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

[AbbA]

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]

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/our-prescription-medicines-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]

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]

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]

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.

 

[brett]

I suspect that this couple does not care about the rental costs in Seattle, the cost of drugs in Canada, Costco’s in Mexico.

They arrived at a solution that works for them. Hopefully they will be able to work the residency issues.

 

[Just_Steve]

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.

I don't get your cost.



BREO

Back to Drug Directory
Pricing
The prices listed are the most recent cash prices. These prices:

Do not account for prescription insurance and co-pays
Apply only to those prescriptions purchased and mailed from Costco.com
Occasionally prices may vary due to differences in generic product selection or the bulk package size stocked.

For prescription prices specific to a Costco warehouse, please contact the Costco Pharmacy nearest you.


Name

Mfr.

60 each

120 each

180 each

Name

Breo Ellipta 100-25 Mcg/Inh Inh Glax
Mfr.

GLAXO SMIT
60 each

$396.85
120 each

$783.97
180 each

$1,168.86
Name

Mfr.

60 each

120 each

180 each

Name

Breo Ellipta 200-25 Mcg/Inh Inh Glax
Mfr.

GLAXO SMIT
60 each

$424.01
120 each

$819.54
180 each

$1,215.20

 

[bmcgonig]

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.

That seems to be a plan that gives great cover globally. They also mention this one that is acceptable for residency/visa but for Spain doctor/hospital only. €150 approx/mo.

https://www.healthplanspain.com/sanitas/sanitas-health-plans/sanitas-mas-salud.html

 

[bmcgonig]

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/GENERIC-48/en/200019 CGHO Sales brochure DTC EN Final.pdf

Read the plan. It seems to cover everything 100% as best as I can see.

https://www.healthplanspain.com/sanitas/sanitas-health-plans/sanitas-mas-salud.html

 

[marko]

I would love to know where you find an apartment in Seattle for $525 that apparently includes water/sewer/garbage.

Apartments well outside of Boston go for about $600.

Oh, I mean $600 PER WEEK. Sorry.

 

[frank]

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.

was the 185 usd actually for the whole year supply or just per month? is it possible for a doctor to write a prescription and have it filled for a year at a time? just started ordering online from canada but at that cost saving it would be worth the trip.

 

[Freedom56]

was the 185 usd actually for the whole year supply or just per month? is it possible for a doctor to write a prescription and have it filled for a year at a time? just started ordering online from canada but at that cost saving it would be worth the trip.

It was for the entire year supply. The cost is $15.41 per month. They allow you to fill 6 months at a time. We had the doctor write it with double dosage with refills. We filled a one year supply in November 2018 and had refills left over to fill it again this year without having to see the doctor in Canada. The cost savings covered two first class tickets on a 787 Dreamliner with lie-flat seats from LAX to YYZ (Toronto Pearson) with plenty of margin to spare.

The exact amounts were:

Sep 26, 2019
COSTCO WHOLESALE W535 TORONTO CA
$184.98

Purchased On
Sep 26, 2019
Merchandise - Wholesale Clubs
Foreign Currency
244.72 CANADIAN DOLLAR CA

There was an article not too long ago in the NY Times about this and other common hormone replacement drugs prescribed to women over 50 where the price increases have been absurd. One example is Premarin cream. Here are the prices from Costco US:

Name
Mfr.
30 grams
60 grams
90 grams
Name

Premarin 0.625 Mg/Gm Cre Pfiz
Mfr.

PFIZER U.S
30 grams

$416.27
60 grams

$825.21
90 grams

$1,235.01

The same 90 grams tube from PFIZER at a Costco in Canada is $68 (CDN) or $51.80 USD. The price difference is absolutely absurd given this drug has been around for decades.

While we were at the Costco in Toronto, we noticed that may people were from the U.S. (New York, Michigan) filling their prescriptions. Do you blame them?

 

[Fermion]

From Blaine, WA, a trip to Canada and Costco is about 30 min drive, including the border crossing (with Nexus).

I hope we don't ever need these expensive medications but nice to know we can get them cheap and fast if we do by going to Canada.

 

[omni550]

While we were at the Costco in Toronto, we noticed that may people were from the U.S. (New York, Michigan) filling their prescriptions. Do you blame them?

That's surprising. For folks who live in southern Michigan, the nearest Canadian Costco is just a short drive south from Detroit into Windsor, Ontario (approx. 6-7 miles from the Ambassador Bridge or the International Tunnel).

