2023 Medicare Drug Prices

I checked Abiraterone last year and am starting this year now. I could get nowhere near that pricing for 120 pills @ 250 mg per month. The best cash prices I found were $200-$300/mo which matched the best Part D plans. Are you in Ohio somewhere? I want to study this further. I am not on any of these drugs but want to be prepared if It happens. I can cover the cash price until the next plan year but Abiraterone varies wildly with the plans and pharmacies.

GoBucks - I checked AARP/Walgreen’s site directly and confirmed the same rates you are seeing in MN. Abiraterone Is one drug that varies incredibly between plans. Not sure how how AARP/Walgreens could get cost so much lower than Caremark/CVS plans but that is why you have to watch this stuff like a hawk. Looks like 2025 will end some of this with the $2K annual maximum. Abiraterone Is the only med that I have seen with such big of a difference between plans.

That is fine but I have no drugs to blame it on. I should be confusing you, not the other way around. I tend to watch this carefully as I was originally on a Blue RX plan that was going up in cost rapidly for no obvious benefit to me.

We switched to WellCare @ $10.50/mo ($7.50 in 2023) where atorvastatin, losartan, lisinopril, HCTZ are no cost. A couple of others are $4/mo. We get a couple of meds for cash pricing since WellCare and the deductible get too expensive (deductible does not apply to Tier 1 & 2 drugs with WellCare)

As a side note, a BlueRx plan in 2023 looks to be competitive again but appears to have changed preferred pharmacies of which ours is no longer preferred thus not as competitive. You would think that Part D would be standardized by now like the Medicare lettered plans but no such luck. You have to look at it every year and anticipate your future drug needs to see if you plan crushes you when Abiraterone gets added like your example. Many of cancer drugs have no deals so you have to go the manufacturers to get relief, my wife is on 3 years of her "free" cancer drug directly from Pfizer so it is possible and not actually have to be broke to do it. The university pharmacy was instrumental in getting us to go for assistance.

akai - This is where you want to go to check drug plans. If you log into your Medicare account, you can do it there also and it will pre-fill the normal drugs you use:

https://www.medicare.gov/plan-compare/#/?year=2023&lang=en

I entered a Pasadena Zip code for 2023 and it came up with the same variances that this thread is about. A number of plans have a good deal on Abiraterone and a bunch don't. There is also a cost issue with the different pharmacies which you can check there also.

If you check Abiraterone on GoodRX, you will find places like Rite Aid and Costco and also mail order will have prices in the $200-$400 per month range so $2400 -$4800 per year if you wanted to pay cash without any insurance "help" which is the most exposure you can have if you did 12 months without changing Part D plans which is unlikely.

You (and me) will have some options if and when the time comes and Medicare slows down the madness after a few months so the annual cost is in the $10-12K range, not $20K+. Keep in mind if you end up on other drugs, there may no better deals and only the manufacturer can cut you a break.

Post Edited (Mumbo) : 10/18/2022 7:44:30 PM (GMT-7)

2025 is an eternity for cancer drug patients. I agree there will be a flip side to this limit somewhere.

Mumbo said...
akai - This is where you want to go to check drug plans. If you log into your Medicare account, you can do it there also and it will pre-fill the normal drugs you use:

https://www.medicare.gov/plan-compare/#/?year=2023&lang=en

I entered a Pasadena Zip code for 2023 and it came up with the same variances that this thread is about. A number of plans have a good deal on Abiraterone and a bunch don't. There is also a cost issue with the different pharmacies which you can check there also.

If you check Abiraterone on GoodRX, you will find places like Rite Aid and Costco and also mail order will have prices in the $200-$400 per month range so $2400 -$4800 per year if you wanted to pay cash without any insurance "help" which is the most exposure you can have if you did 12 months without changing Part D plans which is unlikely.

You (and me) will have some options if and when the time comes and Medicare slows down the madness after a few months so the annual cost is in the $10-12K range, not $20K+. Keep in mind if you end up on other drugs, there may no better deals and only the manufacturer can cut you a break.

Thank you kindly, looks like I may have to change my plan. I am currently on Blue Shield PDP $96.xx a month and getting my medication at CVS. I checked other preferred pharmacies on my plan and they are about the same price at about $1,900 (even at Costco).
I am not currently taking it (stopped Jan 2019) but this is pretty much as a proactive move. I am no longer a AARP member, so I may have to become a member again. I assume that it is for members only?
Akai

Mumbo:

I sent you an email

Mel

I'm on a BC/BS Medicare Advantage plan, that covers my care at Dana-Farber, but when I went on Abiraterone I arranged to get that prescription filled for free by the VA. This being annual enrollment time, out of curiosity I compared my current BC/BS plan with to other high-end Advantage plans. Sure enough the BC/BS plan showed my out of pocket for medications would be $10,000 per year. But another Advantage plan - I think Tufts showed my maximum for medications as $1,300 per year for the exact same meds. I have no Idea how this is possible. But we are subject to a very twisted system. A few months ago I posted a Consumer Reports article about drug plans on this forum. plugged my Abiraterone prescription into several online drug stores listed in the article. One was $1,300 a year even with no insurance. Go figure.

I'm grateful to be one of the lucky few who is able to get my meds for free through the VA. If it weren't for that I'd need to check every year to see which health insurer feels like giving me a reasonable rate for life-sustaining medication.

fyi..quick scan did not see this on the thread. Perhaps you have discussed it but Mark Cuban's Cost Plus Drugs has 30 pills of Abiraterone for $39. Check it out below

https://costplusdrugs.com/medications/categories/prostate/

Mark

I hope everyone here that is a veteran is taking advantage of the VA. What else is great is that because I get everything from the VA I don't need Medicare. That means I get an extra $140 a month on my SS.