Community Chat

[151949]

My DH takes a drug for his type 2 diabetes called metformin/glucovance.He had no trouble at all when we lived in Pitts. and had private insurance getting this drug.He's been on it for 14 years now. Every time the docs try to change him to a different drug he gets blood sugar crashes.Never gets them on this drug. So - it is not formulary for our medicare advantage plan so EVERY YEAR our PCP has to fill out a form explaining why he has to take this particular drug and submit it to the ins. co. EVERY YEAR. They consider it to be off formulary so it becomes a tier 4 drug. Well, that basically means he has to pay for it out of pocket. We shopped all around , including our canadian friends looked into what it costs up there. It was $160 for a 90 day supply at Walgreens, $90 for a 90 day supply at Winn Dixie if you have a coupon and $16 from Canada.There were others but I can't recall the prices - of course he bought from Canada drugs .com.

Absolutely ridiculous how American healthcare is such a huge RIPOFF.And absolutely nothing being done about it by our government.To just allow such huge profittering .... immoral.

[I am still oxox]

Do you have prescription coverage on your Medicare, or an additional prescription plan?

Edited - it was very diffuclt to read your post the type is so small and the formatting made it impossible to read most of your post

[Stray]

It's unfortunate but it's free enterprise and capitalism.  There are different drug stores out there that advertise lower prices but I can't recall who they are at the moment.  I had to change from Rite Aide as express scripts will not approve 90 day refills for medications with them so I had to switch to a small independent pharmacy a few doors down from Rite Aide...go figure..

[BirkiLady]

@151949It's the first drug prescribed for Type II diabetics. Be grateful that's all he has to take or do. 

[151949]

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wrote:

Do you have prescription coverage on your Medicare, or an additional prescription plan?

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Did you read the OP?

[151949]

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wrote:

@151949It's the first drug prescribed for Type II diabetics. Be grateful that's all he has to take or do. 

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Who said that was all he has to do for his diabetes? This was about the drug - the remainder of his diabetes care is immaterial to this topic.

[Trinity11]

Why doesn't he just get a prescription for glyburide and another for metformin? It would resolve the problem. 

Glucovance is a convenience drug. He swallows one pill instead of two ..thus insurance companies put it at Tier 4. 

[Phantom41]

That is pretty pricey for an old drug. I take it off  label for an autoimmune issue and I pay $30 for 90 days and my insurance is not that great anymore.

[Trix]

@151949 I can relate to your frustration because I have a similar situation to deal with regarding certain meds I require which are covered under a higher tier in my Part D formulary.  I too have found these drugs can vary in price from pharmacy to pharmacy and the price in February may not be the same price in March.  Perhaps @I am still oxox didn't quite understand that your Advantage plan does cover the drug, but it requires doctor supplemental documentation to be approved and even with that it is covered at the higher out of pocket tier, so you have to search for the best price.  

We all know the drug companies can freely price the drugs as they like and the insurance companies can choose which ones they cover and at what percentage.  However, I truly hope that we live long enough to see a time where our elected leaders, the drug companies, and insurance companies can come to some type of agreement where prescription drug prices are madated to be within some set structure and share a common price at all pharmacies. In the meantime @151949 all the best to your husband. 

[dex]

Costco sells drugs much cheaper than drugstores.I know that Canada has better prices than the USA.They get a better price to start with from the drug manufacturers.