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Medications & Prescription Treatment

Paying for Prescription Meds

  • By Ali A.

    Hi there,

    I’ve been a migraine sufferer practically my whole life, but feel fortunate that I have found a medication that works for me — Relpax. I’ve been taking this for about 15 years now, and you take a pill at the onset of a migraine and within minutes, the pain dissipates. It’s a miracle drug.

    Relpax doesn’t have a generic version, so it can get quite expensive. I believe under my insurance it was $60 for 12 pills (YIKES) but I was able to get a coupon from the Relpax website to decrease the cost to $10, which is amazing. I refill this prescription every month, so $10 is obviously WAY better than $60.

    However, something changed with my insurance this year, and when I went to pick up my Relpax yesterday, the pharmacist informed me it was $330. I was floored. $330 for 12 measly pills. I literally was on the verge of tears and I needed to refill these (I only had one left and my fellow Migraineurs know that is not OK) and couldn’t believe how this could happen. Turns out the new insurance I’m on has a very high deductible, and I basically have to pay full price until I reach that.

    Having this chronic condition has affected many things in my life, but sometimes I forget the monetary affects it’s had as well. I’ve spent SO much money on medications and treatments and neurologists. I guess I just wanted to know if anyone else has encountered issues like this (this isn’t the first time this has happened to me in the last 10 years) and what they did about it. Most people would laugh and refuse to pay that astronomical amount for a medication, but what do you in the instance where you NEED it?

    Thanks,
    Allison

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  • By Blaine

    My co-pay for Treximet (nominally Sumatriptan + Naproxin, though far more effective than the two taken together) increased from $22 to $75 a couple of years ago, and then last year to $250. A good bit of that last price increase had to do with the manufacturer selling the rights to another company which then began charging 2.5 times the price. I changed to generics, and just live with the rebound migraines they cause.

    This site had an article about how insurers are increasing the price of abortive generic medications:

    https://migraine.com/blog/non-preferred-generics-increase-triptan-costs/

    It seems like the same may be happening with abortive brand names.

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  • By Becky

    I used to use coupons for lots of prescriptions but because I work for a local government I can’t use them anymore. I am considered as having “govt insurance”. Which is bull crap!

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  • By Malissa O

    I am hoping to find a way to not go broke between migraine treatment costs, psychiatric appointments, migraine appointments, and then 11 different medication copays with two not having generics so I pay big time. I am on Disability and have been since 2008. It was on doctor’s advice since I was calling out sick often and needed out to take care of myself full-time. While I did get the disability it adds up to about $250.00 a week. And I only have Medicare Part A which covers ONLY in-patient hospital stays that my husband’s employer’s insurance plan will not. So yes I do have good insurance, Anthem BC/BS but thru my husband and his employer. Each start of the year the employees are given a “Benny MasterCard” to use for copays, and other costs. But its just like a pre-paid credit card, you only use the exact money you put in the card. Now the maximum amount for a year for one employee is $3,000. My husband’s co-workers even with a bigger family, For me its my husband and me and our daughter, which THANK GOD has never in her 11 years had anything wrong health wise except the regular colds and allergies. So his co-workers will put about $1000-$2000 max and use it the whole year. Well again my husband put the max amount of $3,000 and its literally 2 months now, today is 2/22/2015 and I can easily say that ONLY I have used the card so far and its already down over $450…I see my neurologist every three months at $40 per appointment, then my botox appointments he does which I have to pay the first $500 of that treatment which again is every three months. Then I need a sleep study. For the migraines I am on 5 medications with two of those with no generics. So the normal copay for just one script that has a copay is $20. No generic can run in the hundreds. Now I also have a mental illness and need to see my psychiatrist once a week, every week. That runs me $40 each time so in a month its $120. She now has me on 6 medications that cost me $20 each. So my total copays for visits equal about $200-$250 a month and then medication copays hit me the hardest costing up to $400. I was wondering if there was a way to either reapply at the Disability Office since I can’t afford to pay anything extra on my Medicare Part A. In other words I know Medicare has options like part B and more but then you pay or more like they take out even more of me pathetic monthly check already. My husband and I are not doing well at all and he says all the time that I am using him just for his insurance and only because I am the mother of his child who needs to be healthy whether we are together as parents or divorced. And he works 60-80 hours a week at a shop where he is standing in steel toe boots about 11 hours each day and he is in a lot of pain with his feet and back but he is the person who NEVER calls in sick to work, he gets there early and will stay however late his boss asks him to. He hardly goes to a doctor, dentist, and hates medication and will take some Motrin for his pain and aches. I know if I can get some help financially to deal with all the costs that come with me “getting” healthy it might save what little remains of our marriage but even if it doesn’t I still want that burden off of him and not watch him kill himself working because I am more of a liability to my family than an asset. If anyone has any advice I would be so grateful Thanks Malissa

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  • By Katie M. Golden Moderator

    Sweetmalis,
    I’m so sorry to hear you’re going through this. The financial stress of having a chronic disease can be just as bad as the disease itself. I just started my taxes and discovered that my medical costs last year totaled over $13,000. Crazy!!

    I’m not an expert at all on Medicare and have no idea if you can get your coverage changed. It wouldn’t hurt to call your local social security office and see if they can help you.

    What I can tell you is that there are a lot of prescription drug coupons, manufacturer discounts and financial assistance programs out there. This link should help you get started.

    https://migraine.com/offer-center/

    You could also use drugsrx.com to find which pharmacy has the lowest price for your prescriptions in your area, which may reduce your copays. Until recently, I had no idea that drug stores charged different prices for the same drugs.

    I hope this helps, even if it’s just a little bit.

    -Katie
    Migraine.com Moderator

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  • By Malissa O

    Thank-you so much, Katie. Not just for the time you spent reading all of it but also letting me know there are people who do listen and then offer any advice they can do to help. I will using that link right after I replied to you because Again its close to imagine that even with some normal insurance and the Medicare Part A I get from being disabled, I’m still struggling to go to the best migraine specialist, a very expensive one of course and a 2 hour trip from my house, then keeping myself “sane” going to weekly visits with my psych. And no matter what insurance you have the entirety if all these costs are so over-whelming so thank-you again for reading my story, the link that looks really good, and finally the feeling that I’m not the only one but trust me I wish this wasn’t happening to you either. But you are very brave and strong and will take your advice all the way. Thanks and take care of yourself..Malissa

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  • By Katie M. Golden Moderator

    Sweetmalis,
    You are so welcome. I know how hard it is to feel so alone in this horrible disease. I encourage you to use the Forums often to connect with people. We’re all here to support each other!
    I just had a random thought- do you think your psych would do sessions every other week to help with cost? And maybe on the off weeks, you could do a quick phone check-in? Clearly, if you need to go every week and your doc recommends it, then follow his/her instructions. I was just thinking of other ways to help cut costs.

    Also, it can be hard to get an appointment with a headache specialist. Sometimes if you say that you are willing to meet with a resident, you can get an appt faster. I know it’s more expensive and a hassle to get there, but in the long run this could really help you to manage your Migraines better.

    Please keep me up to date!!
    -Katie

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