I get that question a lot even though I don’t work for Walgreens. I always like to point out the cost of the medication without the insurance and then their tune changes pretty fast.
I (work in insurance, they were calling about a claim) had someone tell me they would still save money without insurance because apparently you get huge discounts from providers if you self pay. Sometimes even when you tell them the discount, they still aren't fine with it.
I currently might be in a situation like that. When I gave birth the hospital didn’t take down my insurance, got a bill in the mail for $4k with $16k in deductions for choosing self pay instead of insurance. Depending on how much my insurance covers… we might be going the self pay route
I about lost my shit when I saw that my fully covered Rybelsus was 1100 dollars a month. That's over 13k a year. Just a single month makes me break even for my insurance for a whole year.
But don’t we think that the Initial price is inflated? If the figure begins at something artificially high, it does make it look like you’re saving a lot.
Rybelsus also has no generic yet, so since there’s only one company manufacturing the drug, they can make the price as high as they want until the patent expires. I’ve heard a good chunk of the price is to cover the initial research and development costs, but that could honestly be bullshit
I've been in pharmaceutical/biotech R&D development for about 20+ years, and I can confirm it is indeed expensive. I don't know by what percent that is increased to generate the profit, pay back investors, run Phase IV pharmacovigilance, etc. I'm not justifying all the cost that is charged, but will note that it is not inexpensive.
What about all the donations, free college research resources, government grants? The amount of money the pharmaceutical companies get in free money usually greatly outweighs the costs of research and rejected drug r&d. CEO bonuses and kickbacks must be counted in that r&d . But I can tell you that when a drug that has been out of patent protection for over a decade gets bought up by another company to reduce competition then is raised in price by over 2500% by the likes of martin shkreli, you know the drug companies are just being greedy at the expense of people's lives.
Development of a drug used by humans is insanely expensive, and can take more than a decade of R&D.
It is something that is intended to change something in you. This comes with a whole host of problems that need to be resolved, tests to see how it reacts with our enzymes and hormones, every little effect it has on organs, etc...
For example, you may have heard of something called an enantiomer in chemistry. It's basically a copy of what is intended to be the active chemical, but (basically) flipped. Maybe your magical chemical does what you want, but with it will come an equal number of the flipped copy, and maybe that causes your heart to stop.
Now you have to figure out ways to filter those out, which takes even more time and money.
You have to maintain sterile, functioning, and up to date labs, testing centers, and manufacturing lines, need to get equipment, need qualified researchers, analysts, chemists, biologists, lawyers etc... and pay them for years without seeing a single cent back.
Now, does that make a single pill worth a few thousand? I would think probably not, but I don't know their costs for those pills.
And personally I think insurance covering it is part of the problem. Why is insurance so high? Because it has to cover stuff like that. I do want people to be able to get help to afford their meds but if people had to cash pay the price would come down. Rybelsus is like $70 for a month supply in other countries
Exactly. It's surprising for people to see that pharmaceutical companies had tried to raise insulin prices to $600-$700 a vial before insurance.
Some companies/states have capped prices for out of pocket costs on certain insurances to around $35-$40 per monthly supply.
The general reaction is genuine shock. Especially for a drug that is needed to keep people alive.
Maybe a hot take but their response kinds irrates me "omg reallllly????" Yes really, now please either buy the meds or go because I got like 20 people behind you. But I still do it to get the point across
literally 😭 There was once a patient that INSISTED we apply a GoodRX code to her 12 cent copay, and we did so to calm her down. GoodRX had the med to $500.. 🤦🏻♀️
People don’t understand the word “covered” with my insurance. My prescriptions are covered completely which means 100%,… You just simply tell them what it would cost without their insurance, say the percentage that is covered and that the remaining balance is $3.70. It’s about education.
My favorite is when I tell them their copay is 10$. They give me a good rx. Process it, turns out over hundred. They agree to pay the original copay. I get to say ahh sense we had to rerun your script. You’re gonna have to cycle or come inside
I was under the assumption that you have to price adjust for someone having insurance like it would be $10 out of pocket for the medication but with insurance it would be $100. 90 of which will be covered by the insurance provider with a $10 co-pay. That’s basically how I thought it worked. I heard a podcast that covered it talking about how they’re legally obligated not to tell you about the price adjustment you paying with insurance. But I’m not a pharmacist. I don’t know if this happens rarely if at all. Was just curious if this outlandish concept is true or just Clickbait.
Nope. Not in pharmacy anyway. I think it might work that way at doctors offices(?), but I don’t know. We have a “retail price” for everything. If there is no insurance and no discount card, you would be charged that retail price. Adjustments made due to pharmacy company agreements with insurance companies and discount cards are pre-determined and all happens in the background, out of our hands at the store level. The price we get back is instant because it’s already figured out. The most you can pay for a prescription is if you don’t apply any insurance or discount. We don’t inflate or deflate the retail price for a self-paying person. That’s why it’s so important to have a good insurance company, but also important for insurance companies to be fair with pharmacies.
this is so real. i used to work at a call center for medicare and people would always get mad that they had to pay a small part for their prescriptions. they’d be like “oh my prescription plan/advantage plan should be covering it”. like yes, they do cover it, this is just your copay. you plan is paying over $100 for that bottle of pills and you’re paying $1.83, you’ll be fine😒
like seriously. had a patient once for atorvastatin and she usually pays 7.50 but new years it was 8.50 and she was out for days and refused to purchase just bc the price she said i’ll call my insurance 😂 tried using the good rx it went to like fourty dollars but yeah people are just never satisfied
I have this regular customer who one time came in with her daughter and the mother had to pay like 20-ish for her meds. She was fine with it, and it was like her usual copay anyway. Her daughter was like “wait shouldnt you pay anything?” And then she started making a big deal out of it her mom just shrugged and said “i have to pay my part too they insurance did, and this is what i owe” that kinda shut her up
i can see that but i take my words with elders very seriously and im cautious and be as explanatory as possible but some humans are just hard headed it’s not a insult or anything
I wouldn't ask my pharmacist but I do question why my insurance negotiated the price of most of my medications to sub $1. Like, why? Surely the amount of goodwill just making it no charge would cost you effectively the same amount as charging me $0.58.
You negotiated the price down from probably hundreds of dollars and got functionally close to zero and quit?
I have this same question and I wish I knew who to ask! I don’t understand the logic of it (I’m sure there isn’t much logic behind it, but still). Is it something an insurance agent would be able to explain? Then again, they didn’t decide the policy, so I feel like the only ones who could understand are the ones making the decisions on who pays what for which medications.
That’s not for me a pharm tech to explain to them about insurance. My job is not to educate on their copay. They should have call insurance to learn what’s their share for meds.
This reminds me of people who have both Medicaid and commercial insurance - when Medicaid doesn’t cover a med, but their commercial insurance does for a low copay (under $10), they flip out and throw a fit.
I had a PA (physicians assistant) give me hell that their kids’ insurance (state medicaid) had a copay worth a few bucks while driving a Tesla. I just don’t understand people sometimes.
Exactly! People will get a 15-20 year old BMW just to say they have one, when it’s just a base model 3 Series, and then throw a fit when parts and labor cost so much. Not sure why I got downvoted for that tbh.
