $10 for a 90-day supply. Examples are Glyburide/Metformin (Glucovance), $9 for 60 tablets or $24 for 180 tablets; and Simvastatin (Lipitor), $15 for 30 days and $38 for 90 tablets. Some stores offer reduced prices and even free antibiotics. You still need a prescription from your physician, but these are available for insured and uninsured patients. Keep in mind when you are sick and not feeling well, it is not the best time to search for reduced-price antibiotics because antibiotics usually need to be started as soon as possible. This is something to investigate and keep in mind for future use.
While it was my experience with levothyroxine that made me aware my medical pharmacy plan was not always the most economical, it was a pharmacist at a local supermarket pharmacy who alerted me to online medication coupons. Several years ago, my son was prescribed EpiPen, a life-saving medication for severe allergic reactions. The co-pay with the medical insurance pharmacy plan (not the plan involved with Levothyroxine and Latanoprost) was over $300. Thankfully, the pharmacist informed me that with an online EpiPen coupon the cost would be a mere $10. Basically, a $300 savings by simply printing a coupon.
Recently, I had a similar experience with Restasis (Cyclosporine) eye drops. These were prescribed for dry eyes, which I had developed post-transplant. These eye drops were not on the preferred medication list on my pharmacy plan which meant a $75 co-pay. Luckily, my ophthalmologist had advised me that the pharmaceutical company (Allergan), which made Restasis, had a zero-pay coupon online. Although they list an expiration date, these coupons are often reusable. In this case, the coupon stated that after the expiration date, the coupon could continue to be used with as little as a $5 co-pay.
Some may have low opinions of pharmaceutical companies; however, they can be a resource for free or reduced-price medications. A fellow transplant patient was fortunate that when her co-pay for Revlimid (lenalidomide) increased from $50 a month to $1000 a month, the pharmacist referred her to an organization called Patient Advocate Foundation. This organization assisted her with securing a zero co-pay for this as well as two other medications, Jadenu and Prevymis. Coupons have restrictions; some can only be used by patients with commercial medical plans or uninsured patients. There are also programs available for patients with government plans but these vary by state. For example, in New York, the EPIC program (Elderly Pharmaceutical Insurance Coverage) can supplement out of pocket Medicare Part D drug plan costs for income-eligible seniors, aged 65 and older.
We all have seen the commercials for discount medication prescription cards, which are yet another source for reduced-cost medications. The most well-known of these cards is Good Rx and there are many others: Single Care, Well Rx and Script Relief are a few of the more recognized. An online search will reveal many others. Partnership for Prescription Assistance helps uninsured and underinsured patients find programs that provide medications for free or nearly free. Needy Meds is an information resource devoted to finding assistance programs, which can help patients with medications as well as other healthcare-related costs.
As you can see, there are many possible resources. Ask your physician/medical team, or pharmacist; look online for coupons (medication name/pharmaceutical company), local and national support groups (American Cancer Society), and state/federal agencies. (I am not promoting any one retailer or pharmacy, nor am I extolling the virtues of the pharmaceutical industry.) However, I am enthusiastically sharing information that I wish I had known prior to having a stem cell transplant. Reducing medication costs is useful information for everyone, particularly for cancer and transplant patients. I hope everyone will have their own Restasis, Latanoprost and EpiPen stories and pass them on to friends, family and fellow transplant patients.