Couple retires in Spain and lives comfortably on $2000 per month.

[Fermion]

I just looked at the 5 year stock chart for GSK (GlaxoSmithKline) and it does not look that great. Essentially it has gone nowhere in the last 5 years while stocks like Amazon, Microsoft, Google have been much better investments. Heck, even Boeing, with all its problems has done way better than GSK.

So who is making bank off this $20,000 a year drug?

[aja8888]

Quote:

Originally Posted by Fermion Is it the case where you could get the drug cheaper before you turn 65 and then after 65 the drug gets more expensive? $100 a month doesn't sound like much saving on a drug that costs $20000 a year. This is way off this topic I guess but it does seem to me like a person might be better off under the ACA than medicare, at least for drugs like this.

DW is 74 and has been using Breo for 3 years now. Same drug plan under Part D. Last year, OOP on drugs for her was just under $4,000 not including the plan premium of $75/month. This year OOP automatically jump to ~$15,000 with the only cost difference is in Breo. Plain and simple, Glaxo is screwing older people who need this.

Based on being married and our income (which isn't much) , she doesn't qualify for much. if any, assistance on drugs.

Looks like Canada purchasing is our only real option here. I just have to get her doc to hand write the prescription. Interestingly, looking at a Canada pharmacy and adding this drug to the cart, shows it shipping to us from England where Glaxo has facilities.

[Freedom56]

Quote:

Originally Posted by aja8888 DW is 74 and has been using Breo for 3 years now. Same drug plan under Part D. Last year, OOP on drugs for her was just under $4,000 not including the plan premium of $75/month. This year OOP automatically jump to ~$15,000 with the only cost difference is in Breo. Plain and simple, Glaxo is screwing older people who need this. Based on being married and our income (which isn't much) , she doesn't qualify for much. if any, assistance on drugs. Looks like Canada purchasing is our only real option here. I just have to get her doc to hand write the prescription. Interestingly, looking at a Canada pharmacy and adding this drug to the cart, shows it shipping to us from England where Glaxo has facilities.

My wife's OBGyn prescribed medication common to women over 50 that has been around for decades for menopause symptom relief. A one month supply through CVS Caremark of the brand name prescription was $394 per month out of pocket. We are on a bronze PPO with high deductibles so it would be 100% OOP. The generic version is $266 per month OOP. The quoted prices are from a Costco in Southern California. We bought a one year supply of the same medication (brand name) at a Costco in Canada for about $185 USD (after the exchange). We have traveled to Canada two years in a row and saved a bundle. I can see why people in the border states have been crossing over to Canada to buy their medication over the past decade. I don't mind spending money, but I would rather spend money on things that benefit us rather than greedy executives at pharmacy benefit managers or pharma companies.

[Fermion]

One would think that if it were pure greed, the stock would do better, as a greedy executive generally would lead to a well performing stock for investors.

Somewhere along the line the money is disappearing. Maybe lawsuits? I do know that the opiod lawsuits are siphoning billions out of the drug companies and have bankrupted at least one.

[Freedom56]

Quote:

Originally Posted by Fermion One would think that if it were pure greed, the stock would do better, as a greedy executive generally would lead to a well performing stock for investors. Somewhere along the line the money is disappearing. Maybe lawsuits? I do know that the opiod lawsuits are siphoning billions out of the drug companies and have bankrupted at least one.

The pharmacy benefit managers such as CVS Caremark are the one's doing most of the mark-up. It's often cheaper for people to pay cash for their prescription drugs rather than use their insurance. This is where the lawsuit stands now:

https://www.sfchronicle.com/news/art...t-13977326.php'

[Sunset]

Quote:

Originally Posted by aja8888 DW is 74 and has been using Breo for 3 years now. Same drug plan under Part D. Last year, OOP on drugs for her was just under $4,000 not including the plan premium of $75/month. This year OOP automatically jump to ~$15,000 with the only cost difference is in Breo. Plain and simple, Glaxo is screwing older people who need this. Based on being married and our income (which isn't much) , she doesn't qualify for much. if any, assistance on drugs. Looks like Canada purchasing is our only real option here. I just have to get her doc to hand write the prescription. Interestingly, looking at a Canada pharmacy and adding this drug to the cart, shows it shipping to us from England where Glaxo has facilities.

Have you checked goodRx.com , basically using a coupon from that site at your pharmacy and paying cash (not allowed to use insurance with coupon).

https://www.goodrx.com/breo-ellipta?...mcg&quantity=1

[Offgrid Organic Farmer]

Quote:

Originally Posted by Letj True but the quality of life here would suck.

I have lived in Europe [including owning a home], as a retiree I now live in the US. I feel that our Quality of Life is much better here stateside.

Quote:

Originally Posted by AbbA Wow, which village near Seattle has this kind of COL? I'd be curious to learn more about it. Replace some food with rice and it's $1k/mo. and it's for a couple too. No need to leave the greatest country in the world . WA doesn't have the same weather but one can adapt. How can we pull a list of such super affordable places in the US?