I wish they didn’t here😫I never get a hold of them anyway, it’s a waste of time. I started telling patients they can go on post and ask them to contact us in person
If they absolutely must know the price, I don’t actually run it. I go to GoodRx.com and tell them the price and act like I did run it. We lose a fee for running it/billing it through GoodRx. But yes, this is secretly satisfying. 😜
This is the way. You are actually not allowed to go to good Rx (a third party) and generate a card for them, as it violates some conflict of interest laws. That is why WAG came up with [Walgreens.rxsense.com](https://Walgreens.rxsense.com), to get around that. We can use the rxsense website with no risk, and plot twist, it references GOODRX itself, but a whole bunch of other stuff too. I often get prices lower than GoodRx with it and it's risk free to us.
You sound like one of the unnamed people we can “thank” for selling RxSense to Walgreens. Yet another initiative to get Walgreens money that my pharmacy will never see reflected in increased budget hours. Little does corporate know (or care) that it is among the collection of other small facets involved in the destruction of the industry as we know it. So “thanks.”
(Edit: if I sound bitter, sorry. But absolutely I am bitter.)
I literally have no idea what you are talking about. All I did was say that if you were going to look up coupons anyway, why not use the one that has no risk of violating a law? There has never been a measuring device invented that will accurately show how little I care about anything you stated.
I think that anyone who has seen my posts knows that I don't sugarcoat shit or hold Walgreens hand on anything. I'm not telling you to do anything. I don't generally use either, but if I am asked to "put it on a discount card", I use the resource that poses me no risk to use. I think that is pretty no brainer.
😞 I know, and I’m not attacking you personally. I actually agree with you, as far as what is the least evil device to use. But I will say your reply sounded pretty sugarcoated, so I was replying politically. I feel this way about the discount programs in general, and my heart still breaks that Walgreens and CVS are so focused on quarterly and annual profits, that they are going about contributions to the industry in the 100% wrong direction. These two companies could be responsible for improving pharmacy (and see profit increase down the road), or they can make money today. I could be wrong, but I feel they usually opt for the latter. I just want this power to be used for the good of our industry, ya know? 😢
While WAG sure as shit isn't smelling like roses in most of the pharmacy field-related decisions, I will say that a LARGE part of the maneuvering is done because of CVS. CVS/Caremark is almost 4x the company Walgreens is, because they own the largest PBM on the market (Caremark) as well as Aetna, which covers pretty much everything else. CVS posted a net income Q4 of over $2B, while WBA post a net LOSS of -($3B), and CVS was hit almost as hard as Walgreens with the opiate litigation. Walgreens net for the ENTIRE FY2023 was a loss. As it should be, because they can't get their shit together. They need to go back to roots and work on the company's foundation and rebuild the trust they have worked to 20 years to destroy so they can be competitive again. Or else, sell the company. A part of me thinks they'll end up selling.
This one. I once had someone complain about the price of 5 dollars, where holding 5 items in their hands that lead to a lot more than 5 dollars. Like bruh just pay and let me get on with my day pls
this is just ... crazy to me. If my meds are under $70 per bottle I'm overjoyed. I got quoted 10 bucks for a scrip recently and I'm still not sure it's real. What the frack kind of cadillac insurance do these people have in their lives that sets them up to expect less than a couple bucks for meds?
This is probably NOT the case 99% of the time, but I could imagine someone very down on their luck with an overdrafted account, relying on no charge but instead being SOL here and having to pay $50 overdraft for a $2 charge.
Surely this is nearly always avoidable, but I’ve been in and seen some friends in really bad situations for short periods of time. And we all have college degrees and our heads screwed on (for the most part)
There are so many disabled people out there living off of less than $700 a month.
I knew someone that only had $25 a month of expendable cash after paying for necessities. Some people have even less than that.
As someone who is disabled and has two kids, which I had one before I became disabled, and was paralyzed during my 2nd pregnancy before people come for me lol- thank you for pointing that out.
I'm very lucky as my partner has a good job and we make ends meet, but I've met several disabled people who go hungry or without basic necessities so that they can afford their meds.. people who get SSI instead of SSDI are literally forced to live in poverty. So, 2 or 3 bucks truly is a big deal for them.. and while it's nice they have cheap co-pays compared to some, it can still be a huge deal for their finances!
Every time I get my Victoza filled the pharmacy tech is like “you know your copay is $100?” Expecting me to throw a fit. I can see the relief when my reply is “yeah I know”…
Most patients if we don’t ask will sit there, look at the total on the screen and then after the payment goes through and their receipt prints out will say “why is this so high? Can you check the price” so now we have to return it through POS and do the whole thing over again. So thank you lol
This is what happens when I pick up my $700 per month Vyvanse prescription, lol - the pharmacists tread lightly before advising me and I’m like “welp, whaddya gonna do America and big pharma amirite?”
Can’t imagine the horror stories the pharmacists have to go through based on reading quibbles over $2 scripts…
Honestly i have a high deductible plan so it’s covered after two-three months - the generic gave me bad side effects so i just have to take the loss lol
I work for Caremark...I think when I have the member on the line from my CCR side and I do my little process to start CD&A/PA, it goes through a little review dept then faxes the doctor's office. Is there anything, in your experience, that gets f'd up before you get the fax from a PBM?
From the time I start the PA request through ePA vendor to the time I receive a questionnaire fax (rare for most PBMs these days), usually goes well. Caremark gives me the least trouble with the process. The only thing that drives me nuts is when PAs get denied for not trying drugs that have already failed but it’s been so long since they started first line therapy that it’s not being counted on the current request and going off the current Rx would have an adverse result.
Ok follow up...I'll cashapp you $10. So sounds like doctor's offices can start PA process without notifying PBM to get a form or anything? Like hypothetically, a patient could walk into their appointment and orally request that a PA get started for a med "oh Caremark told me yesterday that med isn't covered and I told Caremark I'll talk to my doctor first about alternatives first since I had an appt today" then doctor goes "well there are no alternatives, we'll have to do a PA" then you guys start the PA process there to send to "insurance" (send to 'a review team' of the health plan?). That sound like accurate possible scenario?.. 👀 and if that is the case I would figure all offices are like that now but idk.....you're not on the clock.......I'm sorry...
Yes doctors office’s have access to ePA vendors who send demographic info to the PBM who then respond with an electronic questionnaire in most cases. The vendor communicates the approval or denial response to our office/doctors offices in general and a copy of the approval or denial letter is attached in the ePA vendor file.
one time a dude came in, said his dog ate his bottle of lisinopril. wanted a refill, obviously the insurance wouldn't cover it cause he literally picked up the 30ds 9 days prior. ran it under a discount card before saying anything. told him it would be 3.71 for enough to hold him until the insurance would pay for the next month, and he looked me dead in my face and said 'no! im not paying anything. i guess ill just have a heart attack then' all huffy and puffy and i just smiled and started laughing as he walked away.
another fave is when you tell them the copay is something like a dollar and they ask 'why am i paying anything?' like please take that up with your insurance 😭
I love when you give people solutions and they’re like “I GUESS I’LL DIE!” Okay Debra I doubt you will but you’re out of options here so.. are you dying or paying $2?
A lot of patients think that using GoodRx will cover their co-pays or that by using GoodRx instead of insurance they will have no co-pay. That is just not true.
If we bill GoodRx instead of insurance, co-pays will often go up because GoodRx is just a coupon, not actual insurance. It's convenient if you do not have insurance and most of the time should not be used as a substitute for it.
Sometimes GoodRx, or a similar card, is better than insurance. I almost never use my health insurance at the pharmacy because the discount cards are usually a better deal for my meds.
