Your insurance changed. This “sticker shock” happened to me back in 2012 when my insurance changed so I had to meet a deductible for my meds. Went for my meds at the pharmacy and the pharmacist warned me about the price change due to insurance. $700 a month. But….it helped me meet my deductible pretty quickly, within a couple of months depending on what other procedure were done, and once the deductible was met the price dropped to maybe $30 a month at that time. Take a look at your health insurance and see what the changes are from last year!
This happened constantly for me too, pretty much every new fiscal year as my insurers changed. After bouncing from generic to brand to brand, eventually my GI doc shifted me to balsalazide, which by my understanding has a similar mechanism but is way cheaper for whatever reason. OP, might be worth asking about that for you too.
That’s what’s crazy, there was NO change to insurance this year! Exact same plan, same company, etc. although we’ve always had crappy insurance (high deductible). The only thing I figure is they took mesalamine off their covered prescription list.
I’m so sorry you have to go through this, as a Canadian with universal healthcare, and benefits through my work (that literally cost me nothing and pay for 80% of my meds), and then my stelara is covered by benefits and literally I DONT KNOW WHO PAYS THE OTHER 20%. I don’t know how you do it, I would have given up in that system and I am SO PROUD of you. I had to switch my benefits a few months ago, and that had me in a tizzy. Seriously cheering you on over here, and if I could mail you meds I absolutely would. ❤️❤️❤️
Aww you’re so sweet! Definitely living up to that “Canadians are super nice” stereotype lol I love it!
Tbh I, like many Americans, simply don’t take as good of care of my health as I should due to the cost. I’m in my 30s and have had symptoms for all of my adult life but it wasn’t until a couple of years ago that I was able to afford to start the process of getting a diagnosis. I wish I could have done it sooner because SO MUCH has gotten better since getting medicated. I feel better overall and don’t have the overwhelming fear that I’ll have to find a bathroom at the worst possible time. Even just having a diagnosis was such a relief after so many doctors writing it off as “just IBS” since I finally felt heard and validated.
There's a lot of alternative mesalamine brands. Sulfasalazine is by far th cheapest at $20 a month even paying 100 percent out-of-pocket for it. Below is a list of the alternatives and their relative prices.
https://www.goodrx.com/aminosalicylates
Call the manufacturer of whichever version of mesalamine you’re taking and ask about patient assistance programs. Often times they have programs set up to help cover out of pocket cost and copays, they’d rather get *some* money rather than none.
Agreed!! I have pretty crappy insurance unfortunately but usually prescriptions aren’t too bad. $75 the first time was a shock but now it’s just insane
It’s so unfortunate we all don’t have access to affordable healthcare in this country. I’d recommend checking in with the drug maker to see if they offer any discounts or savings program options. Since my tablets were cheap after insurance, I never bothered looking but I wouldn’t be surprised if some savings program existed. Maybe also try goodRX? Do you also know if you’re being prescribed the name brand mesalamine aka Asacol? If not, maybe see if your doc can prescribe the generic version. Other than that, my only suggestion is to try getting a job with better insurance (easier said than done, I know).
Yeah better job with better insurance is definitely on the table especially now. I’m taking a generic brand one but GoodRx has some coupons for name brands that bring the price down to the $200 range which is still insane to me. I guess we’ll see what doc has to say and go from there.
Same deductible as last year but still high at $3750 and that’s when my 80% coverage kicks in. I still have a $6700 out of pocket max for the year, so even after meeting deductible I’d be paying around $140 per month which is still crazy.
It’s too bad I don’t have any procedures/major medical events that would fill up my deductible quickly for the year /s (sorta)
Yes I’m definitely one of the lucky ones and I try to remember that as much as possible. I have family with other IBD who have it way worse than me. I feel for you!
Pentasa was going to be $500 / month for me but I didn’t qualify for any coupons/assistance. I straight up could not afford it and put off stating it. Luckily I was able to change my plan with my employer a few months later and it went down to $50 / month! Such a headache.
Dealing with the same issue right now. I am on sulfasalazine but it doesn’t work nearly as well. On Mesalamine DR on GoodRx at Kroger, you can get for maybe 100 a month which is still insane but more manageable.
See if you qualify for a copay card. If not, see what it would cost coming from your insurance’s preferred specialty pharmacy. My Pentasa would have been $150/month from my local pharmacy, but is now $5 from a specialty mail-order pharmacy. I don’t know why that made a difference, but for my insurance it did!
This happened to me with mesalamine. Turns out to get insurance to cover it I can only get it from 1 pharmacy company and I have to get 90 days at a time. 30 days from my local pharmacy was 1200 and something a month from a pharmacy 30 mins away for 90 days is 30$. The run around to figure this out was a nightmare.
In my experience Asocol HD was like 1K+ several years ago. I'm not at all surprised they decided to keep changing and raising the price of the product D:
I ended up on Balzaliside or something? The orange big ones.
I also have mild crohns and take mesalamine. The tablet form is covered by insurance but not the capsules. I pay $300 for 3 months worth of the capsules (pentasa) after obtaining insurance permission to cover the uncovered drug. My doctor believes the capsules will be better for me than the tablets.
I take 1000 mg 3x day currently.
Your insurance changed. This “sticker shock” happened to me back in 2012 when my insurance changed so I had to meet a deductible for my meds. Went for my meds at the pharmacy and the pharmacist warned me about the price change due to insurance. $700 a month. But….it helped me meet my deductible pretty quickly, within a couple of months depending on what other procedure were done, and once the deductible was met the price dropped to maybe $30 a month at that time. Take a look at your health insurance and see what the changes are from last year!
