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Main Forums => Living With HIV => Topic started by: Boo Radley on December 30, 2006, 02:59:48 pm

Title: 10 Trizivir for US $242.33 (including tax!)
Post by: Boo Radley on December 30, 2006, 02:59:48 pm: I was thrilled this morning at Walgreens when I tried to pick up my Trizivir prescription and the clerk told me the cost was $1400 plus change. I qualified for Ryan White funding in 2006 and if I weren't such a lazy bastard should have applied after my SSD award letter arrived 2 weeks ago. My Ryan White funded prescription ran out last night so I brought the prescription my doctor gave me Thursday to Walgreens, my Medicare covered pharmacy plan. The co-pay should have been $50 but now I wonder if a prescription for 30 days wouldn’t be covered due to the calendar date: 12/29/06.

I asked the clerk to dispense 10 pills since it’s a 3 day weekend and I hope it takes only 2 extra days to straighten this out.

There go my plans for hedonistic extravagance in St. Tropez tomorrow night!

Boo
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Tucsonwoody on December 30, 2006, 03:10:21 pm: Hello Boo -

As someone pretty new to getting medication, I have been shocked by some of the prices that they retail for. Sorry you are not going to be able to sun yourself in St Tropez and party all night.

One other thing - if you have to deal with the federal and maybe state government, it is a 4 day weekend due to the funeral for former President Ford. All federal offices will be closedTuesday..I think.

Good luck

Kevin
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Miss Philicia on December 30, 2006, 03:21:46 pm: 12/29/06 is still calendar year 2006
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Boo Radley on December 30, 2006, 03:26:52 pm: Quote from: philly267 on December 30, 2006, 03:21:46 pm
12/29/06 is still calendar year 2006

I know. What I meant is that maybe a 30 day supply was not approved because the date (12/29/06) was so late -- 1/1/07 starts a new coverage year so the cheapskates wouldn't want me to benefit from coverage if there is a chance I'll have different coverage in 2007... I think.

Boo
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Miss Philicia on December 30, 2006, 03:33:20 pm: Sounds odd. I've never had a problem getting anything filled via Ryan White/ADAP during the last days of any calendar year.
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Eldon on December 30, 2006, 09:53:32 pm: (http://i119.photobucket.com/albums/o134/forfun_06/newyears-2007-165x208.jpg)
Yes, I AM Supporting You!

Hey Boo...

Now don't this beat ALL with the current coverage that you have. I AGREE with Philly267 that it IS within the same calender year. So what is the issue? There has got to be some sort of blip in this scenario. I would follow this up if I were you.

Don't You Dare Give Up... Don't You Dare Give In...
BECAUSE It IS ALL Within YOU to WIN!!!
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Bartro on December 30, 2006, 11:14:28 pm: It's a good idea to try to build a bit of reserve of medications. I go to a smaller neighborhood pharmacy (Walgreen's here is a real nightmare). The pharmacist said that there is a couple of days of leeway in which you can get your prescriptions filled. I've been on Sustiva/Truvada combination for about eight months. I reserved two doses each month by getting the prescription refilled as soon as allowed. That gives me about two weeks of reserve. The doctor switched me to Atripla in the middle of December, I still had some Truvada and Sustiva left which I finished. Now I have almost a months supply of Atripla in reserve. I might be a little paranoid but I'm afraid of some sort of disaster, snow storm, fire, chemical leak, terrorist attack or the like that could leave me without. I can't get the picture of those people in New Orleans out of my mind. The meds are all together in a box that would be the first thing I'd grab if I'd have to "get out". My pharmacy bill this year totals $11,800 dollars. Most is covered by my insurance and ADAP has covered most of the copayments. If I had to pay for these myself or even half the cost I'd surely be in deep trouble.

Atripla retail for 30 tablets $1160.12

4/27/2006 Vl 40,800 CD4 339-17% Platelets 1000
05/5/2006 Platelets 26000
06/1/2006 Vl 181 CD4 342-19% Platelets 27000
08/4/2006 Vl <50 CD4 301-20% Platelets 31000
11/2/2006 Vl <50 CD4 364-23% Platelets 38000
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Tucsonwoody on December 30, 2006, 11:49:47 pm: Barto -

Some good ideas for us other paranoid people :) It is awful what drugs retail for isn't it. The Valcyte I was taking was quoted as around $4,000 and had to get a special okay from my insurance company, which is always sooooo easy. When I was picking up my meds one day the lady behind me said her husband takes one medication that costs Medicare $11,000 a month. I take Atripla too and at my Walgreens a 30 day supply is $1,400, good thing insurance knocks that down to $35.