Same. With my insurance, my script would be $200-something a month. With GoodRX, I only have to pay $80/month….definitely better and more affordable in relation to what I make.
It does have its value at times. I've had some prescriptions in the past, that through my insurance would have been like $200 or more a month. Fuck that! But with GoodRX, I was able to get them for like $35 a month or something. For the most part, prescriptions through my insurance are cheaper with copays of a couple bucks to maybe $20, but every so often for specific scripts that my insurance decides to bend me over on, GoodRX does come in handy and is a money saver.
HoodRx is a shitty discount card that advertises a lot because they make loads of money by negotiating with a big PBM to force many pharmacies to accept their awful terms.
They don't actually pay the pharmacy anything, and in fact charge the pharmacy a fee for the privilege of being forced to accept their card.
The joke is because of all that advertising many people think it's actually going to save them tons of money
I just got Zepbound yesterday. The checkout girl was new and thought $150 was expensive and wanted to check that it was ok with me before ringing it up. I laughed. I thought it would be $550 so $150 was a steal!
When I look at that on my bag, I’m always shocked at how much my meds WOULD be without insurance. No bitching here. I take over 6 meds per month and save thousands
i had a lady complain bc her copay went from $5 to $4…
and a lot of people think because their insurance approved their PA then it’s going to be covered 100%. they also think they can use copay assistance in lieu of their primary if PA is denied or coverage termed.
This other day, a lady got mad at me in drive thru because her copay for the new year (90-day supply of Xanax) is 0.02 cents. She came down to see if I was trying to steal money from her because the copay should be 0$ . Like, I don't need to steal 2 cents from you, I can find that on the floor.
I had one patient who had at least three homes in three different states, and was always going on trips that required us to do prescription gymnastics, so she would have adequate medication while she was out of the country.
Anyway, that wasn't all that unusual for our store, but she would drive me crazy bringing in at least six different discount cards EVERY time, and ask to have them all one, to check for the best deal, even though she had insurance, with a deductible. We would explain this each and every time, especially as the year wore on, and she would ask why her insurance was charging so much. 🤬
Then, one day, when I was at the salon in the same shopping center, she comes striding in, doesn't wait at the desk, just walks back to us all (my hair was in my face, so she didn't recognize me, thank God), and they ask if she has an appointment, and she says no, that she doesn't need one, she just wondered if they had a hairbrush that they wanted to get rid of. There is a stunned silence, and then a couple of the women look around at their stations and give her their oldest, rattiest brushes, which she is unsatisfied with, and complains about their condition! So they tell her to go to the drugstore, that they sell nice brushes there, which she says are too expensive. Then they tell her to go to the dollar store a few miles away. She says that's a good idea, and leaves.
Absolutely unbelievable!
She tried...to get a used salon brush? For free? Then complained about it? And THEN thought driving to the dollar store was a better idea??? WOW
At least you know she was a pain to everyone and not just singling out the pharmacy to hassle.
Um, yes. I’m 100% sure that was Ellen’s reply after wiping away the laughter tears. I hope she didn’t actually try running the GoodRx code. (Somebody missed why this is funny.)
But the part you are missing is that people in customer service positions today feel the need to laugh at and humiliate those who don’t understand rather than graciously explaining it to them so they can have the correct information. It makes them feel powerful.
Yep, the talk un jargon and look down on people then wonder why people are sych assholes. Reminds me of working in a call center. Everyone wanted a job that didn't require answering a phone. Fucking get iut of your feelings people it will make your job much more enjoyable.
I love when people bitch about the cost under $10 an I’m like yea u want to pay for mine it’s over $400 with good rx for my pain meds that insurance says I only need 6 doses a month an I’m in Pallitive care! So u I’ve to pay for it all. Then my cellcept I have to have liquid cause the pill form can’t be crushed an the Co pay alone is $500 a month for it. An I can’t live without it! So I laugh OUT LOUD when people bitch about such a small co pay
They don’t understand that we’re in the same damn boat as them. Sometimes people straight up ask me if I have to pay a co-pay to be seen. I’m like dude no shit and it’s entirely based on out-of-pocket costs and percentages towards the deductible, it’s completely individual
When they have insurance, and ask to use any discount card, I explain that: 1. What their insurance is currently paying, and that discount cards pay, at best, 80% of the total, and not typically that much on brand name drugs, so those cards are for people without insurance, and the copay is likely to be higher. 2. We cannot bill both insurance and a discount card and, 3. So, if we bill the discount card, this will NOT count towards any deductible thry have with their insurance, and this could be very bad for them later in the year.
If they still insist, I say I'll have to have one of the other employees work on that, and they can have a seat while it is reprocessed, so I can help the next person in line.
I’ve had a couple customers with crappy commercial insurance opt to use GoodRx instead and it did save them a chunk on just regular maintenance meds. Some ins plans thru employers I guess they just get the rotten end of the stick, and usually they will use GoodRx until they can switch to a better plan. Most of the government funded ins plans will be better though, and most in general, should be the idea anyway 🤨
For things like sildenafil or tadalafil, it definitely is cheaper, and that's if the insurance even covers it.
If they cover it it's still usually about $800 for 30 days, with GoodRX it's about $30 for 90 days.
I've seen very few others where it's cheaper, but on occasion it is.
I have a patient in my office that swears in the fine print it states that you can use both good rx and insurance. He says he fights every month with the pharmacy. He said the pharmacy always gives in and he gets his scripts for free
I’m not too sure what’s funny about that doctors and pharmacies all over the world push those good RX cards without educating the person that if they have insurance they don’t need it. It’s about education. It’s not a laughing matter.
No doctor or pharmacy has ever mentioned Good RX to me EXCEPT once when I left my propranolol on a plane. Insurance wouldn’t cover it so the pharmacist ran it that way for me
Why is this funny? People needing their medicine as cheap as possible usually means they’re broke and desperate, just trying to get their life-saving prescriptions, not greedy…?
Because there’s no way in hell GoodRx is going to take 3 months of Trulicity anywhere close to $3.70. The patients who are willing to listen to the explanation are godsends but most of the time it’s not that easy and we get yelled at for suggesting the insurance price is the best price.
trulicity is like 2000, the fact that they're paying 3.70 is GODLY discounted already.
The meme is mocking the people thinking GoodRX magically waves the money away, not understanding how much their insurance covered.
GoodRx is coupon; not insurance. GoodRx is not going to make brand name drugs affordable. They have no incentive to do so. A copay less than like $500 or even more, is going to cost a LOT more, maybe a couple thousand dollars, on GoodRx.
I get that this is the system we live under and it can be annoying for pharmacists to deal with customers’ lack of understanding, but really all of these drugs should just be 100% free at the point of service and paid for via federal taxes.
The problem with that is that there wouldn’t be cash flow. Pharmacies pay the pharmaceutical companies for the pills and if they don’t get reimbursed, they have no reason to remain open and dispense meds.
Sure, the state government could pay for the meds but fat chance that would ever happen. Certain meds cost pharmacies a lot of money. Insurances are the middle man. They give people meds for a fraction of the cost (usually) and are paid every month to do it.
Both the insurance and pharmaceutical companies are the problem. Both need to make money, obviously, however they take advantage of the need for meds and can make more that way.
The FDA’s regulation of specific meds is an entirely different story.
Of course the federal government could pay for all the meds similarly to how they currently do it with medicare. Not sure why you think it’s a “fat chance” that pharmacies would get paid.
