Bison Bud

Yeah, we often use Good-RX, as it can be cheaper to buy a script outright using their coupons than to pay the co-pay on the insurance. Anyway, it certainly pays to look up and check each drug prescribed and even their prices can vary quite a bit from vendor to vendor. In any case, it certainly pays to shop around. However, most all the lower tier generics are no cost to us through the mail order pharmacy and we make use of that whenever possible.

David Martin Loc: Cary, NC

FYI - I posted similar information about GoodRx earlier in the thread.

What I also found was that if you join a "pharmacy savings club" the cost for Symbicort could be as low as $125 each, saving you even more.

jerryc41 Loc: Catskill Mts of NY

Yes, CVS/Caremark is less than ideal, but that's where I have to get my Rx.

JBRIII

Suspect problem with mail-in coupons is need to mail in original coupon, coordination with order, time, etc. to carry out. There are machines which can robotically fill pill bottles. I can see the email setup being one person sending data to the machine which then handles everything else, no one else involved.

I suspect in the years to come, if not already, warehouses will be completely automated from arrival of pallets, all nicely labelled, to the mail truck, no one involved until something breaks. If trucks go self driving, maybe no one from factory to customer. Only problem will be no jobs, no paying customers, etc. Only purpose for humans sill be as customers for robots.

Bison Bud

I have to agree with your statement that our healthcare system is broken and wish I knew what to do about it! Healthcare is currently not about helping the patients, it's about corporate profits. Frankly, I have no problem with them making a reasonable profit, but this thing has really gotten out of hand. The current two price system is a big part of the problem where a doctor or hospital bills the insurance company an outrageous sum and then the insurance company only allows a portion of it per their plan agreement. The big problem there is if you don't have insurance, or you are not in their "Plan" then you will have to pay the full amount billed without the discount. Some places even still try to bill you for the difference if possible. Anyway, this discount system also drives doctors and hospitals to pad the bill further by only doing one thing at a time rather than taking a discount for multiple services on one visit. This forces the patient to pay multiple co-pays and waste time on multiple visits that really aren't necessary. Hospitals can be even worse by running nearly every Specialist and/or Therapist in the building through to see the patient and/or ordering unneeded tests or things like a flu shot while your in the hospital. I personally had a hospital refuse to release me until they administered a flu shot even though I refused it multiple times, because I could get it for far less at my doctor's office or even Walgreens. I also refused to let them send in the Occupational Therapist after my fifth knee surgery, because there was nothing they could tell me that they hadn't done multiple times previously. Believe it or not, they still billed nearly $800.00 for the Occupational Therapist even though they never performed any service whatsoever during that visit and we had a huge fight over the billing because of it.

All in all, it's pretty obvious to me that "Greed" is the driving factor in most all healthcare and healthcare insurance costs and the price differences in the asthma meds. discussed here is just one more example of a system that has frankly been broken for quite some time. I wish I knew what the long term answer really is, but I do know that I will be watching my bills and claims very carefully and will escalate issues as needed to try to keep it as fair and reasonable as possible. It really shouldn't be this difficult!

David Martin Loc: Cary, NC

By and large doctors no longer own their practices and can no longer make the rules, regarding hours worked or what they charge. Doctors nowadays tend to be employees of corporations; they clock in and clock out. If employed by an HMO, they are told the number of patients they must see per hour. If you look closely, you'll find that many practices are actually owned by hospitals or even by investment firms.

In-network hospitals and doctors who try to bill beyond what is allowed by insurance, are in violation of their contract.

You might also be interested to know that it is actually a federal crime for doctors and hospitals not to try to collect the patient's share of the total allowed Medicare payment. Not trying to collect the patient's share is considered to be committing an act of fraud on the insurance payer.

You can thank the billing and coding system established by the government (Medicare, which sets the standard for all insurance payers) and the AMA. Doctors can only bill for one level of service per patient visit per day. For example, it is not possible to bill for both an annual physical and addressing a simple medical problem or two. There are code suffixes that could be used, but these are ignored by insurance companies.

