This was instated by Express Scripts and Caremark, companies that deals with many drug benefits for insurance companies. The reason they did this? There may be cheaper brands or generics available that are similar and treat the same issue. It means that your insurance will only cover these cheaper brands or generic meds. If you want the dropped medication you will need to pay full price, out of your own pocket (thankfully for many, Medicare plans are excluded from this).
For Mrs G. this was not an option. She didn’t want to take a generic version of Femara (which her insurance dropped) and was suddenly faced with having to pay $600 for her medication. She now orders it online for only $100.
Elyse M started buying her meds online as her insurance stopped paying for Flonase Spray and she is allergic to the US generic version that her insurance does cover.
People like this are forced to pay crazy prices for essential medications.
In 2014 many drugs used for Asthma, COPD, Diabetes, heart, cancer, hormones and nasal sprays. These include Advair, Flovent, Proventil, Novolin, Novolog, Victoza and Androgel, some of the most widely used drugs in the USA.
GoodRX covered an article on insurance companies dropping drugs. The article lists the 50 medications dropped by Express Scripts and Caremark during 2014. As we approach the end of 2014, it will be interesting to see how many more drugs get dropped in 2015.
What would you do if the drug you depend on finds it’s self on the exclusion list but you still want to keep using it?
Either you have to absorb the full US cost from your own pocket or you can look to buy the drug online using any number of online pharmacies that offer vast savings. You can actually save up to 70% off the US full price so for many people it’s worth waiting a few days for the parcel to arrive. Especially if the medication is to be taken for the longer term and refills will be required.
If you head online be sure to check out our previous blog post on buying medication online. “The Online Guide to Ordering Medication” – it explains what to look out for and how to decide on which online pharmacy is best for you. It can also help you avoid buying from a scam pharmacy.
Let’s take a few of the drugs mentioned above and give examples of cost saving when buying the drugs online instead.
Advair Diskus 250/50mcg is an inhaler that treats COPD. It can cost as little as $89* online but in the US full price can set you back a minimum of $295**.
Flovent is a steroid used to treat Asthma. It only costs $21* online for 100mcg disk (60 doses). The US full price is $145**.
That is some crazy savings! If you are one of those people who look down at those who buy online, think again about why people do it and then take a look at how much your own meds cost. How much would you pay if you bought them online? The price may even work out less than your copay.
*Online prices are based on IsraelPharm.com prices – 17.9.2014
**US prices are based on GoodRX prices – 17.9.2014