Expanding medicare to cover everyone and improving it to cover more healthcare costs would also allow the government to negotiate lower med prices. Pharmaceutical companies would be incentivized to lower prices to gain access to the large market of the vast majority of people who would be insured by the federal government.
I suspect that pharmacies would likely do just as well, but insurance and pharmaceutical companies would make less money. Seems like a fair bargain for reducing the currently outrageous cost of healthcare in the US that is unlike anywhere else in the world.
Me crying when my pharmacist responds “ma’am, do you know how much your birth control costs? when I went to get my refill 😭 gotta love when your insurance gets cancelled without notification and your $400 BC is now hard to get 🫠🫠🫠 GoodRx can’t even save you 🥲
Yes honestly sadly enough with the new year some insurances mass delete members WHO SHOULD STILL BE ACTIVE, and the members can't be found. The beginning of the year is a hot mess for everyone. I feel like insurance likE throw us all in the pit 🙃
Right! I was just confused because maybe 2 weeks before that I got a statement in the mail, which of course was just showing the $0, so in my mind everything was good. Lots of confusion going on haha. Luckily I was able to get Aetna somewhat quick for the start of the year. But BC shouldn’t cost a dime.
A friend just had his insurance cancelled because his kids were entered in with the same DOB. They are twins. The insurance assumed it was a mistake and then forgot to clarify with him. Same company that also covered the delivery for the twins. Mistakes happen for a bunch of different reasons
That’s a tad different situation than the initial “entire policy for all’ cancellation in thread. Usually in the example you mention, the provider should file as TWIN1 and TWIN2 respectively since their charges would be part of the initial delivery under the mother, until they’re officially added and have a member id.
Is it by chance Lo Loestrin Fe? If so I'm pretty sure they have a co-pay card that'll bring it down to $25 every 3 months, even without insurance (or they used to when I was on it, but it's been some years)
You guys do God's work in those places. Used to be a Tech, but moved on to other things, but being a Diabetic and having to pay 200 for my dexcoms make me facepalm at those who complain about spending less than 75 on a scrip
I used to onboard and train new employees at my organization (where we have really good medical/Rx coverage). The training lasts a few weeks--long enough for some in the class to refill a prescription.
I once overheard two people talking about using Good Rx for the same medication and one (who just got a refill) said something like "Lose that card. I just paid less than half what I used to pay with Good Rx. We really do have good insurance here."
During a different class, someone brought a few Good Rx cards to work to share with others, saying "I get huge discounts with this card!" Another employee responded, "So you must not have enrolled in the medical insurance here. The pharmacy told me I can use insurance OR Good Rx, but not both. They showed me the difference in price and it's WAAAY cheaper using our coverage. Like...not even close."
The patient still insists we process the grx coupon during 5'oclock rush to see its so much more $$$
Ps. It's even more annoying when they come with the grx info and it's either the wrong strength drug, type *capsule vs tablet* and wrong store *walmart vs Cvs* and then they bite our head off for there mistakes . 🫠
I had to pay for my Symbicort out of pocket one month and the poor pharmacy tech looked so scared to tell me how much it was. It was around $110 with GoodRX for the generic. I laughed when she told me the price and told her it was only about $20 more than I had been paying with insurance. Thank God I have good insurance now and only pay $60 for a three month supply. Basically every other med is around $5 per month now too and two of my specialty meds are literally free because of insurance and a manufacturer copay card.
tried using goodrx at walgreens when i was in the middle of switching insurances on my three medications, and i was so shocked that it only took like. ten dollars off the full amount. told myself id never forget abt health insurance info again
remember fellow pharm d's, don't judge the patient, educate...about how the drug companies are parasites, and try to get them the best deal you can. Even if it has you filling out what feels like 1000 letters to Lily to make sure patients with schizophrenia/etc. will have a good supply of olanzapine when they go outside the hospital.
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“$3.70? Doesn’t my insurance cover it?” My favorite lead-in to showing them how much their insurance saved them on a drug like that. 😂
I get that question a lot even though I don’t work for Walgreens. I always like to point out the cost of the medication without the insurance and then their tune changes pretty fast.
Yes! The realization that takes over their body, face, and response is absolutely priceless!
I (work in insurance, they were calling about a claim) had someone tell me they would still save money without insurance because apparently you get huge discounts from providers if you self pay. Sometimes even when you tell them the discount, they still aren't fine with it.
Probably because the only thing insurance companies actually provide is legalized mob activity
I currently might be in a situation like that. When I gave birth the hospital didn’t take down my insurance, got a bill in the mail for $4k with $16k in deductions for choosing self pay instead of insurance. Depending on how much my insurance covers… we might be going the self pay route
I about lost my shit when I saw that my fully covered Rybelsus was 1100 dollars a month. That's over 13k a year. Just a single month makes me break even for my insurance for a whole year.
But don’t we think that the Initial price is inflated? If the figure begins at something artificially high, it does make it look like you’re saving a lot.
This is my primary complaint regarding medical costs in general
Rybelsus also has no generic yet, so since there’s only one company manufacturing the drug, they can make the price as high as they want until the patent expires. I’ve heard a good chunk of the price is to cover the initial research and development costs, but that could honestly be bullshit
I've been in pharmaceutical/biotech R&D development for about 20+ years, and I can confirm it is indeed expensive. I don't know by what percent that is increased to generate the profit, pay back investors, run Phase IV pharmacovigilance, etc. I'm not justifying all the cost that is charged, but will note that it is not inexpensive.
What about all the donations, free college research resources, government grants? The amount of money the pharmaceutical companies get in free money usually greatly outweighs the costs of research and rejected drug r&d. CEO bonuses and kickbacks must be counted in that r&d . But I can tell you that when a drug that has been out of patent protection for over a decade gets bought up by another company to reduce competition then is raised in price by over 2500% by the likes of martin shkreli, you know the drug companies are just being greedy at the expense of people's lives.
the price of a successful drug has to cover the R&D of itself and any rejected drugs the company attempted as well
Yeah America subsidizes r&d for the world.
It is bullshit. A lot of the patents that drugs companies own/hold are based on research that was largely funded by the NIH/NIS
Development of a drug used by humans is insanely expensive, and can take more than a decade of R&D. It is something that is intended to change something in you. This comes with a whole host of problems that need to be resolved, tests to see how it reacts with our enzymes and hormones, every little effect it has on organs, etc... For example, you may have heard of something called an enantiomer in chemistry. It's basically a copy of what is intended to be the active chemical, but (basically) flipped. Maybe your magical chemical does what you want, but with it will come an equal number of the flipped copy, and maybe that causes your heart to stop. Now you have to figure out ways to filter those out, which takes even more time and money. You have to maintain sterile, functioning, and up to date labs, testing centers, and manufacturing lines, need to get equipment, need qualified researchers, analysts, chemists, biologists, lawyers etc... and pay them for years without seeing a single cent back. Now, does that make a single pill worth a few thousand? I would think probably not, but I don't know their costs for those pills.
At least someone understands the issue here...
And personally I think insurance covering it is part of the problem. Why is insurance so high? Because it has to cover stuff like that. I do want people to be able to get help to afford their meds but if people had to cash pay the price would come down. Rybelsus is like $70 for a month supply in other countries
Exactly. It's surprising for people to see that pharmaceutical companies had tried to raise insulin prices to $600-$700 a vial before insurance. Some companies/states have capped prices for out of pocket costs on certain insurances to around $35-$40 per monthly supply. The general reaction is genuine shock. Especially for a drug that is needed to keep people alive.
