Humana 2009 Drug Formulary

[Ric Wilke]

I just got a "love" letter from Humana giving me a heads up that Epzicom is being moved from Tier 2 to Tier 3.  This means that my co-pay for a 90 day supply will go from $300.00 up to heaven only knows.  Humana can't (or won't) answer any of my questions.  Nor will they tell my what prompted this change.  They did say that I could file a "Grievance/Appeal".  Like that is going make them change their minds.  I'm pissed, big time.

[J.R.E.]

Hello Ric,

I also take Epzicom and also on Humana.  If I understood it correctly, and I received a letter also , my monthly co-pays were going from $30.00 to $50.00 per month. I don't receive my meds on the 3 month plan. From tier 2 to tier 3. I will officially know the cost when I renew on January 1st,09

Make sure to look into GSK's  Supportcard @  www.mysupportcard.com   I've mentioned this to my doctor, but still haven't heard back as of yet. It could be a savings of 100.00 per month. See if you qualify for this. I will be mentioning this again in January, to my doctor.


Peter mentioned in this thread :

http://forums.poz.com/index.php?topic=24209.0



Ray

[YaKaMein]

Just curious. Is either of your insurances a with Humana a Medicare, part D plan? or are these non-Medicare related policies? I hope there's some relief for Ric if his copay may surpass $300/mo and a way for Ray to reduce his copays. How might your copays change for other meds, if on any?

[aztecan]

I am seeing this type of thing happening a lot more often than I would like.

This "tier" system can be terrible. One person I know has a tier 4 medication, meaning he is required to pay a percentage of the drug cost, not a basic copay.

He pays $431 a month for Atripla. That just went up last month. It had been $422 a month.

I know I couldn't afford a copay of that sort. Luckily, there is a program here that covers the copay for him. If not, he would probably have to stop his meds.

Not a pretty picture.

HUGS,

Mark

[allopathicholistic]

Nor will they tell my what prompted this change. 

I guess they lose money (ie dont make a profit) on Epzicom and so they try to offset the loss on the backs of folks  who need Epzicom to live - that's us pozzies.

[edfu]

Empire Blue Cross/Blue Shield in New York State is changing its RX-benefits administration as of Jan. 1, and Epizicom has been removed from the new formulary.  I strongly suspect that this is the result of all the recent negative research news about the increase in cardiovascular events for those on abacavir (Ziagen), one of Epzicom's two constituent drugs.   It is also due, no doubt, to the removal of Epzicom, because of these research studies,  from the most recommended HAART RX governmental DHHS preferred formularies to a secondary  position.  This is most unfortunate, needless to say, since there is still  considerable controversy and debate about the accuracy of the cardiovascular studies.  Most experienced HIV physicians are not removing their patients from
Epzicom if it has been working and if the patient is not already predisposed to cardiovascular problems. 

http://www.aidsmeds.com/articles/abacavir_heart_smart_2211_15079.shtml

http://www.aidsmeds.com/articles/hiv_guidelines_Prezista_1667_15551.shtml