My pharmacy adventures

A couple of months ago, I started taking 5 mg cialis daily, to see what effect it would have. I was having "good enough but not great" erections and some leakage at random times, again nothing serious. The Urologist PA gave me a weeks worth of free samples and the "30 day free" script from Lilly. I found that taking it did help, on both the erections and the leakage.

Then I started looking into getting a long-term script.

My employer's prescription drug plan is through Express scripts, and one can go to their website and get pricing and availability for drugs, and I found that 5, 10, 20 mg cialis is available from the plan, but limited to 8 pills per refill. And that is whether one refills every 30 days or every 90 days. Oddly enough, I could get 2.5 mg pills for daily use 90 at a time. So, to avoid the black market, I thought I'd try something. I asked for a script for 2 per day, 2.5 mg, with refills every 90 days. Believe it or not, it worked. I got a package in the mail yesterday with 6 30 ct boxes of 2.5 mg pills.

I share this to observe that there are ways to work the system and get what you need. Word is, that the patent for cialis runs out in 2017. That will be a good thing.

Fairwind said...
As soon as the patents run out, these drugs will be available over-the-counter like Ibuprofen. Ten cents a pill ....

I doubt that VERY much...

BTW, patent holders sometimes use legal 'tricks' to postpone the introduction of generics in the marketplace.

There is nothing wrong with making a profit. This is drives our system and helps drive research.

GOUGING is something different!

I'll leave it at that.


Getting back to the drug tales. I have an interesting situation.

Since retiring from my job (with a great Cadillac insurance plan) I am now on what looks like a good plan: BCBS MediCare Advantage. But, the drug part is strange. They push for me to do mail order (OptumRX). Yet, it is far cheaper to do a 30-day supply at my local pharmacy than to do the 90-day mail order deal (at least with the few generic drugs my wife uses).

Anyone else experience this?

Mel

Mel, that's probably more common than you think. Could it be that they want you on the 90-day mail order plan because with it THEY get a kickback where they don't from your local Walgreens?

I really don't get how a pharmacy can refuse to fill a legitimate script or supply something other that what was prescribed. In my case mentioned above, I don't have the option of paying out of pocket for more than their 8 pills a month....which I would willingly do. I'm just glad that for this 90 days anyway, I found a way to get what I need.

My plan is simple for the PDE5 inhibitors. None are covered at all for ED, but there is a slight exception with Cialis for BPH after other drugs have failed. This is how it works in every single ACA plan in the state. However, the employees of our only in-state insurance company have a plan that gives them great coverage for these meds. It's just the peasants - customers - that can't have them.

compiler said...

Since retiring from my job (with a great Cadillac insurance plan) I am now on what looks like a good plan: BCBS MediCare Advantage. But, the drug part is strange. They push for me to do mail order (OptumRX). Yet, it is far cheaper to do a 30-day supply at my local pharmacy than to do the 90-day mail order deal (at least with the few generic drugs my wife uses).

Anyone else experience this?

Mel

I know what you mean, Mel. The mail order route isn't necessarily the lowest cost option. I've gone the route of standard Medicare, supplemental insurance, and a BCBS drug plan but only get prescriptions filled at a local pharmacy. When I became eligible for Medicare I looked over the "by mail" information on prescriptions and it wasn't necessarily a better deal than the local pharmacy plus I remembered the occasional problems my in-laws had with "by mail" shipments getting lost or delayed so I just have everything done at a local pharmacy.

Ron

Mail order pricing and 90 day fills look good in theory. However, getting renewals and prior authorizations sorted out between a local provider's office and the online pharmacy carries a price of its own. One nurse clued me in on a discount card that just about makes it cheaper to pay out of pocket and forgo insurance altogether.