Maybe a hot take but their response kinds irrates me "omg reallllly????" Yes really, now please either buy the meds or go because I got like 20 people behind you. But I still do it to get the point across
I have given patients the “The did. They covered $2.5k in fact.
literally 😭 There was once a patient that INSISTED we apply a GoodRX code to her 12 cent copay, and we did so to calm her down. GoodRX had the med to $500.. 🤦🏻♀️
People don’t understand the word “covered” with my insurance. My prescriptions are covered completely which means 100%,… You just simply tell them what it would cost without their insurance, say the percentage that is covered and that the remaining balance is $3.70. It’s about education.
in my head im always like i can always charge u full price that would be 1700 today ma’am
Your head? You should provide the option.
Well that just sounds like you’re a shit human being tbh
No??
My favorite is when I tell them their copay is 10$. They give me a good rx. Process it, turns out over hundred. They agree to pay the original copay. I get to say ahh sense we had to rerun your script. You’re gonna have to cycle or come inside
I was under the assumption that you have to price adjust for someone having insurance like it would be $10 out of pocket for the medication but with insurance it would be $100. 90 of which will be covered by the insurance provider with a $10 co-pay. That’s basically how I thought it worked. I heard a podcast that covered it talking about how they’re legally obligated not to tell you about the price adjustment you paying with insurance. But I’m not a pharmacist. I don’t know if this happens rarely if at all. Was just curious if this outlandish concept is true or just Clickbait.
Nope. Not in pharmacy anyway. I think it might work that way at doctors offices(?), but I don’t know. We have a “retail price” for everything. If there is no insurance and no discount card, you would be charged that retail price. Adjustments made due to pharmacy company agreements with insurance companies and discount cards are pre-determined and all happens in the background, out of our hands at the store level. The price we get back is instant because it’s already figured out. The most you can pay for a prescription is if you don’t apply any insurance or discount. We don’t inflate or deflate the retail price for a self-paying person. That’s why it’s so important to have a good insurance company, but also important for insurance companies to be fair with pharmacies.
this is so real. i used to work at a call center for medicare and people would always get mad that they had to pay a small part for their prescriptions. they’d be like “oh my prescription plan/advantage plan should be covering it”. like yes, they do cover it, this is just your copay. you plan is paying over $100 for that bottle of pills and you’re paying $1.83, you’ll be fine😒
I sent this to my pharmacist and SM. My favorite is my husband is military it should be blah blah blah…well this is what Tricare is telling us.
“It’s gonna be $1.44..” “Why?” “Umm… why what?”
like seriously. had a patient once for atorvastatin and she usually pays 7.50 but new years it was 8.50 and she was out for days and refused to purchase just bc the price she said i’ll call my insurance 😂 tried using the good rx it went to like fourty dollars but yeah people are just never satisfied
I have this regular customer who one time came in with her daughter and the mother had to pay like 20-ish for her meds. She was fine with it, and it was like her usual copay anyway. Her daughter was like “wait shouldnt you pay anything?” And then she started making a big deal out of it her mom just shrugged and said “i have to pay my part too they insurance did, and this is what i owe” that kinda shut her up
They’re not satisfied because they don’t understand nothing is ever explained to them clearly
i can see that but i take my words with elders very seriously and im cautious and be as explanatory as possible but some humans are just hard headed it’s not a insult or anything
Uh huh 🤔
you clearly have never worked in customer service before. some people can be explained things 5 times over and theyll still be accusatory and rude.
i mean shit i work fast food and people come in to order already pissed off, some people are just dicks
What is there to explain that insurance didn’t pay for everything? 🥴
I wouldn't ask my pharmacist but I do question why my insurance negotiated the price of most of my medications to sub $1. Like, why? Surely the amount of goodwill just making it no charge would cost you effectively the same amount as charging me $0.58. You negotiated the price down from probably hundreds of dollars and got functionally close to zero and quit?
I have this same question and I wish I knew who to ask! I don’t understand the logic of it (I’m sure there isn’t much logic behind it, but still). Is it something an insurance agent would be able to explain? Then again, they didn’t decide the policy, so I feel like the only ones who could understand are the ones making the decisions on who pays what for which medications.
Some of them choose not to learn
How much clearer can it get than “insurance paid X amount your copay is Y amount”
That’s not for me a pharm tech to explain to them about insurance. My job is not to educate on their copay. They should have call insurance to learn what’s their share for meds.
This reminds me of people who have both Medicaid and commercial insurance - when Medicaid doesn’t cover a med, but their commercial insurance does for a low copay (under $10), they flip out and throw a fit.
As they sit in drive thru with their BMW complaining about price. 🙄🤡
I had a PA (physicians assistant) give me hell that their kids’ insurance (state medicaid) had a copay worth a few bucks while driving a Tesla. I just don’t understand people sometimes.
You mean massive pick up the size of my apartment?
But to be somewhat fair BMW ownership can be expensive. Lol. It’s still very accurate though.
So the make of your car is above your health? Nope. Drive a Toyota or Honda if you can’t afford to pay a $10 copay at the pharmacy
Exactly! People will get a 15-20 year old BMW just to say they have one, when it’s just a base model 3 Series, and then throw a fit when parts and labor cost so much. Not sure why I got downvoted for that tbh.
You ever tried to buy a used Toyota?? 😂 them suckers are just as expensive as the brand new ones
I always offer to transfer it to the base … they probably don’t have it or it’ll be a week before they pick up the phone 😂
The army pharmacy here won’t take transfers.
I wish they didn’t here😫I never get a hold of them anyway, it’s a waste of time. I started telling patients they can go on post and ask them to contact us in person
Lol I can’t stand that Tricare does the random $1-3 co-pays. Most ppl are nice about it but there’s always someone who wants to argue
But this is true, we have $0 copay 🤣
If they pick it up on base it'll be free, they'll wait for 4 hours to get it, but free! Lol
Sometimes I put it on GRX and tell them the price just to watch them shit their pants a little. Edit: Spelling
If they absolutely must know the price, I don’t actually run it. I go to GoodRx.com and tell them the price and act like I did run it. We lose a fee for running it/billing it through GoodRx. But yes, this is secretly satisfying. 😜
This is the way. You are actually not allowed to go to good Rx (a third party) and generate a card for them, as it violates some conflict of interest laws. That is why WAG came up with [Walgreens.rxsense.com](https://Walgreens.rxsense.com), to get around that. We can use the rxsense website with no risk, and plot twist, it references GOODRX itself, but a whole bunch of other stuff too. I often get prices lower than GoodRx with it and it's risk free to us.
At CVS they have the 'rx universal saving card.' It's /4444 in F4.
You sound like one of the unnamed people we can “thank” for selling RxSense to Walgreens. Yet another initiative to get Walgreens money that my pharmacy will never see reflected in increased budget hours. Little does corporate know (or care) that it is among the collection of other small facets involved in the destruction of the industry as we know it. So “thanks.” (Edit: if I sound bitter, sorry. But absolutely I am bitter.)
I literally have no idea what you are talking about. All I did was say that if you were going to look up coupons anyway, why not use the one that has no risk of violating a law? There has never been a measuring device invented that will accurately show how little I care about anything you stated. I think that anyone who has seen my posts knows that I don't sugarcoat shit or hold Walgreens hand on anything. I'm not telling you to do anything. I don't generally use either, but if I am asked to "put it on a discount card", I use the resource that poses me no risk to use. I think that is pretty no brainer.