Another good reason for congress to allow Medicare to negotiate with the drug companies...IMHO. Anyway, don't want to hijack this thread into whining bout my meds and the state of medical costs in the US of A.

Thanks again,

Kevin
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Oceanbeach on December 31, 2006, 01:22:29 am: Hi Boo,

Had to do a double check but a bottle of Trizivir is priced at $1200, plus a few bucks. At least that is what my pharmacy provider charges Medicare and ADAP. Since the Medicare Donut hole began, I have been told twice that I could not leave the pharmacy with almost $3,000.00 in pills and no payment. I spent hours on hold w/Walgreens to get a representative. I reminded that her employer spwent a lot of their money marketing to me and if I am ever inconvenienced, my pharmacy and medical provider is inconvenienced, I will change pharmacy providers. I got my meds.

I have been altering the refill dates. Order a few days earlrier than usual, put a dosage or two aside for a rainy day. The cost of the monthly meds is almost 3 X's my income. Can't take chances when the government is involved. Have the best day
Michael
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Miss Philicia on December 31, 2006, 02:41:50 am: Oh yeah... I always refill my mine as early as usual to build up a reserve. Been doing that for over a decade. I can fill mine five days early.

Everyone should REALLY do this.
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Oceanbeach on December 31, 2006, 04:14:13 am: Drug companies market medical providers by leaving free samples of their products. I have been treated at 3 HIV clinics over the past 10 years, each has a "drug closet" of samples. There may be a supply at your clinic for emergencies. Never hurts to ask. Have the best day
Michael
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Ann on December 31, 2006, 06:21:01 am: Boo,

If this has indeed happened because of the fact that although purchased in 2006, you will be using them in 2007, well, try telling them that since hiv is a retrovirus, you take your meds retroactively and therefore they have no right doing what they're doing.

Um, yeah, sorry, probably not helpful - unless I made you smile. I hope you get this sorted out and soon.

Hugs,
Ann
xxx
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Boo Radley on January 02, 2007, 11:07:35 pm: Quote from: Ann on December 31, 2006, 06:21:01 am
Um, yeah, sorry, probably not helpful - unless I made you smile. I hope you get this sorted out and soon.

Hugs,
Ann
xxx

It did make me smile at the absurd notion I could ever be anything but a doormat! ;)

After evening perambulations with the pooches I'm heading to my conveniently located Walgreens to pick up some non-HIV meds and ask them to check what my copay will be on a new 30 day prescription. Assuming it's $50 I'll get the pills and pursue Ryan White again, although I'm not sure about how changes to Medicare might affect Ryan White. This year it appears the Medicare annual cap of $3000 for non-preferred drugs like Trizivir is no longer in effect and Trizivir is in the formulary with a lot of other HIV drugs at the $50 copay rate. I can probably afford $50 a month for Trizivir even though I'd rather spend it on DVDs or computer crap or any random sperm-of-the-moment spendthrift bagatelle. Then I can really start being horribly obnoxious to anyone who doesn't have SSD and Medicare about how much they use the system and I'm not a leech and sundry other niceties... like some people.

Boo
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Bartro on January 03, 2007, 03:29:24 pm: I forgot to mention when building up a reserve be sure to rotate the medications to avoid expiration (of the meds that is).
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Boo Radley on January 04, 2007, 07:54:06 pm: I know how many of you missed and are still missing sleep over this issue so please put your minds to rest. As it turns out the copay is only $25 a month and there is no annual cap on the costs paid by the Medicare HMO/PPO/SOBs, whatever.

Now maybe I'll apply for Ryan White and give those drugs to someone who needs them but can't afford them. But you didn't hear me say that.

Boo

P.S. Building a reserve of Trizivir will be hard because the clever insurance company allows only so much leeway in refilling prescriptions and if you refill too soon they don't cover any of the cost. The only way I could build a reserve would be to lie and say I lost mine or the dog ate them (and died...).
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Miss Philicia on January 04, 2007, 11:03:08 pm: They only allow me a five day leeway but that's enough to build up a month reserve within 6 months.
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Boo Radley on January 05, 2007, 12:43:17 am: Quote from: philly267 on January 04, 2007, 11:03:08 pm
They only allow me a five day leeway but that's enough to build up a month reserve within 6 months.

Mine only allows a five-day to a week leeway, period. If I order a refill on 1/29/07 I can order another refill on or a day or two before 2/28/07 but the next refill wouldn't be authorized until 3/28/07. If I try to refill before then the cost isn't covered. This has always been the case with my Medicare provider. They have it down to a science, believe me.

Boo
Title: Re: 10 Trizivir for US $242.33 (including tax!)
Post by: Miss Philicia on January 05, 2007, 01:18:56 am: Weird. I'm on Medicare Part D too and I've never had a problem. That sucks.