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Posted 2/28/2013 5:02 PM (GMT 0)
So I took cymbalta for about 6 months with very positive results. However, now I am unable to afford it because of a change in my insurance policy (which essentially forces me to pay for it out of pocket). I know there are coupons online but if I use those at the pharmacy, whatever I pay will not be applied to my deductible (I've already tried). Any suggestions? I know my plan states that any "preventative medicine" (ie contraceptives) are covered 100%. Can I get a doctor to label it as preventative somehow?
Thank you. Best wishes.
Posted 2/28/2013 5:26 PM (GMT 0)
I would think that labeling it as preventative would be an off-label usgae, meaning cymbalta is not labelled as preventative medicine by the drug companies. I think you would lose that wording battle, even if doc would go along with it.

Hm. Why won't insurance pay for it? Have they reclassified it somehow? Even if it is in the highest tier of druges, there should be some responsibility there. Unless you have lost prescription drug plan.
Posted 2/28/2013 6:26 PM (GMT 0)
It is probably because it isn't on their prefered list. They will probably try to get you to try something that is. Cymbalta is a brand name drug and a lot of insurance companies don't want to pay for it. I had a lot of changes in my prescription drug plan this year. But they actually worked out for the best for me. Not so much for my husband. It is hard when we have to pay full price for medications and until they get a generic, they are very expensive.

Best wishes.

http://needymeds.org

This might help you.

Hugs, Karen
Posted 2/28/2013 8:18 PM (GMT 0)
I'm afraid perhaps that I wasn't clear enough. Their reasons for not covering it are unrelated to the actual medication or the fact that its a brand name. I already went through pre authorization for the meds and it was covered previously. Our new policy doesn't cover anything at all ( doctors appt, tests, prescriptions, nothing) until our deductible is paid off. That's why I can't use those discount prescription cards for online.. Because the pharmacy has to use either the or the insurance company and then the $200 price tag won't count towards the deductible.
Posted 2/28/2013 9:06 PM (GMT 0)
Talk to your pharmacy because it looks like Cymbalta may have now gone generic...which would be great for you. The pharmacist would know for sure. Then you could take the medication at a much lower price. It's worth checking out. According to Google sites, it was due to go generic in 2013. Now that will be great on the wallet and you probably could afford that and it would go towards your deductable.

Many of us have this problem. I have that with my insulin pens but have to bite the bullet and get it anyway. I usually don't use my credit cards but I do in this circumstance. Then I can pay it off in segments with not much interest.

Sherrine
Posted 2/28/2013 9:43 PM (GMT 0)
It doesn't look like it will go generic until December :( but thank you for that information! It's sad that people can patent and price gouge medications that people need.
Posted 2/28/2013 9:52 PM (GMT 0)
It cost those companies a ton of money to develop these medications that are helping us and pay their overhead, equipment, scientists, etc. When they do go generic, these other companies step in and just copy what it took the original company years to discover and work out, and get it approved, etc. And they are now making a lot of money off others ideas. So I personally do understand the patents.

I too wish they weren't expensive but I do understand why and am happy when the generics come out. I take generics whenever possible.

Sherrine
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