Findings underscore importance of prevention efforts
by Tulsatom on Sun Sep 02, 2007 12:00 AM
We have been purchasing Temodar each month for $25 using our co-pay with Blue Cross - now they tell us that the drug has been reformulated and we are responsible for 30% of the cost which is over $800 - they also did the same thing to her nausea drug in the same month so we went from a $50 bill to over a $1000 bill each month. Is anyone else runinng into this?
by Osborne on Mon Sep 03, 2007 12:00 AM
by Wreed on Mon Sep 03, 2007 12:00 AM
We ran into the same problem. What they usually meany by special pharmacy is mail order. If you try to get it filled at a regular Rx, it will most likely cost a fortune. Our NO uses a mail order Rx, which is considerably less. I think my mom is getting the Temodar for $100 per month through Anthem blue acces. They are also using the generic nasuea medication. I think it is Zofran. It might cost $10 per month. The other Oncologist my dad was seeing was not very good or experienced. She knew nothing about the mail order RX, so you might have to press harder and demand that they use it. She was also prescribing a very expensive anti-nasuea medication that was going to be over $500. I think it is called dytril or something like that. The new NO that we see is much more experieced and said the Zofran will work just as well. Make sure you doctors are not out for the money or kickbacks they can receive. Unless you ask, you may not get good info. Good luck!! It is very stressful, and until we dug deeper, my mom was terrifed about the cost. You should not have to worry about the reformulation if that did happen. You can still get it for less.
by Houston_Wife on Tue Sep 04, 2007 12:00 AM
I checked with United Health Care, our provider, and was told that there have been no changes in the price of Temodar. My co-pay was still at $35.00.
With Blue Cross there may be an appeals process to help with this cost. I wish you the best of luck with this. It is appaling to me that the drug companies and the insurance companies would make it so difficult, and in some cases, impossible to help people who depend on these drugs for there survival.
by Donna610 on Tue Sep 04, 2007 12:00 AM
by Madeline_Ruth on Tue Sep 04, 2007 12:00 AM
by bpanc on Tue Sep 04, 2007 12:00 AM
My husband was on Temodar for 42 days at the same time he was receiving radiation. My company healthcare plan uses Caremark. My husband's oncologist called and ordered the Temodar, Caremark shipped it to us (next day air) from their specialty pharmacy in Illinois. They only sent us enough for the first 30 days but told me to call them when we had enough left for about a week. I did, and they then shipped out the remaining 12 days worth of pills. It was effortless and cost me my $60 co-pay ($60 for the first 30 days and another $60 for the last 12 days).
by RosaDawn on Wed Sep 05, 2007 12:00 AM
My Dad's Temadar has not gone up but they would not let him have it on the mail program. He has Blue Cross and they made him go to another sick med after the first month.
Rosa (Dad dx 02/07)
by Sharon_D_2 on Thu Sep 06, 2007 12:00 AM
Our Blue Cross/Blue Shield is through my husband's work. When he was diagnosed, the human resources manager gave me information on a health care advocacy business, which is the inbetween for the ill patient and dealing with the insurance company. Perhaps you may be entitled to an organization like that as well. They have given me some direction when my husband returned home from surgery. At that time I was overwhelmed at the thought of what lies ahead with drastic life changes, immediate loss of income, and how will we survive.
The 2nd prescription of Temodar had to come through Caremark (mailorder), and there was no problem. Our oncologist was familiar with the system. All the other drugs were able to be picked up at the local pharmacy. It doesn't make any sense to me, we just have to play the game (which I dread, there's enough on our plate as caregivers besides being put on hold with insurance companies and long distance drug suppliers). If I had a full-time job, I'd never have the time to take care of these issues on the phone.
Keep asking questions, eventually answers are received. Good Luck.
Hugs to all the caregivers, Sharon D.
by gardenbug on Tue Mar 06, 2012 01:15 PM
We just went to pharmacy to get Temodar and also found that Blue Cross charged us $800 for on prescription, I am not thinking this drug will break us and what else are they going to do to us now??? But they deducted it from our yearly out of pocket fee of $1500 for the year, and next month, although it is a lot to bite off in one month, I will pay the entire yearly out of pocket off. Then from now on, I will not have to pay anything for medical the rest of the year. So, see if they deducting this amount from your yearly out of pocket, which may mean that after so much, you don't have to pay anything for medical the rest of the year. Still though, hard to believe that anyone would have to pay such horrible fees up front for these types of medications, it drains you, financially and emotionally to have to go through all of it. Hope this helps, because most insurance companies do not even bother to explain to you that they high co pays for drugs come off your yearly out of pocket. Crazy fees for medical drugs!
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