It’s the little things

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Mom always said the best gift was one that wasn’t expected. Most of the time it’s the gift that didn’t cost the giver anything but was of great value to the receiver.

When Mom said that it was a “not so subtle” hint that she wanted more time, not stuff. (Gotta love her. She was not a subtle person! I know, the apple does not fall far from the tree.)

This past month I’ve been wrestling with the whole drug price issues. There is a new one for dry eye that actually works for me but it’s priced outrageously. There is a chance I’ll be able to get it discounted (I’ve applied) but usually I don’t qualify. You have to be poorer than dirt. The irony is that people who could qualify don’t go to the doctor unless it’s seriously life threatening.

Over the years I have given or received (legal) drugs from other people. When I had a diabetic cat, I was lucky to get the insulin supply of a friend (my cat only responded to people insulin) who was put on an insulin pump. She no longer needed her injectable supply. That was a savings of over $500.

When I was diagnosed with cancer they took me off an estrogen-based drug for osteopenia. It was costly so I gifted my remaining supply to a friend who was also on it.

I’ve shared Valium with a friend who was scheduled for an MRI. (Yes I know I’m not supposed to do that. What friend would let someone they cared about go through the MRI with the jack hammer going outside their head when they could help?)

The thing is that you don’t know when people are on medications. Unless you are incredibly boring, that’s not an upbeat topic of conversation. So how do you do it?

I have a friend who has just about every chronic illness known to man (excluding leprosy). It’s not imagined. She has rheumatoid arthritis and one look at her deformed hands and feet tell the story. That’s an immune disease that makes you susceptible to lots of stuff. If the disease doesn’t, the medications you take, do.

She has been an encyclopedia of information about health, doctors and drugs because she’s had a lot of experience.

Recently I sought her advice on the eye drug. Her doc had put her on it in the fall and it didn’t work for her. She had a small supply that she happily handed over to me. That will last me until I find out if I qualify for reduced costs. This particular product is packaged in individual daily tubes so there is no chance of contamination.

She was happy she wasn’t throwing it out. I was delighted I would have a good chance to try it (takes a few weeks to work) before making a decision.

It made me wonder why we can’t do that more broadly. Some meds are packaged in a way that you know there were no grubby hands fingering it. Why can’t they be shared?

Better still, why can’t some drugs come in a small “trial” quantity (at a low cost) so you know if it works before you plunk down your high-end co-pay (trust me any drug developed after 1980 is costly).

My friend, because of extensive health issues, qualifies for low-cost drugs but she still had to pay out a healthy co-pay for an eye drop she couldn’t use.

This is an area that could use a good “look see” to improve it. I don’t understand why drugs are cheaper in other countries.

Let me be clear. I am not talking about self-diagnosis or taking a drug that isn’t approved by your doc. I am talking about low-cost ways to get a drug your doc thinks may help.

As a postscript, this drug was recommended by a doctor who specializes in dry eye treatments. My own eye doc won’t even talk about it. His take is “no one wants to pay for it so what’s the point?”

He is right. That is unless you are a tenacious person who tries all the angles.

So dear readers, if you have any tips in how to manage high drug costs, I am all ears.

 

48 thoughts on “It’s the little things”

  1. I remember the pre-Obamacare years when Americans were having a lot of health care debates. I was often asked about the situation here in Austria and found it very difficult to break down any preconceived notions about “terrible” socialized medicine. People asked me how much this or that drug cost and I had no idea, because every drug here costs the same – the $4.50 prescription fee.
    Drugs are expensive in the States because, as far as I know, insurers can’t use leverage to negotiate for lower prices. That isn’t the case here with a single payer system. Drugs can also not be advertised directly to the consumer. There are no “Ask your doctor!” commercials with their long gruesome lists of possible side effects. Few patients go to doctors and specifically request some drug by name, unless it was recommended by a friend who is also taking it.

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    • My co-pay for generics isn’t that low. A life without drug commercials would be wonderful and a place where people can get healthcare along with prescriptions affordably is perfect. There are too many lobbies here that don’t want socialized healthcare.