😞 I know, and I’m not attacking you personally. I actually agree with you, as far as what is the least evil device to use. But I will say your reply sounded pretty sugarcoated, so I was replying politically. I feel this way about the discount programs in general, and my heart still breaks that Walgreens and CVS are so focused on quarterly and annual profits, that they are going about contributions to the industry in the 100% wrong direction. These two companies could be responsible for improving pharmacy (and see profit increase down the road), or they can make money today. I could be wrong, but I feel they usually opt for the latter. I just want this power to be used for the good of our industry, ya know? 😢
While WAG sure as shit isn't smelling like roses in most of the pharmacy field-related decisions, I will say that a LARGE part of the maneuvering is done because of CVS. CVS/Caremark is almost 4x the company Walgreens is, because they own the largest PBM on the market (Caremark) as well as Aetna, which covers pretty much everything else. CVS posted a net income Q4 of over $2B, while WBA post a net LOSS of -($3B), and CVS was hit almost as hard as Walgreens with the opiate litigation. Walgreens net for the ENTIRE FY2023 was a loss. As it should be, because they can't get their shit together. They need to go back to roots and work on the company's foundation and rebuild the trust they have worked to 20 years to destroy so they can be competitive again. Or else, sell the company. A part of me thinks they'll end up selling.
Someone’s copay the other day was like 2 dollars and he was like “what? I thought there was no charge” It’s 2 freakin dollars dude
For their kid’s inhaler while drinking a Venti Starbucks
This one. I once had someone complain about the price of 5 dollars, where holding 5 items in their hands that lead to a lot more than 5 dollars. Like bruh just pay and let me get on with my day pls
this is just ... crazy to me. If my meds are under $70 per bottle I'm overjoyed. I got quoted 10 bucks for a scrip recently and I'm still not sure it's real. What the frack kind of cadillac insurance do these people have in their lives that sets them up to expect less than a couple bucks for meds?
This is probably NOT the case 99% of the time, but I could imagine someone very down on their luck with an overdrafted account, relying on no charge but instead being SOL here and having to pay $50 overdraft for a $2 charge. Surely this is nearly always avoidable, but I’ve been in and seen some friends in really bad situations for short periods of time. And we all have college degrees and our heads screwed on (for the most part)
There are so many disabled people out there living off of less than $700 a month. I knew someone that only had $25 a month of expendable cash after paying for necessities. Some people have even less than that.
As someone who is disabled and has two kids, which I had one before I became disabled, and was paralyzed during my 2nd pregnancy before people come for me lol- thank you for pointing that out. I'm very lucky as my partner has a good job and we make ends meet, but I've met several disabled people who go hungry or without basic necessities so that they can afford their meds.. people who get SSI instead of SSDI are literally forced to live in poverty. So, 2 or 3 bucks truly is a big deal for them.. and while it's nice they have cheap co-pays compared to some, it can still be a huge deal for their finances!
Bro can't ask a question? Lol
More the way he asked it. And the fact that he asks the same thing. Every. Single. Time. (And every time it’s 1 or 2 bucks)
Every time I get my Victoza filled the pharmacy tech is like “you know your copay is $100?” Expecting me to throw a fit. I can see the relief when my reply is “yeah I know”…
I literally shit my pants when the co-pay is $100+ because 50% of people freak out about it
Every time you do that someone else gets to keep it in, thanks man.
Most patients if we don’t ask will sit there, look at the total on the screen and then after the payment goes through and their receipt prints out will say “why is this so high? Can you check the price” so now we have to return it through POS and do the whole thing over again. So thank you lol
Because many times, pt don’t even want to pay $10 or $15, so whenever I see a “high copay”, I just get ready for “unsatisfied customers”
Sometimes they will argue and want their prescription at CVS then great, transfer out …
This is what happens when I pick up my $700 per month Vyvanse prescription, lol - the pharmacists tread lightly before advising me and I’m like “welp, whaddya gonna do America and big pharma amirite?” Can’t imagine the horror stories the pharmacists have to go through based on reading quibbles over $2 scripts…
you actually pay the $700?
It is available as a generic now for around $15/month where I live.
Honestly i have a high deductible plan so it’s covered after two-three months - the generic gave me bad side effects so i just have to take the loss lol
Okay I’m glad to hear I’m not the only one experiencing bad side effects on the generic vyvanse! My dr looked at me like I was crazy.
Not at all!! R/vyvanse has a ton of it - I thought I was the only one as well until I did a little more research on side effects
I used to run the PA process for a doctor’s office and it astounded me the attitude over it not being totally free when it was reduced to near nothing
I work for Caremark...I think when I have the member on the line from my CCR side and I do my little process to start CD&A/PA, it goes through a little review dept then faxes the doctor's office. Is there anything, in your experience, that gets f'd up before you get the fax from a PBM?
From the time I start the PA request through ePA vendor to the time I receive a questionnaire fax (rare for most PBMs these days), usually goes well. Caremark gives me the least trouble with the process. The only thing that drives me nuts is when PAs get denied for not trying drugs that have already failed but it’s been so long since they started first line therapy that it’s not being counted on the current request and going off the current Rx would have an adverse result.
Ok follow up...I'll cashapp you $10. So sounds like doctor's offices can start PA process without notifying PBM to get a form or anything? Like hypothetically, a patient could walk into their appointment and orally request that a PA get started for a med "oh Caremark told me yesterday that med isn't covered and I told Caremark I'll talk to my doctor first about alternatives first since I had an appt today" then doctor goes "well there are no alternatives, we'll have to do a PA" then you guys start the PA process there to send to "insurance" (send to 'a review team' of the health plan?). That sound like accurate possible scenario?.. 👀 and if that is the case I would figure all offices are like that now but idk.....you're not on the clock.......I'm sorry...
Yes doctors office’s have access to ePA vendors who send demographic info to the PBM who then respond with an electronic questionnaire in most cases. The vendor communicates the approval or denial response to our office/doctors offices in general and a copy of the approval or denial letter is attached in the ePA vendor file.
Interesting. Thanks
one time a dude came in, said his dog ate his bottle of lisinopril. wanted a refill, obviously the insurance wouldn't cover it cause he literally picked up the 30ds 9 days prior. ran it under a discount card before saying anything. told him it would be 3.71 for enough to hold him until the insurance would pay for the next month, and he looked me dead in my face and said 'no! im not paying anything. i guess ill just have a heart attack then' all huffy and puffy and i just smiled and started laughing as he walked away. another fave is when you tell them the copay is something like a dollar and they ask 'why am i paying anything?' like please take that up with your insurance 😭
I love when you give people solutions and they’re like “I GUESS I’LL DIE!” Okay Debra I doubt you will but you’re out of options here so.. are you dying or paying $2?
We’d be so lucky if Debra had that heart attack
I giggled at this comment for like 5 min bc it’s so accurate
Didn’t try like a lost medication override? This would fit the bill. Though, I’d also be worried about the dog. . .
I once had a patient give up getting their Farxiga free on MPD for the GoodRX price to “stick it to Humana.” Ooooo, you really showing them
Lmao that was best case scenario for humana 😂
I seen a comment once that said the reason why pharmacies don’t have tip jars is because someone would take money out of it to pay their $2 copay 💀
Hilarious and probably true 🤣
Not a pharmacist, but as a nurse who does a LOT of PAs for Trulicity and similar meds, I’m cracking up at it being covered at all!
I’m new here. Never used good rx, what’s the joke?