Perhaps the Michiganders you spotted were in Toronto (250 miles, 4 hrs. by car from the Detroit border crossings) for other reasons and made the Costco Rx stop a part of their visit.

omni

 

[Koogie]

American drug tourism and online ordering is starting to have an affect on our domestic supply in Canada. The pharmacist and doctor associations in various provinces have started to speak out about it.

canadian-pharmacists-report-rise-in-drug-shortages-causing-patient-confusion-and-distress
https://www.ctvnews.ca/health/canad...sing-patient-confusion-and-distress-1.4525119

From the article:
"“With over 20 pieces of legislation at the state and federal levels, the biggest risk for Canadians is exacerbating drug shortages – our drug supply simply is not equipped to supply a country 10 times our size.”"

 

[brett]

In Canada we feel that WE pay too much for prescriptions compared to some European countries!

 

[Freedom56]

From Blaine, WA, a trip to Canada and Costco is about 30 min drive, including the border crossing (with Nexus).

I hope we don't ever need these expensive medications but nice to know we can get them cheap and fast if we do by going to Canada.

These are not supposed to be expensive medications or specialty drugs. They are all generic and have been around for decades. The drug companies and pharmacy benefit managers are driven by pure greed to take a 90g tube of cream that 15 years ago cost about $28 and now charge over $1235. Keep in mind Costco's prices are lower than other pharmacies but come on $28 to $1235. The outrage was directed at Martin Shkreli but should also been directed at the CEO of Pfizer, CVS Caremark, and others.

 

[Buckeye]

My wife requires a drug named Breo by Glaxo for her COPD. Drug plans show this drug's retail cost of ~$20,000/month. It's a "Tier III" drug under Medicare Part D and is not discounted very much. According to Texas Part D plans, we will be paying over $1,100/month (average) for that drug. Last year we paid about 1/4th of that cost.

Remember, when our illustrious government was looking out for us citizen's best interests.... but, for some reason, they did not negotiate drug pricing with drug companies when Medicare was started. In essence, doctors and hospitals have negotiated rates, but not drug companies.

My mother, a 60+ year smoker, had (and died) from COPD. She used an inhaler-type drug (Spiriva) but she also got tremendous benefit from Part B drug (Perforomist) she took through her nebulizer. She had Plan F so all copays were covered.

 

[aja8888]

I don't get your cost.

We ran the Part D (on Medicare's calculator) for 2020, not this years pricing which we are good with. Our OOP cost FOR 2020 is around $15,000 for my DW's drugs, they the largest cost being $1,150/month for Breo.

In 2019 (this year) the Part D cost for her whole plan is about $3,000 OOP, all drugs combined.

 

[aja8888]

My mother, a 60+ year smoker, had (and died) from COPD. She used an inhaler-type drug (Spiriva) but she also got tremendous benefit from Part B drug (Perforomist) she took through her nebulizer. She had Plan F so all copays were covered.

DW takes Spiriva also. She takes 11 drugs, 5 of which are related to her advanced COPD. Breo is an inhalant powder and is recommended by her Doc.

I don't know anything about a "Part B" drug as Part B is not a drug plan from what I understand.

 

[aja8888]

Thanks for all the help and suggestions for the Breo pricing dilemma we are facing for 2020. We have until early December to sign her up on a Part D plan or just keep the same one we have now. It really doesn't matter which plan we sign her on as the costs are about the same for the top 5 plans as Breo pricing is the bad guy.

We will evaluate the Canada drug purchasing opportunities and see what comes of it. Too bad there is no generic for this drug until 2023.

Thanks again for all the suggestions, now back to the thread subject at hand!

 

[ShokWaveRider]

Thanks again for all the suggestions, now back to the thread subject at hand!

You will be lucky.

 

[ncbill]

Pretty sure his "cancer treatment" amounted to a squirt or two of liquid nitrogen, which would not have cost a lot more than $100 in the USA either.

Get back to me when an ex-pat in Spain can get CAR-T treatment for lymphoma for $100

Plenty of expats keep paying Medicare premiums...one I read came back to the U.S. when he needed an organ transplant...on Medicare's tab.

 

[Teacher Terry]

Aja, your medication cost is insane. Many could never afford that.

 

[aja8888]

You will be lucky.

You mean "we" will be lucky?