Before I retired, I owned a home in Bremerton Washington. We found the COL in Washington to be fairly high.

After I retired when returned stateside and decided to settle in Maine. This is much more affordable for us.

Quote:

Originally Posted by explanade Those can't be Seattle prices. A lot more sun in Spain than in Washington State. Also within a 1-2 hour flight to all of Europe.

A 2-hour flight from Seattle would put you in Europe?

I don't think so.

[Teacher Terry]

The poster was talking about Spain being a short flight for most of Europe.

[Offgrid Organic Farmer]

Quote:

Originally Posted by AbbA Holy cow!! Do all people get hit with such exorbitant costs when they're unfortunate to have cancer or COPD (sorry not sure what kind of disease this is)? I thought once one is on Medicare and buys a drug plan, they're good, but I never imagined that it takes $22k+/year. Or is this for people with very high income?

I have Prostate Cancer. The first year, for all the tests, biopsies, and robotic surgery to remove my prostate, my co-pay was $37.

Four years later, my cancer returned. I went through radiation treatments for a year, and I started hormone therapy. The co-pays for these have been $20 a quarter.

My hormone therapy uses 'Lupron' the market price for it is $6,000 for 6 months. My co-pay just for the shot is $12.

[aja8888]

Quote:

Originally Posted by Sunset Have you checked goodRx.com , basically using a coupon from that site at your pharmacy and paying cash (not allowed to use insurance with coupon). https://www.goodrx.com/breo-ellipta?...mcg&quantity=1

Yes and It's better than the Part D plan cost. But the Walmart she gets her drugs at does not take "coupons". That seems to be the trend around here. I'm sure if we shopped the coupon someone will take it. I like the Canada mail order route better as we could set up a monthly deal.

[Freedom56]

Quote:

Originally Posted by aja8888 Yes and It's better than the Part D plan cost. But the Walmart she gets her drugs at does not take "coupons". That seems to be the trend around here. I'm sure if we shopped the coupon someone will take it. I like the Canada mail order route better as we could set up a monthly deal.

I personally would not go the Canada mail order route. Those mail order companies are not well regulated and you don't know the origin of the drugs. This is why we travel to Canada to get the prescription filled. The drugs are sourced in Canada when you buy at pharmacies in Canada. All the major pharma companies have manufacturing operations in Canada due to the tax incentives from the government. The fact that on-line Canadian pharmacies are sourcing drugs from outside Canada is a red flag.

This is a list of drugs GSK produces in Canada:

https://ca.gsk.com/en-ca/products/ou...-and-vaccines/

[aja8888]

Quote:

Originally Posted by Freedom56 I personally would not go the Canada mail order route. Those mail order companies are not well regulated and you don't know the origin of the drugs. This is why we travel to Canada to get the prescription filled. The drugs are sourced in Canada when you buy at pharmacies in Canada. All the major pharma companies have manufacturing operations in Canada due to the tax incentives from the government. The fact that on-line Canadian pharmacies are sourcing drugs from outside Canada is a red flag. This is a list of drugs GSK produces in Canada: https://ca.gsk.com/en-ca/products/ou...-and-vaccines/

Thanks!

[lordjust]

Quote:

Originally Posted by Fermion I put in a quote for the Sanitas Mundi 1 million plan (which is acceptable for residency/visa) and for a single person age 51 the premium is 408.86 euro per month. So $456 a month roughly. That actually IS pretty good but you can get cheaper insurance in the USA if you qualify for a subsidy, which it is likely that this couple would if their only income is $2000 a month.

I would have to see the total cost of having the plan. The monthly premium isnt where the large cost is that I have run into. What was the plan's deductible?

I see quite a few people choosing to pursue healthcare in other countries which is why i asked what you found in the US that is similar cost. I started investigating cigna but didnt get to far into it. Not sure if we getting off topic here or to far into the weeds but i find it interesting for those that want to travel a lot or be an expat in another country.

https://www.cignaglobal.com/dvc-pdfs...EN%20Final.pdf

[Sunset]

Quote:

Originally Posted by aja8888 Yes and It's better than the Part D plan cost. But the Walmart she gets her drugs at does not take "coupons". That seems to be the trend around here. I'm sure if we shopped the coupon someone will take it. I like the Canada mail order route better as we could set up a monthly deal.

Until you get the mail order set up, you could transfer your prescription to some pharmacy that does take coupons.

You could phone around asking for drug "x" what is the cost , and if I use Rx codes "zz" "yy" (that is what is on the coupon) what is the price ?

I know Costco takes it, (and you don't need a membership to buy prescriptions there).
Same with Sam's club. (although note, Sam's club does offer incredible drug discounts on about 600 drugs with their premium membership).

[bigreader]

If you plan to live long term outside the US, it might help to start with figuring out how to get legal residency in the place you want to call home. I say that because in a lot of countries in the EU, legal residents (not only citizens) are entitled to very good public health care. Initially, you will need to have a plan like this to get a visa, but you can drop it once you are a legal resident.

