Small Rant about GI Visit and Cost of Meds!!

Yesterday I had a visit with my GI -- it's been almost three years. I haven't had a reason to see him, but my new GP wanted me to check in with my GI. Since the demise of Asacol, I have been taking Pentasa with good results...meaning I'm still in remission. I have a high-deductible health care plan, so the beginning of the year I pay cash for my meds until I reach deductible, which is usually hit the first time I pay for my meds.

Here's my discussion with my GI yesterday:

Him: You are taking Pentasa? Why?

Me: Yes. Because your office referred me to my GP to get the prescription after Asacol was discontinued.

Him: So you don't take the Asacol anymore?

Me: No it was discontinued.

Together: We both mentioned Delzicol....

Me: Delzicol is just Asacol in a capsule

Him: But they changed the coating.

Him: Throw out all the Pentasa and start on Lialda.

Me: I have a high deductible health plan and I just paid $1600 for a three month supply.

Him: $1600? You are kidding? Throw it out anyway and start with Lialda. Maybe we can give you some samples.

***ME SHAKING HEAD***

Interesting that the doctors have NO knowledge of what their patients pay for meds. I would really like the pharma reps to tell the doctors just what it costs for our meds. Maybe they will start thinking before writing prescriptions, and doing procedures that are not necessary. Maybe it's our job to inform them to. We've live in a world where nobody really thought about how much meds and procedures cost, just had them doled out to us.

Yes... I believe medical debt is the leading cause of bankruptcy in the United States, so I feel your pain. At the end of the day, it's a fairly big business (like hollywood) and profits matter the most.

Just as an FYI, a small percentage of doctors used to collude with pharmaceutical representatives to "advertise" some of the medications to their patients - it would mean getting kickbacks (as well as all expense paid trips) for prescribing the drugs. It's a known tactic, but hopefully not as common as it once was.

The best thing to do is look up your doctor on dollars for doctors and see if any companies are giving him compensation to prescribe. I think you genuinely have the right to question his integrity and ask if he has any known affiliations.

I am sure they know the high prices of medications and some are nice enough to work with their patients depending on insurances, or give out samples.

Best.

Post Edited (Guardian7) : 1/29/2015 9:00:34 AM (GMT-7)

That's just plain stupid to switch from something that was working. I would have never let them do that to me. I'm the boss and if they can't deal with it then they're fired. I would highly suggest you put your foot down and demand to stay on Pentasa and that you aren't switching. If he balks you find a new GI. By the way, I also have a high deductible plan where once the deductible is finally met, my meds are totally free, zero cost. Once I reach that point I begin ordering my meds every three weeks and stockpiling them. They allow you to reorder after 21 days and never figure out that you are reordering every three weeks instead of four. This year I have almost a half year's worth of Pentasa to start the year out.

Carol,

How long have you had UC for? Are you at the 10 year mark? That's about the time that we are supposed to go for C-scopes more frequently. I figure that you haven't had one in a while because you haven't seen your GI in 3 years.

I can't believe how much it people have to pay for 5ASAs when patients only have to ~$30 for the expensive biologicals.

Every time my GI would switch my meds he would always give me samples; he even gave me 4 humira pens while they were waiting on my insurance company to approve Humira for me.

Bad news for you - most scopes use propofol now I bet, and not versed.

Glad you figured out that your scope is covered!

Darn, Kazbern, I was so looking forward to the Versid! Now I'll have to look at the other drug to figure out what it does. Thanks so much!!

Lonie - I got the same sticker shock recently. I have been on Lialda for the last several years and this year there is a huge price difference for me. As I just posted in a new thread I have gone from ~$135 a month to ~$600 a month for Lialda. This is with the same insurance company and the same pharmacy filling the prescription.

I am hoping my doctor will change the medication to something else.

I do love how when I expressed outrage at the new price the insurance company chimed in that it would be applied to my deductible. No crap and F you very much.

How far do you think I will get if I go into work tomorrow and tell them you know I made $XXX dollars last year. This year however you have to pay me 5x as much for the same job and work.

No propofol yet my neck of the woods for c-scopes. I'd reject it for sure....I really liked Demerol..lol. Don't like Versed...

I prefer to watch the monitor and be nicely stoned, I mean relaxed.



Carol..can't believe the doc's response of dumping the Pentasa and switching to Lialda. What was his reason for that??

q

Notso: Those discount cards only work well if you have copays. I used to have insurance that did not have copays on drugs. It was just applied to my high deductible. I think my Lialda at the time cost around $825 per month and the Lialda discount card maxes out and gave me $125 off that $825 cost. $125 was the most the card subsidized. If you don't have copays the card will not subsidize more than that amount so even with the card I still had to pay like $700 per month until my deductible was met. By then my prescriptions were free and the discount card had nothing to discount. I have different insurance now that does have copays but I actually believe my older insurance was better overall, when you take the entire year into account.

My company seeds our HSA accounts at the beginning of the year, and then when we reach deductible, it's 80/20. I also have about $200 every two weeks deposited from my paycheck into my HSA so I have the funds for my meds. My husband takes meds that are all no-charge because so many people at my company are taking them...so they get a "group" discount. No-go for me though!! So I'm the one costing my family all the $$.

I checked my instruction sheet, and it says that they use Versed and Demerol for a concious sedation during the colonoscopy. I'm happy with what ever they give just so I'm loopy enough not to feel anything.

Quincy, the doc's reason for the switch and throwing out the meds is that he feels that Pentasa is for Crohn's patients, and that the meds aren't reaching the lower part of my colon. I don't know...the last two years I've been fine. I guess it's the fine line I am worried about -- when you are doing good, you don't want to tip the scales.

Doctors don't really know what their patients pay for meds because it's different for everyone. Yes they cost a lot of money at retail value, but insurances cover all different amounts of that retail value. For example, a lot of people have talked about Lialda costing them hundreds. When I was on it my giant bottle was only $20.

Lialda didn't work for me (intolerant to mesalamines) and I still have the rest of the meds by the way lol. So if anyone wants them... ;) Pretty sure that's illegal, but why throw them out especially if someone can use them?

That... that doesn't sound like a GI you should be going to, ditch this asshat Now!

One more thing a box of 100 pills of 500mg ferring's pentasa is $35.86 without insurance, prescription or anything required in Egypt , for the amount you're paying take a vacation trip instead and buy a large supply :D


I think i had a similar incident with a GI suggesting remicade early on, which is not covered by insurance or anything here, which is Ridiculously expensive here something like $15,000 a year ( the average income here for my age is like $3500 a year), he also said "i am going to make you an offer for each 3 vials you get an extra one for free", i was like Riiiight goodbye.