I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: chuckdims on January 20, 2015, 10:36:41 AM
-
Why the hell does Aetna require me to get my Sensipar from their pharmacy? It is such a pain in the ass. I get all my medicines from the same pharmacy but now they require me to get it from them.
They say because it is a "specialty drug" and they want to give me their team of pharmacists and nurses on my side. Bull. Shit. They want to pay themselves for it rather than somebody else so they make more money.
Also, how is my Renvela not considered to be a speciality drug? What is a specialty drug if Renvela isn't one?
Sometimes I hate Aetna. I let them know. Of course, they didn't care.
Ok, that's the end of my rant.
-
Mine is the same. I have BCBS and use Express Scripts. I have to use their specialty pharmacy for Sensipar. Reminds me - I need to place an order. blah.
-
I just got jerked around by CVS Caremark for the same thing. I always got my tacrolimus and mycophenelate through CVS local pharmacy. I always ordered with plenty of lead time and there were never any supply problems. I got shoved into the specialty pharmacy for these two drugs for 2015. Now I have to worry about mail order. I didn't do mail order for a REASON. I do not want my medications sitting in my mailbox and I also do not want my inept company mailroom handling them.
The damn drugs are only $25 each per 90 day script so having a specialty team handling them is like shooting a fly with a cannon.
-
My wife works at CVS and so I had her check the cash prices. The Sensipar costs $710.99 for 30 pills, but my monthly supply of Renvela costs $1,959.99. So why on earth do they make me do the Sensipar through them but not the Renvela?
All my other meds are either through the Fresenius Pharmacy or another one (can't remember the name) that sends the meds directly to my clinic and I get them each month from my nurse. With both, I do nothing and the meds either get mailed automatically or I just pick them up at my clinic appointment. Now I have to refill my Sensipar each month! I know that's a small thing to bitch about...
By the way, the best part of the Fresinius Pharmacy is that they do not charge me a co-pay for my Renvela. I don't know why. I think it's a mistake, but I've never pointed it out to them...
-
The damn drugs are only $25 each per 90 day script so having a specialty team handling them is like shooting a fly with a cannon.
Is the "only $25" your copay or the drug cost? Ask what the cash price is.
Now I have to refill my Sensipar each month!
The shorter refill time is so the supplier will save drugs costs if you die, or you are taken off the drug, before the 90 days on a longer Rx is up. Same reason some clinics have their suppliers rebox dialysis needles into smaller boxes of 50 (fortunately, my clinic has the warehouse ship me an entire box of 250 or 300 when I order them)
Why the hell does Aetna require me to get my Sensipar from their pharmacy? ..... They want to pay themselves for it rather than somebody else so they make more money.
Answering your own question.
-
The damn drugs are only $25 each per 90 day script so having a specialty team handling them is like shooting a fly with a cannon.
Is the "only $25" your copay or the drug cost? Ask what the cash price is.
If it's like mine, it's about $25 per tablet. My co-pay is a couple hundred dollars.
Now I have to refill my Sensipar each month!
The shorter refill time is so the supplier will save drugs costs if you die, or you are taken off the drug, before the 90 days on a longer Rx is up. Same reason some clinics have their suppliers rebox dialysis needles into smaller boxes of 50 (fortunately, my clinic has the warehouse ship me an entire box of 250 or 300 when I order them)
I can still get a 90-day supply. It's just a hassle to call them when I need refills instead of doing it online through Express Scripts. Wait on hold. Verify everything every time. They ship it overnight or 2-day by FedEx instead of through regular mail like my other prescriptions.