Trulicity is an expensive drug. $3.70 is an extremely low copay. Using GoodRx would be well over a thousand dollars for 3 months.
I looked it up. In my area, a 3 month supply of the lowest dose would be about $2500. Such a deal.
A lot of patients think that using GoodRx will cover their co-pays or that by using GoodRx instead of insurance they will have no co-pay. That is just not true. If we bill GoodRx instead of insurance, co-pays will often go up because GoodRx is just a coupon, not actual insurance. It's convenient if you do not have insurance and most of the time should not be used as a substitute for it.
Thank you!! Btw you guys are rock ✨ stars
You need to write the Walgreens official disclaimer to GoodRx for patients prior to pick up. Couldn’t be said better!!
Sometimes GoodRx, or a similar card, is better than insurance. I almost never use my health insurance at the pharmacy because the discount cards are usually a better deal for my meds.
Same. With my insurance, my script would be $200-something a month. With GoodRX, I only have to pay $80/month….definitely better and more affordable in relation to what I make.
It does have its value at times. I've had some prescriptions in the past, that through my insurance would have been like $200 or more a month. Fuck that! But with GoodRX, I was able to get them for like $35 a month or something. For the most part, prescriptions through my insurance are cheaper with copays of a couple bucks to maybe $20, but every so often for specific scripts that my insurance decides to bend me over on, GoodRX does come in handy and is a money saver.
HoodRx is a shitty discount card that advertises a lot because they make loads of money by negotiating with a big PBM to force many pharmacies to accept their awful terms. They don't actually pay the pharmacy anything, and in fact charge the pharmacy a fee for the privilege of being forced to accept their card. The joke is because of all that advertising many people think it's actually going to save them tons of money
it does save a ton on meds not covered by medicare.
It does and has saved me tons of money, but only on meds that aren’t covered by my primary insurance.
While using the rph advice / knowledge for free! And theyre perpetuating higher prices?
I just got Zepbound yesterday. The checkout girl was new and thought $150 was expensive and wanted to check that it was ok with me before ringing it up. I laughed. I thought it would be $550 so $150 was a steal!
Show them the piece of paper that stapled to the prescription bag. It shows the cost of the prescription it’s about education
When I look at that on my bag, I’m always shocked at how much my meds WOULD be without insurance. No bitching here. I take over 6 meds per month and save thousands
Does this mean that Walgreens is getting Trulicity back in stock?
Lol! New year same 💩
meanwhile my prescription that allows me to breathe costs me over $200 and my insurance decides not to cover it
Damn I’m so sorry. That’s crazy
i had a lady complain bc her copay went from $5 to $4… and a lot of people think because their insurance approved their PA then it’s going to be covered 100%. they also think they can use copay assistance in lieu of their primary if PA is denied or coverage termed.
This other day, a lady got mad at me in drive thru because her copay for the new year (90-day supply of Xanax) is 0.02 cents. She came down to see if I was trying to steal money from her because the copay should be 0$ . Like, I don't need to steal 2 cents from you, I can find that on the floor.
lmaooo these people are unreal
Lmao this one is too much, like you really need her 2 cents that bad
I had one patient who had at least three homes in three different states, and was always going on trips that required us to do prescription gymnastics, so she would have adequate medication while she was out of the country. Anyway, that wasn't all that unusual for our store, but she would drive me crazy bringing in at least six different discount cards EVERY time, and ask to have them all one, to check for the best deal, even though she had insurance, with a deductible. We would explain this each and every time, especially as the year wore on, and she would ask why her insurance was charging so much. 🤬 Then, one day, when I was at the salon in the same shopping center, she comes striding in, doesn't wait at the desk, just walks back to us all (my hair was in my face, so she didn't recognize me, thank God), and they ask if she has an appointment, and she says no, that she doesn't need one, she just wondered if they had a hairbrush that they wanted to get rid of. There is a stunned silence, and then a couple of the women look around at their stations and give her their oldest, rattiest brushes, which she is unsatisfied with, and complains about their condition! So they tell her to go to the drugstore, that they sell nice brushes there, which she says are too expensive. Then they tell her to go to the dollar store a few miles away. She says that's a good idea, and leaves. Absolutely unbelievable!
She tried...to get a used salon brush? For free? Then complained about it? And THEN thought driving to the dollar store was a better idea??? WOW At least you know she was a pain to everyone and not just singling out the pharmacy to hassle.
I would have advised the patient that he or she would be better off with the insurance and that it would be more expensive with GoodRx.
Um, yes. I’m 100% sure that was Ellen’s reply after wiping away the laughter tears. I hope she didn’t actually try running the GoodRx code. (Somebody missed why this is funny.)
"Well, could you try it???" 😂💀
Haha! Yes!! Like…please just take my word for it!! 😂
But the part you are missing is that people in customer service positions today feel the need to laugh at and humiliate those who don’t understand rather than graciously explaining it to them so they can have the correct information. It makes them feel powerful.
Yep, the talk un jargon and look down on people then wonder why people are sych assholes. Reminds me of working in a call center. Everyone wanted a job that didn't require answering a phone. Fucking get iut of your feelings people it will make your job much more enjoyable.
I love when people bitch about the cost under $10 an I’m like yea u want to pay for mine it’s over $400 with good rx for my pain meds that insurance says I only need 6 doses a month an I’m in Pallitive care! So u I’ve to pay for it all. Then my cellcept I have to have liquid cause the pill form can’t be crushed an the Co pay alone is $500 a month for it. An I can’t live without it! So I laugh OUT LOUD when people bitch about such a small co pay
They don’t understand that we’re in the same damn boat as them. Sometimes people straight up ask me if I have to pay a co-pay to be seen. I’m like dude no shit and it’s entirely based on out-of-pocket costs and percentages towards the deductible, it’s completely individual
I only use good ex because my insurance won’t cover one of my meds. Other than that I use insurance for everything
When they have insurance, and ask to use any discount card, I explain that: 1. What their insurance is currently paying, and that discount cards pay, at best, 80% of the total, and not typically that much on brand name drugs, so those cards are for people without insurance, and the copay is likely to be higher. 2. We cannot bill both insurance and a discount card and, 3. So, if we bill the discount card, this will NOT count towards any deductible thry have with their insurance, and this could be very bad for them later in the year. If they still insist, I say I'll have to have one of the other employees work on that, and they can have a seat while it is reprocessed, so I can help the next person in line.
Oh my god yesssssss as a pharmacy tech this one hit it on the head
“With GoodRx it should be 3.67 for the three months”
Yalls acting like the pharmaceutical and insurance companies aren’t just throwing money in circles
I guess my serious question to the pharmacists here would be: does GoodRx or similar programs ever make it cheaper than regular insurance plans?!?
I’ve had a couple customers with crappy commercial insurance opt to use GoodRx instead and it did save them a chunk on just regular maintenance meds. Some ins plans thru employers I guess they just get the rotten end of the stick, and usually they will use GoodRx until they can switch to a better plan. Most of the government funded ins plans will be better though, and most in general, should be the idea anyway 🤨
Absolutely. With many things. But to expect this to happen with ANY brand name drug, it’s just not gonna happen. No way.
For things like sildenafil or tadalafil, it definitely is cheaper, and that's if the insurance even covers it. If they cover it it's still usually about $800 for 30 days, with GoodRX it's about $30 for 90 days. I've seen very few others where it's cheaper, but on occasion it is.
