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$4 Lipitor Co-Pay. Not for All. Beware
Old 01-07-2012, 04:58 PM   #1
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$4 Lipitor Co-Pay. Not for All. Beware

Possibly some can get Lipitor for $4, but with my Anthem Insurance, my cost through CVS is now a $51 ripoff.

This scheme is so tricked up, it boggles the mind. According to my CVS pharmacy, when the patent expired and the $4 co-pay started, Pfizer DOUBLED the price of Lipitor.

So here's the trick. They say they are giving you $50 off, but it is apparently $50 off of the new doubled price. With Anthem, my copay is now more than $51, so I and others with Anthem (and likely lots of other insurers) now have to PAY MORE than we ever paid in the past. Ironically, I can still get Crestor for $25 with their loyalty card, so you can guess what I will do!

It sure seems that Pfizer thinks consumers has no choices, are stupid, and won't be able to figure this out. Wrong!

To add insult to injury Pfizer has apparently bought off many pharmacy chains requiring them to not sell generic Lipitor, in trade for perks or rebates they will receive - according to a lawsuit recently filed by a pharmacy which did not agree to Pfizer's terms. The source for this is Courthouse News Courthouse News Service

The lawsuit states that Pfizer is effectively trying to extend the patent of Lipitor by forcing the generics out of the market in the US - so that if you want Lipitor or generic Lipitor you will have no choice, at least in the near term

I'm no lawyer but this sure stinks to high heaven. I would be surprised if the FTC does not get involved as this sure seems as if it may be illegal, and as if it may be an unlawful restraint of free trade.

Greed is not good - no matter what the movies say. Pigs get fat, but Hogs get slaughtered.
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Old 01-07-2012, 07:51 PM   #2
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obamacare?
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Old 01-07-2012, 07:59 PM   #3
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obamacare?
Not at all. It is simply the effort of a pharmaceutical company to deal with the end of patent protection on its blockbuster drug and the consequent onslaught of generic competition. You would be amazed at the lengths to which these companies will go in order to squeeze the last bit of revenue out of the drug. There are far more nefarious means that have been attempted by the drug companies.
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Old 01-07-2012, 08:21 PM   #4
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obamacare?
This has nothing to do with the new health care legislation as far as I can tell. It may have some side-effects that increase some costs, but I don't think this is one of them.

As far as I can tell, this is "creative marketing" by a pharma company trying to figure out how to keep milking a cash cow after the patent teat has gone dry.

The more important thing for consumers to remember here is that now that the patent has expired, there are other alternatives including generics.
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Old 01-07-2012, 09:46 PM   #5
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My Megacorp retiree drug coverage is also through CVS. I don't take Lipitor, but just for fun I plugged in numbers for a 90 day supply (one a day) of Lipitor 20 MG. My cost would be $257.51. The website offered a number of generic alternatives. one of which is the med I do take, pravastatin sodium. According to the website, Lipitor 20 MG is equivalent to pravastatin sodium 80 MG. The cost for that for a 90 day supply is $35.73. I take pravastatin sodium 20MG. the cost for a 90 day supply is $9.67.

I take a variety of meds. I don't hesitate to take the CVS price list to my doctors. I find they are often shocked at the prices charged for some of the brand name meds.
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Old 01-07-2012, 09:58 PM   #6
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It seems that it is a common practice for brand name drug manufacturers to increase their price before a patent expires, that way they can gouge squeeze the patient and make even more money off of it.
But not only has Pfizer done that but they have also 'partnered' with Watson pharmaceuticals to sell the authorized generic version of Lipitor (so now they have their hand in not only the brand but generic version of their own drug).

Ranbaxy was the first to challenge (and win) the patent protection on the drug so they get exclusive rights for the next 180 days (thanks Hatch-Waxman Act) to be the only generic manufacturer (the only reason Watson also gets to be on the market is because Pfizer has authorized them to do it, the company that has the patent can make their own generic at any time but of course they won't until another generic comes out).

So, since Ranbaxy is the exclusive generic supplier they aren't going to sell the product for $10/bottle - they want to make their money while they have the 180 day window. They only drop the price by 10 to 15% of what the brand is charging so they are 'less expensive' but not by much. I hardly think they need prodding by Pfizer to do this and it has been done many times before - see Prevacid and Protinix to name two.

Now insurance companies are playing around and saying that the generic is not covered because it costs them more to cover it instead of the brand name. Easy number example: Brand Lipitor $100 for #30, copay is $40 because it is brand-insurance pays pharmacy $60. Generic Lipitor $90 for #30, copay $5 or $10 for generic-insurance pays pharmacy $80 to $85, $20+ more than paying for brand name.

