Another nutty medical cost

[F4mandolin]

Been trying Androgel testosterone cream out a couple of times over the last 1.5 years. I am right at the bottom of the ok levels. First time I tried it I didn't respond well....made me tired and I went back off it after 3 weeks. Tried it again recently but went to a half dose....think it worked a bit there. Went in for a refill and mentioned to the pharmacy folks that I was really only taking a half dose....so for $40 I would stretch it out to well over a month. I kind made a kidding joke that $40 was more than I paid last time. There comment was "hey, we charge the insurance folks $700". And that is whether they give me one tube or two (2 tubes is the normal amount). They said if I told the Dr I was only using half he might cut the prescription down to just 1 tube....but it would still be the $700 charge without insurance. $700!! And it doesn't depend on how much they give you! The system is really really broke.

[Texas Proud]

If that cost is real.... yep, another example of a broken system....

[heeyy_joe]

Lyrica is another example of this insanity.

[JOHNNIE36]

My testosterone levels were low also and I felt weak. After appropriate blood work my doctor suggested testosterone cipionate gel. I tried this for about 20 days. I stopped because one of the side effects is diarrhea. Doc said it is a rare side effect and suggested I go to the cipionate shots every thirty days. Took one shot and never got a chance to see results as the only result I noticed was more diarrhea. I quit the stuff and will have to explore other methods to add strength.

Interesting that the cipionate gel cost me $255 for a 90 day supply (drug plan paid $657) while the cipionate shot (three injection supply) cost $15 total. I can understand the added cost for the gel tubes and packaging but that is a huge difference ond the shot is much more convenient. If I were you, I would check out the shots.

[UtahSkier]

One shot every 30 days is huge.

I am doing self injections twice a week. The goal is to keep the T levels as constant as possible.

At Walgreens, I get a 10ml bottle of T cyp for about $90.00. I use about .9ML per week.

Its the cheapest solution available.

FYI - Mens health has a forum that discusses T. Its a very useful resource.

[dgoldenz]

One of my recent clients wanted to buy an individual policy instead of paying for COBRA. Their child takes Solodyn for dry/itchy skin. Solodyn costs over $1,000/month. They pay $50/mo copay for it and had no idea it was so expensive. Third party payments are one of the biggest cost-drivers of the American healthcare system IMO, as evidenced by this example and a hundred others I could come up with from my client list.

[Buckeye]

Quote:

Originally Posted by dgoldenz One of my recent clients wanted to buy an individual policy instead of paying for COBRA. Their child takes Solodyn for dry/itchy skin. Solodyn costs over $1,000/month. They pay $50/mo copay for it and had no idea it was so expensive. Third party payments are one of the biggest cost-drivers of the American healthcare system IMO, as evidenced by this example and a hundred others I could come up with from my client list.

I think you are saying (and I heartily agree) that if we knew the real cost of our choices to "the system," it is very likely we would make different choices.

[dgoldenz]

Quote:

Originally Posted by Buckeye I think you are saying (and I heartily agree) that if we knew the real cost of our choices to "the system," it is very likely we would make different choices.

Yep

[Buckeye]

Another reason for increased costs. This one takes the cake. This cardiologist admitted to ordering $19 million in unnecessary tests. He was paid $70 million between 2004 and 2012. Unfortunately, the top end of the possible sentence is 84 months. Scum.

theheart.org: trusted cardiology news and opinions

[Texas Proud]

Quote:

Originally Posted by dgoldenz One of my recent clients wanted to buy an individual policy instead of paying for COBRA. Their child takes Solodyn for dry/itchy skin. Solodyn costs over $1,000/month. They pay $50/mo copay for it and had no idea it was so expensive. Third party payments are one of the biggest cost-drivers of the American healthcare system IMO, as evidenced by this example and a hundred others I could come up with from my client list.

Wow... looked it up and it would cost me $577 per month for this drug... but the cost is $900 total...


Yep, I would not be using this if I had to pay that amount....

[dgoldenz]

Quote:

Originally Posted by Texas Proud Wow... looked it up and it would cost me $577 per month for this drug... but the cost is $900 total... Yep, I would not be using this if I had to pay that amount....

Looks like pricing varies by dosage. 115mg is $1047/mo according to Humana. Here it is along with a few other fun ones:

[Texas Proud]

Quote:

Originally Posted by dgoldenz Looks like pricing varies by dosage. 115mg is $1047/mo according to Humana. Here it is along with a few other fun ones:

Yea, I should have checked because it is the same with other drugs... I just picked the first one which was kinda in the middle...


STILL, way to expensive for any kind of general use....