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  2. There should be a ban on drug companies advertising. Totally not necessary and docs tell me all the glossy postive ads ( with the fine print and fast talking about bad effects hardly noticed) cause a lot of problems: people come in with self diagnosis ( aided by “information sheets telling you how to talk with your doctor/health care provider” from drug companies). If patients push hard enough some docs give in and go ahead and prescribe – docs and hospital systems are so worried about the consumer rating/reviews that can effect medicare/medicaid reinbursements by the fed gov now. (Customer ratings: Another recent healthcare mandate that hasn’t worked so well)
    About 4-6 years ago there were new regulations by Congress/gov. to limit “visits”/freebies/perks/meals to docs by pharm companies. Hopsital groups/practices have taken this it very seriously (fear based). The thought was that companies had far to much influence over what drugs were prescribed by docs. With so many new drugs coming on the market, hard for some busy docs to keep up and the ones that depended on info from reps ended up prescribing what was frequently offered to them by reps. So far fewer samples available to those who could really use them.
    Drug prices are insane. There used to be buses that left big cities each month that drove seniors to MX where you could by the same drug from the same company cheaper. Same with Canada. Pharm companies stopped that. It’s called smuggling now. Border agents were mandated to confiscate and charge people. (They let humand swarm across the border which is against the law and sometimes dangerous, but penalize seniors trying to keep healthy with what money they have.) You can no longer even mail order drugs with prescirptions from outside the country – cuts into their US profits.
    I use one very old drug. The generics with their vehicle compounds are not the same and cannot be substituted. The price has skyrocketed over the past 4 years – for no reason. It’s not to pay for development. Greed because they can.
    I think it’s great people are managing to hand off high dollar drugs carefully. When one of the ancient relatives dies, the survivors are right to look at the meds and say “who’s taking this in this dosage?” Kindness – and we are being forced to do this.
    Sorry for the lengthy responbse, but this whole situation drives me nuts

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    • That explains a lot. I knew that there weren’t samples like there used to be but didn’t know why. Also after I wrote this blog, I checked the prices in Canada and it was $50 higher. I know 10 years ago insulin was considerably cheaper there. The big pharms are gonna kills us all, then who will buy the drugs?

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  4. You should always ask the doctor or staff if they have samples of the drug, especially when it’s new. If they don’t, they can in touch with the pharmaceutical rep that may be able to hook you up with samples or coupons. We are always supplied with coupons and samples that sit in a cabinet. It’s worth a phone call. Also, sometimes you can get the coupons online. Google the drug name to see what pops up. Good luck!!
    I paid $160 for eye drops that did nothing. The bottle was the size of my thumb nail. Ridiculous!

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    • I am in the cycle to see if I qualify for any price break with the pharmaceutical company. The specialist did give me a small sample supply but my normal eye doc doesn’t want to talk about it. I have yet to get anything free from him including otc eye drop samples which most eye docs have. I’m going back in today for eye plugs and I’m getting a new doc in the practice. Maybe I’ll work him over…. 🙂

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  5. Just this week, my friend who recently lost a young dog to cancer still had two doses left of a thousand-dollar drug (to jump start restart blood cell production). It’s hard to get, as well as being super expensive. Her vet called her and begged her for the unused doses to try and save another dog. She was so happy to hand them over, even though they couldn’t reimburse her, because her dog saved a life.

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    • At the end of Jake’s life, I was out of insulin. I found a source where I could buy a single pen (they come in packs of 5 normally) for $110. I used it twice before he was gone. I had a 4 month supply left. I asked my vet and she passed it on to another diabetic cat. It made me feel good to do that. Kudos to your friend who did a lot to try to save her dog.

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  6. Don’t get me started on drug companies. Prescriptions are cheaper in other countries because Americans are charged more for the same thing. You might not want to do this, but I used to order from India and drugs are much cheaper. All their drugs are generics. You must send a prescription. They do not take insurance. They do not dispense any narcotics. I do not order from them now as my insurance pays, although Medicare is getting to where they do not cover half of it. Some people scream not FDA approved, but these are people with good drug insurance.

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    • When my cat Jake was on people insulin, I looked into getting it from a Canadian pharmacy. Much, much cheaper and I would have done that if I didn’t find that friend. Their source was Turkey for the drug but it was a brand name with no generic versions. I had a friend who lived in Southern California and she said that people often crossed the border to get their prescriptions filled. Same drugs, trained people, nothing shady.

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      • It is all up front and perfectly legal. You do not have to buy at American prices. I looked into Canadian drugs, but the ones I needed were not a lot cheaper, not worth the trouble. It needs to be something you take on a regular basis as it takes several weeks to receive it. You cannot wait that long if you need it right away.

