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Author Topic: How much is THIS costing me??  (Read 3441 times)
KT0930
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« on: August 18, 2007, 07:55:40 AM »

Time to rant again... :rant;

I get a call every month from CVS pharmacy asking me if I need to refill my Sensipar. First, how much is this convenient little service costing me and my insurance company? This might very well explain why when on my old insurance most of my meds were a $35 copay and Sensipar was $65. It's considered "nonformulary", they tell me. Well yeah, and you want to re-coup the expense that the pharmacy adds for AmGen making them call every patiient who's on it every month. Second, do they think I'm that dumb that I can remember to refill all six of my other meds but somehow I'm just dimwitted enough to forget the Sensipar? Or do they think the Sensipar is just that much more important?? GGGGGGGGGRRRRRRRRRRRRRRR. Does anyone else get this call every month?

Ok, maybe I'm upset because everytime they call, my cell phone says "private number" and I'm always on edge that it might be THE CALL, and today I had two hang-ups from "private number" before I got a person.

Rant over.
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paddbear0000
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« Reply #1 on: August 18, 2007, 09:09:23 AM »

I don't think CVS charges anything, at least they've never charged me to do that. That's a service they provide on certain drugs that must be taken for the rest of your life. They did it for me when I used to get my insulin from them. The reason your Sensipar costs more is because it's non-formulary. Insurance companies charge for Rx's based on a tier system, which includes formulary and non-formulary drugs. They want you to get cheaper drugs so that they don't have to pay out as much money, so cheaper drugs, like generics and drugs that are cheaper to make are put in the first tier. Slightly more expensive ones are in the second tier, and so on. Drugs that have a cheaper equivalent (usually generics) or are really expensive are generally placed in the non-formulary category and charged the most for. The insurance co. is hoping you will opt for a cheaper version if it's available. At least that's the way I understand it. Hope this helped!
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kitkatz
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« Reply #2 on: August 18, 2007, 09:13:45 AM »

Don't you know dialysis automatically puts you on the stupid list with the pharmacy for the rest of your life?  :rofl; :rofl; :rofl;
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« Reply #3 on: August 18, 2007, 09:42:10 AM »

Call CVS and demand that they take your name off the list.  Surely there must be an opt-out on that!  Walmart Specialty does the same thing with my Aranesp, which is annoying, since my dose changes on a weekly basis with my blood work, so I'm never out at the times they choose to call - but their number shows up on caller id, so I just ignore it and let the machine get it.
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KT0930
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« Reply #4 on: August 18, 2007, 10:38:31 AM »

I checked with my insurance co about that, pad. They explained basically the same thing about tiers. I spoke to my dialysis nurses and my doc, and there are no other options to sensipar (or hectorol, which is in the same "tier"), so I took my argument to the insurance co. Didn't matter. Oh well, my new insurance only charges me half as much. I was just ranting, anyway.

Kit, yes, I noticed that.
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"Dialysis ain't for sissies" ~My wonderful husband
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thegrammalady
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« Reply #5 on: August 18, 2007, 04:20:35 PM »

sensipar is a relatively new drug and there is no generic.
« Last Edit: August 19, 2007, 04:52:54 PM by thegrammalady » Logged

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goofynina
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« Reply #6 on: August 18, 2007, 04:32:32 PM »

When i was first put on Sensipar, i had the hardest time getting it approved.  When i took the prescription in, they said for that drug they needed some other form (forgot what it was called) but it was some kind of receipt with a carbon copy attached, anyways, i finally got it to them, then they said they couldnt fill it, it was a strictly mail order drug, i told them the doctor wants me on it RIGHT AWAY, they told me i had to call the mail order place and have them overnight it,  so, i called the mail order place BUT they needed some paperwork from my doc as well, i was getting quite frustrated already,  after getting that squared away, come to find out my insurance didnt cover that so it was going to cost almost $150.00 (for a 30 day supply) thats about how much i was paying for my renagel, i had to get it anyways, so after begging, borrowing and ok, stealing :P  i got the money together and asked them to send it, THEN, they said they couldnt send it to my house, it had to be sent to the pharmacy, OMG, WTF?  i was sooo upset, i called the pharmacy and they didnt know why they would say that but they agreed to have them send it overnight and i picked it up the next day,  after all that, i now get my Sensipar free from the nephrologist, thank God, but now because of all this, i have a bad drinking problem  :wine;  lol :P ;)
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« Reply #7 on: August 19, 2007, 05:35:31 AM »

I'll drink to that  :wine;  ;)
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KT0930
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« Reply #8 on: August 19, 2007, 08:31:34 AM »

You're goofy, Goofy! Glad to hear that it's not just me having problems with this drug, and that my problems aren't near as bad as some! Another reason I love this site...y'all put things in perspective.
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"Dialysis ain't for sissies" ~My wonderful husband
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I received a 6 out of 6 antigen match transplant on January 9, 2008. Third transplant, first time on The List.
boxman55
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« Reply #9 on: August 19, 2007, 08:59:07 AM »

Just curious Goofy.. is that what it took to develop a drinking problem. mine was ..just waking up..Boxman   :cuddle;
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thegrammalady
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« Reply #10 on: August 19, 2007, 04:58:34 PM »

When i was first put on Sensipar, i had the hardest time getting it approved. 

having on idea what type of prescription insurance you have, i can't really comment, however i've never had any difficulty getting any prescription filled, including the sensipar. sensipar and renegel are the only name brands i take, everything else has a generic.
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If you can smile when things go wrong, you have someone in mind to blame.

Lead me not into temptation, I can find it myself.

Life isn't about waiting for the storm to pass, it's about learning how to dance in the rain.

Some mistakes are too much fun to only make once.

Meddle Not In The Affairs Of Dragons
For You Are Crunchy And Taste Good With Ketchup
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