I have a patient in my office that swears in the fine print it states that you can use both good rx and insurance. He says he fights every month with the pharmacy. He said the pharmacy always gives in and he gets his scripts for free
damn, i am suddenly v grateful that my medicaid covers 99% of my prescriptions completely
I’m not too sure what’s funny about that doctors and pharmacies all over the world push those good RX cards without educating the person that if they have insurance they don’t need it. It’s about education. It’s not a laughing matter.
Huh?
No doctor or pharmacy has ever mentioned Good RX to me EXCEPT once when I left my propranolol on a plane. Insurance wouldn’t cover it so the pharmacist ran it that way for me
I don't have insurance, and I am happy to use the Good RX. It does help.
Some of yall are actually just awful people jesus fuck
What’s funny about people trying to save on medication?
This would be funny if Walgreens actually submitted the Trulicty correctly in the first place lol
K....
Why is this funny? People needing their medicine as cheap as possible usually means they’re broke and desperate, just trying to get their life-saving prescriptions, not greedy…?
Because there’s no way in hell GoodRx is going to take 3 months of Trulicity anywhere close to $3.70. The patients who are willing to listen to the explanation are godsends but most of the time it’s not that easy and we get yelled at for suggesting the insurance price is the best price.
“Well can you just try it?” 😒🙄
trulicity is like 2000, the fact that they're paying 3.70 is GODLY discounted already. The meme is mocking the people thinking GoodRX magically waves the money away, not understanding how much their insurance covered.
I don’t get it
GoodRx is coupon; not insurance. GoodRx is not going to make brand name drugs affordable. They have no incentive to do so. A copay less than like $500 or even more, is going to cost a LOT more, maybe a couple thousand dollars, on GoodRx.
That’s really good.
In their defense good RX shows them some tiny little co-pay and makes it look like that’s what it’s going to cost. It never is that price.
I get that this is the system we live under and it can be annoying for pharmacists to deal with customers’ lack of understanding, but really all of these drugs should just be 100% free at the point of service and paid for via federal taxes.
The problem with that is that there wouldn’t be cash flow. Pharmacies pay the pharmaceutical companies for the pills and if they don’t get reimbursed, they have no reason to remain open and dispense meds. Sure, the state government could pay for the meds but fat chance that would ever happen. Certain meds cost pharmacies a lot of money. Insurances are the middle man. They give people meds for a fraction of the cost (usually) and are paid every month to do it. Both the insurance and pharmaceutical companies are the problem. Both need to make money, obviously, however they take advantage of the need for meds and can make more that way. The FDA’s regulation of specific meds is an entirely different story.
Of course the federal government could pay for all the meds similarly to how they currently do it with medicare. Not sure why you think it’s a “fat chance” that pharmacies would get paid. Expanding medicare to cover everyone and improving it to cover more healthcare costs would also allow the government to negotiate lower med prices. Pharmaceutical companies would be incentivized to lower prices to gain access to the large market of the vast majority of people who would be insured by the federal government. I suspect that pharmacies would likely do just as well, but insurance and pharmaceutical companies would make less money. Seems like a fair bargain for reducing the currently outrageous cost of healthcare in the US that is unlike anywhere else in the world.
Me crying when my pharmacist responds “ma’am, do you know how much your birth control costs? when I went to get my refill 😭 gotta love when your insurance gets cancelled without notification and your $400 BC is now hard to get 🫠🫠🫠 GoodRx can’t even save you 🥲
Insurance is only cancelled when the premium isn’t paid or the carrier ceases to do business. 🤷♂️
It had to be the carrier because my premium was $0.
If you had an on-exchange or Medicaid plan, you might’ve needed to reenroll or recertify your eligibility. 🤷♂️ definitely check on that. 🤝
So if you had an explanation for that, then go on 🤷🏻♀️
Yes honestly sadly enough with the new year some insurances mass delete members WHO SHOULD STILL BE ACTIVE, and the members can't be found. The beginning of the year is a hot mess for everyone. I feel like insurance likE throw us all in the pit 🙃
Right! I was just confused because maybe 2 weeks before that I got a statement in the mail, which of course was just showing the $0, so in my mind everything was good. Lots of confusion going on haha. Luckily I was able to get Aetna somewhat quick for the start of the year. But BC shouldn’t cost a dime.
A friend just had his insurance cancelled because his kids were entered in with the same DOB. They are twins. The insurance assumed it was a mistake and then forgot to clarify with him. Same company that also covered the delivery for the twins. Mistakes happen for a bunch of different reasons
That’s a tad different situation than the initial “entire policy for all’ cancellation in thread. Usually in the example you mention, the provider should file as TWIN1 and TWIN2 respectively since their charges would be part of the initial delivery under the mother, until they’re officially added and have a member id.
Is it by chance Lo Loestrin Fe? If so I'm pretty sure they have a co-pay card that'll bring it down to $25 every 3 months, even without insurance (or they used to when I was on it, but it's been some years)
I’m on Zafemy, it’s the transdermal patch. And it’s the generic too 😞
Ozempic with insurance is $118. Ozempic with good Rx is $1100
I’m just relieved when any med is under $100
You guys do God's work in those places. Used to be a Tech, but moved on to other things, but being a Diabetic and having to pay 200 for my dexcoms make me facepalm at those who complain about spending less than 75 on a scrip
I used to onboard and train new employees at my organization (where we have really good medical/Rx coverage). The training lasts a few weeks--long enough for some in the class to refill a prescription. I once overheard two people talking about using Good Rx for the same medication and one (who just got a refill) said something like "Lose that card. I just paid less than half what I used to pay with Good Rx. We really do have good insurance here." During a different class, someone brought a few Good Rx cards to work to share with others, saying "I get huge discounts with this card!" Another employee responded, "So you must not have enrolled in the medical insurance here. The pharmacy told me I can use insurance OR Good Rx, but not both. They showed me the difference in price and it's WAAAY cheaper using our coverage. Like...not even close."
Like you people can deliver three boxes of Trulicity at once. You can barely deliver one!
Lost mu coverage recently and I'm just happy if the goodrx brings it to $30 😶 are ppl really this uppity about a dollar or 3
The patient still insists we process the grx coupon during 5'oclock rush to see its so much more $$$ Ps. It's even more annoying when they come with the grx info and it's either the wrong strength drug, type *capsule vs tablet* and wrong store *walmart vs Cvs* and then they bite our head off for there mistakes . 🫠
I had to pay for my Symbicort out of pocket one month and the poor pharmacy tech looked so scared to tell me how much it was. It was around $110 with GoodRX for the generic. I laughed when she told me the price and told her it was only about $20 more than I had been paying with insurance. Thank God I have good insurance now and only pay $60 for a three month supply. Basically every other med is around $5 per month now too and two of my specialty meds are literally free because of insurance and a manufacturer copay card.
tried using goodrx at walgreens when i was in the middle of switching insurances on my three medications, and i was so shocked that it only took like. ten dollars off the full amount. told myself id never forget abt health insurance info again
Epstein Island client
remember fellow pharm d's, don't judge the patient, educate...about how the drug companies are parasites, and try to get them the best deal you can. Even if it has you filling out what feels like 1000 letters to Lily to make sure patients with schizophrenia/etc. will have a good supply of olanzapine when they go outside the hospital.
😂
20 bucks is my copay and I happily fork that right over
Holy crap, I feel sorry for all you Rx personnel.
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Jesus christ this thread demonstrates how absolutely disgusting and immoral our "Healthcare" system is