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  7. Do you worry about giving somebody a medication that interacts adversely with something else they are on? I am quite skittish when it comes to medications. I’ve had a lot of adverse reactions and so has the gardener, so maybe that’s part of it. You being prescribed a med you can get from a friend is another matter, of course, so that seems like a good idea.
    On another note, I took Kana to the vet today because something is off with her, and she threw such a cow they couldn’t draw blood or anything! Now I have to get some pricey compound of a sedative (so that it’s liquid) and bring her back another day!

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    • I wouldn’t give a drug that the person’s doctor didn’t prescribe. Poor Kana. Hazel is the toughest cat I have to take the vet but all the issues are about catching her (she instinctively knows when it’s a vet trip) and getting her in the carrier. Our new top zip carrier is eons better than the front load hard sided ones. Once she is at the vet, she is a pussy cat. (no pun intended!) I think she is just too scared to react. However, my vet got new rubber mats on the metal tables and I noticed huge claw marks so someone wasn’t happy to be there but it wasn’t mine!

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      • Oh, that would be a little terrifying to see those claw marks. Imagine the distress that caused that! You must have to outsmart Hazel. I was lying awake last night imagining rounding up 3 of them (2 for nail trims) this morning. Of course, Tiger weewee-ed all the way from where I picked her to the kennel, and I didn’t notice until after. My clothes were soaked through my underwear, and the wood floor was a trail all across the house :(.

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        • 🙂 When my cats get old, they pee in the carrier. I always have a towel in there and with Jake I took a towel along to change so he would have a dry ride back. When I was a young adult we didn’t have a carrier so my Mom held my cat on her lap. The cat got so nervous she pooped on my Mom’s good raincoat. I couldn’t stop laughing!

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  8. I worked in the medical profession for over 20 years and in the beginning we always had drug “reps” coming by and leaving samples. Slowly but surely that stopped (also because the doctors didn’t want to take the time to listen to the “spiel” of the reps. I think your way is a great idea, as long as you are making sure it is the exact drug being used. I also heard that guy talking about drug companies but he’s “talked” about a lot of things so we’ll just have to wait and see.

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    • Thanks for the validation. I don’t have a lot of luck getting free samples and haven’t in years and I do ask. I used to be able to get samples of otc eye drops but it’s hard to get those. I like to try them out before I buy them even though they aren’t outrageously expensive. I don’t think my routine eye doc or my primary care physician give time to reps which may be the problem. We have to see about the guy. I have no idea what he intends to do.

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  10. Years ago, my father had been prescribed a crazy expensive (despite it being a generic) drug while temporarily in a nursing facility (I think because only one manufacturer made it). After a few years of paying the price, his regular doctor asked me why he was taking it and recommended that he stop because it was useless. He stopped with absolutely no issues. Our health system is broken and the blame is shared by many. We, the patients, just get screwed.

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  11. I recently dodged a bullet with a med my wife had been taking that was expensive. I wanted to switch health plans, but couldn’t because the one we were on priced that med cheaper than any other plan I was considering. But then at the 11th hour she was taken off the med, good fortune I hadn’t anticipated. I noticed Trump made some comments about drug companies the other day. Let’s hope this (brief?) populist approach of his has a follow-through.

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    • I can only hope some good stuff will come out of this debacle! My med is so new that it’s not approved by any health plan yet. Working to see if “medically necessary” or “preapproved” or “gonna die without it” works.

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  13. Like Nancy, I’ll ask for free samples, but I’ve never been denied. My infusions I have every six weeks for Crohn’s Disease, to the tune of 15k a pop are covered 100%. I don’t even pay a co-pay. It’s a true miracle that I’m so thankful for.

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  15. Glad you found a way to try the drugs on the “down low” while waiting to see if you qualify for a discount. No good tips for you other than asking your doctor for free samples to try before you buy.

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    • I always do and the answer is almost always no. Perhaps they save them for the poorest of the poor. Back in the day, most doctors dispensed drugs in the office (most were antibiotics or other simpler drugs).

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  16. This is a subject that ALWAYS make me so angry. Drug companies have no business advertising on TV. None. It is costly and so non productive for the average person. Instead of pandering to Dr.’s and health care professionals, they chose to target the consumer. The person who is least qualified to know whether or not the drug will help. Or in fact do you really have that disease. And those commercials are very expensive…ah big surprise that between the advertising and huge salaries of the drug industry employees the cost of a prescription is so expensive. Oh I could go on and on…but alas what good would it do me!!!

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    • I believe the advertising is a tax write off but I’m no expert. I’m not sure why they advertise to the general public. Sometimes I don’t know what the med is for. I’d love to see some of the money funneled into low cost options.

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