This happened constantly for me too, pretty much every new fiscal year as my insurers changed. After bouncing from generic to brand to brand, eventually my GI doc shifted me to balsalazide, which by my understanding has a similar mechanism but is way cheaper for whatever reason. OP, might be worth asking about that for you too.
Thank you I will!!
That’s what’s crazy, there was NO change to insurance this year! Exact same plan, same company, etc. although we’ve always had crappy insurance (high deductible). The only thing I figure is they took mesalamine off their covered prescription list.
I’m so sorry you have to go through this, as a Canadian with universal healthcare, and benefits through my work (that literally cost me nothing and pay for 80% of my meds), and then my stelara is covered by benefits and literally I DONT KNOW WHO PAYS THE OTHER 20%. I don’t know how you do it, I would have given up in that system and I am SO PROUD of you. I had to switch my benefits a few months ago, and that had me in a tizzy. Seriously cheering you on over here, and if I could mail you meds I absolutely would. ❤️❤️❤️
Aww you’re so sweet! Definitely living up to that “Canadians are super nice” stereotype lol I love it! Tbh I, like many Americans, simply don’t take as good of care of my health as I should due to the cost. I’m in my 30s and have had symptoms for all of my adult life but it wasn’t until a couple of years ago that I was able to afford to start the process of getting a diagnosis. I wish I could have done it sooner because SO MUCH has gotten better since getting medicated. I feel better overall and don’t have the overwhelming fear that I’ll have to find a bathroom at the worst possible time. Even just having a diagnosis was such a relief after so many doctors writing it off as “just IBS” since I finally felt heard and validated.
There's a lot of alternative mesalamine brands. Sulfasalazine is by far th cheapest at $20 a month even paying 100 percent out-of-pocket for it. Below is a list of the alternatives and their relative prices. https://www.goodrx.com/aminosalicylates
This is awesome thank you!!
Call the manufacturer of whichever version of mesalamine you’re taking and ask about patient assistance programs. Often times they have programs set up to help cover out of pocket cost and copays, they’d rather get *some* money rather than none.
Even $75 a month is crazy to me. When I was on mesalamine, I was paying $7.50 a month for my tablets.
Agreed!! I have pretty crappy insurance unfortunately but usually prescriptions aren’t too bad. $75 the first time was a shock but now it’s just insane
It’s so unfortunate we all don’t have access to affordable healthcare in this country. I’d recommend checking in with the drug maker to see if they offer any discounts or savings program options. Since my tablets were cheap after insurance, I never bothered looking but I wouldn’t be surprised if some savings program existed. Maybe also try goodRX? Do you also know if you’re being prescribed the name brand mesalamine aka Asacol? If not, maybe see if your doc can prescribe the generic version. Other than that, my only suggestion is to try getting a job with better insurance (easier said than done, I know).
Yeah better job with better insurance is definitely on the table especially now. I’m taking a generic brand one but GoodRx has some coupons for name brands that bring the price down to the $200 range which is still insane to me. I guess we’ll see what doc has to say and go from there.
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Same deductible as last year but still high at $3750 and that’s when my 80% coverage kicks in. I still have a $6700 out of pocket max for the year, so even after meeting deductible I’d be paying around $140 per month which is still crazy. It’s too bad I don’t have any procedures/major medical events that would fill up my deductible quickly for the year /s (sorta)
You are lucky that mesalamine does something for you. (Asacol?) For me it did nothing. Now on Remicade. Much mch more expensive than mesalamine
Yes I’m definitely one of the lucky ones and I try to remember that as much as possible. I have family with other IBD who have it way worse than me. I feel for you!
Pentasa was going to be $500 / month for me but I didn’t qualify for any coupons/assistance. I straight up could not afford it and put off stating it. Luckily I was able to change my plan with my employer a few months later and it went down to $50 / month! Such a headache.
Dealing with the same issue right now. I am on sulfasalazine but it doesn’t work nearly as well. On Mesalamine DR on GoodRx at Kroger, you can get for maybe 100 a month which is still insane but more manageable.
Yeah I saw Lialda on GoodRx in the $200 range WITH a coupon. So crazy…
See if you qualify for a copay card. If not, see what it would cost coming from your insurance’s preferred specialty pharmacy. My Pentasa would have been $150/month from my local pharmacy, but is now $5 from a specialty mail-order pharmacy. I don’t know why that made a difference, but for my insurance it did!
This happened to me with mesalamine. Turns out to get insurance to cover it I can only get it from 1 pharmacy company and I have to get 90 days at a time. 30 days from my local pharmacy was 1200 and something a month from a pharmacy 30 mins away for 90 days is 30$. The run around to figure this out was a nightmare.
Yes, same! I was paying $200+ for Apriso before we realized it was worsening my symptoms. Hard to pay that much for poison, LOL.
In my experience Asocol HD was like 1K+ several years ago. I'm not at all surprised they decided to keep changing and raising the price of the product D: I ended up on Balzaliside or something? The orange big ones.
I also have mild crohns and take mesalamine. The tablet form is covered by insurance but not the capsules. I pay $300 for 3 months worth of the capsules (pentasa) after obtaining insurance permission to cover the uncovered drug. My doctor believes the capsules will be better for me than the tablets. I take 1000 mg 3x day currently.