If you are not living abroad but just traveling, there are separate travel insurance programs (Cigna and others) that are a lot cheaper. Your US plan may also cover you in the case of an emergency. Of course, you are limited by the length of your travel visa and your appetite for filing foreign tax returns!
br

[AbbA]

Quote:

Originally Posted by Offgrid Organic Farmer I have Prostate Cancer. The first year, for all the tests, biopsies, and robotic surgery to remove my prostate, my co-pay was $37. Four years later, my cancer returned. I went through radiation treatments for a year, and I started hormone therapy. The co-pays for these have been $20 a quarter. My hormone therapy uses 'Lupron' the market price for it is $6,000 for 6 months. My co-pay just for the shot is $12.

I wish you to beat this beast again and not to relapse.
Do you have to pay the market price OOP for "Lupron". Perhaps you would need to do some research and hopefully can lower your expenses like aja8888 is doing now.

[AbbA]

Quote:

Originally Posted by Freedom56 I personally would not go the Canada mail order route. Those mail order companies are not well regulated and you don't know the origin of the drugs. This is why we travel to Canada to get the prescription filled. The drugs are sourced in Canada when you buy at pharmacies in Canada. All the major pharma companies have manufacturing operations in Canada due to the tax incentives from the government. The fact that on-line Canadian pharmacies are sourcing drugs from outside Canada is a red flag. This is a list of drugs GSK produces in Canada: https://ca.gsk.com/en-ca/products/ou...-and-vaccines/

Thanks for sharing your knowledge, Freedom. Thanks to you and others, aja8888's might save big bucks on one drug. I'm guessing there isn't any law or a bad treaty between the US and Canada telling Canadian doctors and pharmacists not to sell drugs to Americans. If they go to Canada, can a Canadian doctor prescribe for 12-18 months and buy the whole supply on the spot? Wouldn't it cause a problem on the border back to the USA?

Since aja8888 lives in TX, isn't Costco in Mexico? I've never heard of advice to buy necessary medications in Mexico but it's better to make a trip to Canada to buy there. Why? Lots of American expats reside in that country and I'm pretty sure they buy medications there too.

[aja8888]

Quote:

Originally Posted by AbbA Thanks for sharing your knowledge, Freedom. Thanks to you and others, aja8888's might save big bucks on one drug. I'm guessing there isn't any law or a bad treaty between the US and Canada telling Canadian doctors and pharmacists not to sell drugs to Americans. If they go to Canada, can a Canadian doctor prescribe for 12-18 months and buy the whole supply on the spot? Wouldn't it cause a problem on the border back to the USA? Since aja8888 lives in TX, isn't Costco in Mexico? I've never heard of advice to buy necessary medications in Mexico but it's better to make a trip to Canada to buy there. Why? Lots of American expats reside in that country and I'm pretty sure they buy medications there too.

Most of us here view Mexico as not a safe place to visit these days, especially for buying drugs (pharmaceuticals).

[Buckeye]

Quote:

Originally Posted by Fermion I looked at their budget and their activities and they are spending quite a bit more than we do in the USA at near the same ages. Their apartment: $665 Our apartment: $525 Their electricity: $82 Our electricity: $57 Their water: $33 Our water: $0 Their phone: $44 Our phone: $40 (Visible wireless cell with unlimited internet and tethering) Their internet: $33 Our internet: $0 (included in cell phone plan) Their health insurance: $130 Our health insurance: $89 ($910 subsidy for silver plan with cost sharing and max $250 per year oop) Their food: $490 Our food: about the same. We have other expenses by choice, like a car but it is not needed where we live. There is a great bus system and the library is across the street, city hall is 3 blocks away, Safeway is 5 blocks away, Wal-Mart is about 1 mile away. Costco is 60 miles away, quite a drive, but how close do they live to Costco? I mean if you want to be in Spain, be in Spain, but you can live cheaper in the USA with good healthcare.

I would love to know where you find an apartment in Seattle for $525 that apparently includes water/sewer/garbage. My disabled friend's mother died and she must move out of the family home soon. She has been in the housing lottery for 5 years just trying to get on the probably 5-year waiting list for Section 8 housing. She has a real concern of becoming homeless so an apartment for $525 per month would be a godsend.

[Fermion]

Quote:

Originally Posted by Buckeye I would love to know where you find an apartment in Seattle for $525 that apparently includes water/sewer/garbage. My disabled friend's mother died and she must move out of the family home soon. She has been in the housing lottery for 5 years just trying to get on the probably 5-year waiting list for Section 8 housing. She has a real concern of becoming homeless so an apartment for $525 per month would be a godsend.

Not Seattle. North eastern Washington state. Mountains, not as much rain, but hotter in the summer. Great snow in the winter for skiing and riding snowmobiles, which is what we do quite a bit. Actually quite a nice place compared to Seattle, somewhat cleaner too.

We keep our sailboat on the Puget Sound though, so are going back and forth often. Takes about 6 hours but it gives life some variety going from salt water to mountains and back again.

I really don't know why anyone would want to live in Seattle or the surrounding area unless they must be there for work.