[ERhoosier]

Won't get into specifics, but US health care system has gone nuts with it's obsession for "the best" treatment for every case. First- what's "best" is often a perception fueled by who has the best ad campaign. Second- What's "best" treatment is often just newer (higher profit margin) with a marginal (or no) benefit over older proven treatments. How many times have we seen expensive new drugs/treatments get pulled because further research has not born out their touted benefits? Finally- That marginal benefit of using "best" treatment often comes at a HUGE increase in cost. What good is a doc prescribing a (theoretical) 95% effective drug for chronic condition over a 90% effective drug when the 95% drug costs so much the patient cannot afford it and therefore takes NO treatment Obviously there are a few truly groundbreaking tests & treatments, but IMHO these are generally not responsible for the bulk of run way health care costs.

[wmc1000]

I agree the system for prescriptions is broken. My wife and I have found it less expensive to avoid the insurance company prescription plan through my employer in lieu of getting our prescriptions through a registered online pharmacy out of Ohio. We were paying $150 per mo for 6 RX through the insurance co. approved mail order drug provider plan and now we get those same RX's for $40 per mo WITHOUT ANY INSURANCE DISCOUNT! How crazy is that?

[Katsmeow]

Quote:

Originally Posted by dgoldenz One of my recent clients wanted to buy an individual policy instead of paying for COBRA. Their child takes Solodyn for dry/itchy skin. Solodyn costs over $1,000/month. They pay $50/mo copay for it and had no idea it was so expensive. Third party payments are one of the biggest cost-drivers of the American healthcare system IMO, as evidenced by this example and a hundred others I could come up with from my client list.

My son took this for awhile. We have high deductible plan so we do have to pay out of pocket until the deductible is met. The cost ended up being OK because the manufacturer gave a card where the manufacturer paid the vast majority of the cost that that the insurer wouldn't pay. I told my DH that when that card ran out we would tell the physician to change medications. I mean there was no way I was going to pay that kind of amount (I think it was $700 or so a month) for acne medicine. The physician also prescribed another very expensive acne medication - same deal, manufacturer gave a card that paid most of the money.

It actually made me angry with the physician to even be prescribing something that expensive for acne except in the most extreme of situations (which this was not).

[Silver]

Quote:

Originally Posted by Katsmeow It actually made me angry with the physician to even be prescribing something that expensive for acne except in the most extreme of situations (which this was not).

Not everyone understands that many physicians (not all....but many) receive "incentives" from drug companies to prescribe their drugs. The physicians and drug companies are uncomfortable calling it a kick-back. The payments to the physician are often disguised as some sort of fee for service, but it is what it is.

[travelover]

Bottom line, if you want to know why medical care / drugs are so expensive in the US, follow the money.

[Snow White]

I know this isn't a good excuse but some physicians just have no idea how expensive the meds are that they prescribe. I worked as an RN Case Manager for a few years and it wasn't uncommon at all for me to call the prescribing doc to let her/him know that a med they prescribed was too expensive for the patient. Some were quite shocked to learn what their patient would have to pay. They WANT you to take prescribed meds and know you won't if cost is a barrier.

Docs and Nurse Practitioners don't have the time to review every patient's insurance plan and medical formulary. We have to speak up when a new drug is being prescribed and ASK how much it costs and if there are less expensive alternatives. I never cease to be surprised at the folks who don't want to "bother" the doc or are embarrassed to admit that they don't have an unlimited budget. No one cares more about your money (or your health) than you do!

[imoldernu]

Colcrys 60 tablets (for gout) $311.16

Colchicine has been in common use since 1820, for treatment of gout. The cost of production was $.0004 per tablet, and the pharmacy price to the customer until 2010 was about $.09/tablet (nine cents). I bought it then for less than $5.00/60 tablets.

A 600+ percent increase.

Here's what happened (from Wikipedia):

Quote:

FDA approval Oral colchicine had been used for many years as an unapproved drug with no prescribing information, dosage recommendations, or drug interaction warnings approved by the U.S. Food and Drug Administration (FDA).[8] On July 30, 2009 the FDA approved colchicine as a monotherapy for the treatment of three different indications (familial Mediterranean fever, acute gout flares, and for the prophylaxis of gout flares[8]), and gave URL Pharma a three-year marketing exclusivity agreement[9] in exchange for URL Pharma doing 17 new studies and investing $100 million into the product, of which $45 million went to the FDA for the application fee. URL Pharma raised the price from $0.09 per tablet to $4.85, and the FDA removed the older unapproved colchicine from the market in October 2010 both in oral and IV form, but gave pharmacies the opportunity to buy up the older unapproved colchicine.[10] Colchicine in combination with probenecid has been FDA approved prior to 1982.[9]

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Another case. DW was prescribed Prolia, a single injection drug for osteoporosis. As an authorized tier 3 drug, our cost was $15. It is a twice a year injection, so $30. In 2013, the drug was removed from the approved list. That's when we found out the actual cost per injection, is $1300.00, or $2600.00/year.

[sengsational]

And in many parts of the world, you can walk into a pharmacy, no prescription, and buy that same drug, made in the same factory, no insurance, for one tenth or less.