Actually hospitals cannot call physicians to see a patient; only physicians and their midlevels (PAs, NPs) can do this.

Again, this would have had to be a decision made by your doctor or other provider. The flu shot must have been ordered, and the staff could not discharge you until the order was either fulfilled or cancelled.

I believe it.

Healthcare in the late '80s and '90s became increasingly managed as a business. Patients became customers, and doctors became assembly line workers. With all the compassion of a typical factory.

Bison Bud

"With all the compassion of a typical factory" is about as true and representative statement as could be put into words!

SteveR Loc: Michigan

I'm not sure what insurance you have. Even for very expensive drugs, like my insulin and Trulicity, I only pay minimal amounts, like $125 for a 3 month supply of insuline and $35/month for Trulicity. I'm mildly asthmatic as well, and Breo and Pro-Air are reasonable as well. If you're on Medicare it really helps to have a really good supplemental insurance company. However, I do pay $257/mo. for my supplemental insurance as well as what I pay for Part B.

Hamltnblue Loc: Springfield PA

Before the diagnosis, what drugs were being used? If none I would recommend the rescue inhaler only and change lifestyle.
My wife was diagnosed with COPD and was told she would be on oxygen by age 50.
It looked like they were right with breathing steadily getting worse and her inhalers being increased. Simple walks or tasks resulted in shortness of breath.
After plenty of reading she decided to wean herself off of the inhalers. It took several months to do so. She forced herself to walk each day, increasing the distance over time.
Today she’s 60 and feeling much better. She can walk at a fast pace for 3miles. Tasks that used to result in out of breath are signicantly easier.
Long term steroid use is not good. Getting your diet under control and keeping away from pharma is a good thing to look into.
Read on alternatives.

Reuss Griffiths Loc: Ravenna, Ohio

A bit of perspective regarding these types of drugs. I've got COPD and have been on inhalers for several years. I used to take Spiriva which cost me, via insurance coverage, about $45/mo or $90/3 mo. until you reached the donut hole. A limit set by our government on what can be charged and when. After you reach the donut hole, based on retail cost of the drug, not the discounted price, your insurance company switches to another format for pricing. Without going into details, A 30 day supply cost ~ $45 until you reach the donut hole and then $325 until the next year. I'm currently taking Anora and it's pretty much the same in both pricing strategies, $45 then $300.

What most people don't check is the actual amount of drug in a single dose. Most prescribed drugs are measured in milligrams (mg). For reference there are about 454,000 mg per pound. But the active ingredient in Spiriva is measured in micrograms (mcg). There are 454,000,000 mcg per pound. If you do the numbers, the active ingredient in Spiriva costs about $250,000,000 per pound. That one billion dollars for 4 pounds. I used to work in the pharmaceutical industry and I know that they threre are many loosers for every winner. And the cost of all the loosers must be recovered in the price of the winners. Given the volume of these drugs being sold. Somebody is rolling in dough!!!

SteveR Loc: Michigan

I'm very fortunate. Once I reach the donut hole, my supplemental then picks up Medicare's portion. I don't get hit with that huge expense before reaching catastrophic. It's one advantage of having a wife who was a nurse at a major hospital. The doctors wanted premium coverage so we all benefited. If the Dems do away with private insurance and we lose this supplemental we'll be sunk. Since my wife was a long-term employee, her supplemental insurance is free. That saves us a nice bit of money.

jerryc41 Loc: Catskill Mts of NY

It all comes down to who makes the laws and why they make the laws they do.

SteveR Loc: Michigan

It all depends on whether a person has cheap or expensive insurance. You're gonna pay one way or another. If you get good insurance you're gonna pay for it monthly but have good benefits. Drugs will be covered. Cheap insurance not so much. We really need to know what kind of insurance the OP has to have a proper discussion.

olddutch Loc: Beloit, Wisconsin

My local clinic twice now thru a program has hooked me up with a Rx at no cost. Without that I would not have afforded the Rx. They have a Social worker that takes care of that. L O L.

John Hicks Loc: Sible Hedinham North Essex England

I. Feel sorry for all you Americans here in the UK if you are over 65 years of age prescriptions are free