Pfizer has their hands in 2/3 of the pie with the brand and Watson generic, last 1/3 goes to Ranbaxy to get as much as they can.

The problem with the $4 Lipitor card is that the card is not valid with any Medicare programs, yes that includes Medicare part D and the max that they will cover is $50. So unless you have a $54 copay or less and are not a Medicare or other government funded program (medicaid, tricare) your copay is more than $4.

Good news is that in 180 days (150 now) when 5 more companies start selling Atorvastatin the price will really drop, unless you go to a pharmacy that is going to take their cut and keep the price artificially high to make their profit and yes that happens too

Watson Pharmaceuticals Launches Generic Lipitor - WSJ.com

Watson launches first generic Lipitor - Business News - Business - The Independent
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Old 01-07-2012, 09:59 PM   #7
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I saw the news about $4 copay for Lipitor, but it wasn't clear if I could apply it with my mail-in orders. I got far enough to see it would apply to all of 2012, and I needed a refill late Nov, so I just went for it.


A 90 day supply was regularly ~ $85 for me, ~ $55 this time. So price has come down for me, but I'll look into the $4 before next refill.

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Old 01-08-2012, 09:30 AM   #8
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I started taking Lipitor in the 3rd quarter of 2010 and discovered the $4 co-pay
card online. I had zero problems getting the $4 cost but then was uninsured for
a period and so had NO meds for a while and didn't see the point of taking/buying
ONLY the Lipitor.

When the new insurance became effective, I ordered all of the meds online as
always but when I went to pick them up, I was shocked that the Lipitor was now $55!
I should add that this was the 2nd quarter of 2011...and...as is the way of the tightwad,
I politely told them that they could keep it but I did get back on the other meds.

I later pulled out my card and began reading and was confident that it entitled me to a
MAXIMUM cost of $4 for a 30 day supply and after a discussion with the Wally
World pharmacist's billing specialist, it seems that it requires a special coding
entry to split the bill, a coordination of benefits using what I assume is Pfizer
as the secondary claim, with my insurance as primary. It appeared that mine
was the 1st case like this for them (or possibly no one else has complained)
and to their credit, they did call in their coding specialist to take a look

The result was and is that the $4 co-pay still works!....at least it did in
December when I got my latest refills....and the card has an expiration date
od 12/31/2012 on it and so I expect that it will be effective until then....or
until the end of the world on 12/21/2010
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Old 01-08-2012, 11:13 AM   #9
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Whatever....
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obamacare?
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Old 01-08-2012, 11:23 AM   #10
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Whatever....
Care to elaborate?

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Old 01-08-2012, 11:53 AM   #11
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No. I am resting today, my first day off in two weeks. Too tired. Sorry.
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Care to elaborate?

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Old 01-08-2012, 03:39 PM   #12
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I have been using this since May 2011 and it works exactly as the Pfizer website says. I order a three month fill from my mail order pharmacy, then follow the instructions for using a non-participating pharmacy (I send Pfizer a copy of the invoice showing how much I paid, along with a copy of the card) then about two weeks later I receive a paper check in the U.S. Mail for the amount I paid minus $12, making my final price $4/month.

You might try treating CVS like a non-participating pharmacy and see what happens.
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Old 01-08-2012, 04:24 PM   #13
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Originally Posted by JakeBrake View Post
My Megacorp retiree drug coverage is also through CVS. I don't take Lipitor, but just for fun I plugged in numbers for a 90 day supply (one a day) of Lipitor 20 MG. My cost would be $257.51. The website offered a number of generic alternatives. one of which is the med I do take, pravastatin sodium. According to the website, Lipitor 20 MG is equivalent to pravastatin sodium 80 MG. The cost for that for a 90 day supply is $35.73. I take pravastatin sodium 20MG. the cost for a 90 day supply is $9.67.

I take a variety of meds. I don't hesitate to take the CVS price list to my doctors. I find they are often shocked at the prices charged for some of the brand name meds.
A few years ago my doc prescribed Crestor for my first cholesterol drug and it was in the neighborhood of $80 for a 30 day supply. Not long after that I saw where Walmart was selling certain generics for $4/mo that included a couple of cholesterol generics. I asked my doc about it and he just shrugged it off stating the newer drugs were better. I insisted on giving the generics a try and sure enough, my numbers were just as good. The doc was even impressed. I now pay $9.67 for a 90 day supply of generic Mevacor. Your mileage may vary.

I'm sure all docs are not the same, but you better ask for generics if you want them. My mom has experienced the same thing with her doc.
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Old 01-08-2012, 07:06 PM   #14
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I have been taking Lipitor for about 5 years or so but have yet to pay anything for it as Tricare picks up the full cost if I fill my RX @ the local military base 3 miles away.
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