Tuesday, August 29, 2017

Poverty Blog: Pharmacy Benefits

Upon realizing that I had lost my health insurance and pharmacy benefits after June 30, I called my local pharmacy to see what the drugs would cost me without insurance.  The results were shocking.  I reeled!

In the past, I had paid $8 for 30 day prescriptions, and $24 for 90 day prescriptions. 

Here are the figures they gave me for the cost without insurance:

* Clonazepam is the drug that helps control my “essential tremors” disorder. It keeps my hands from jumping around like the old “Mexican beans.”  I need it to function in the world.  Cost with insurance for 30 days: $8. Cost without insurance: $28.58.
* Lisinopril keeps my carotid artery clear after my surgery in 2015.  With insurance  for 30 days: $3.  Without insurance: $49.40.
* Effexor: The antidepressant I desperately need, having lost my job and facing an uncertain future.  With insurance for 90 days: $24.  Without insurance: $356.17.  Needless to say, I decided I couldn’t afford this prescription that I most needed.
* Prilosec: A digestive drug that helps me.  With insurance for 30 days: $8.  Without insurance: $227.96.
* Prevachol: Helps with cholesterol.  With insurance for 90 days: $24.  Without insurance: $437.55.

As you may imagine, I decided I couldn’t afford any of these prescriptions.  I saw my life and health crashing around me.

But here’s a weird thing.  I’ve used the same locally owned pharmacy almost since I moved to Jefferson City.  The first time I called them to renew a prescription was to ask for the Clonazepam.  I explained that I had lost my job and was without insurance.  The pharmacist said, “Let me check the lowest cash price.”  And the price was $7.64.  Not the $28.58 they had initially quoted.  Not even the $8 that I paid with insurance. 

Next I needed to refill the Prilosec, which was supposedly going to be $227.96.  When they checked the “lowest cash price,” they gave it to me for $11.38.

Fortunately, I got my insurance reinstated before I had to refill any of the other prescriptions, but they are all now back to where they were before.

Where is the justice in this?  As a person with insurance, I had very affordable prescriptions.  Having lost my job and my insurance, I was quoted utterly unaffordable insurance.  But then, perhaps because I’m a longtime customer, a pharmacist happened to check the “lowest cash price,” and some of them were even lower than what I had paid with insurance. 

This was just one of the things that made me realize how very privileged I am.  If I were a person who had never been insured …. and if I didn’t have a longstanding relationship with this pharmacy, would they have told me that there is such a thing as a “lowest cash price”?  I suspect not.  I suspect that if I were an ordinary poor and uninsured person, I would have dropped all my prescriptions.  And my health would have declined dramatically.

I am so lucky.  And the poor and unconnected are so deprived by our medical/pharmaceutical system!



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