I used to work for a prescription drug company as an inside sales representative. I've always known that most prescriptions in the US are way over-priced. The manufacturers claim it's for research and development but any fool knows the majority of drug companies spend their money on marketing drugs to people via TV commercials and print ads in magazines.
So I've known all of this for a long time and it never bothered me because I've always had an insurance plan with a tiered co-pay system where the most I paid for anything was $40 per month. I could live with that.
My husband's company had gone with an HSA insurance plan this year and the prescription drug coverage SUCKS. I just got off the internet checking the prices of two of my regular prescriptions and here's the damage: Three month supply of Effexor XR 150mg capsules, one capsule twice a day: $401.77 through their prescription mail service. It won't even price it out at a retail pharmacy. Here's another one: Three months of Abilify 5mg tablets, one tablet once a day: $1,071.24. One month at a retail pharmacy totals $444.47.
Insurance companies don't seem to understand that it would be much cheaper for them to offer these drugs used to treat depression at a reasonable cost versus patients (let's take me for instance) to not be on them and then need inpatient treatment because without the meds, chances are sooner or later I'd go out of my mind. But the pharmaceutical portion of my insurance plan is not linked to the medical portion of my insurance plan so the left hand doesn't care what the right hand is offering. If I worked for UnitedHealth I would make damn sure that the prescription coverage would help save money on the medical side of the plan. Because I do very well when I'm regularly taking my meds; I haven't been in the hospital for depression in well over 3 years which is pretty good for the population I belong to.
I investigated the prescription assistance plan for these two medications and for the Effexor I need to make 200% less than the national poverty level and for the Abilify program my household income cannot exceed roughly $36,000 annually. Oh, and for either program I can't have any prescription drug coverage. At this point, for all intents and purposes, I do not have prescription drug coverage because it's too expensive to use. What good is it doing me? None.
There are samples of something similar to Effexor and samples for Abilify, but I'm sure I'm not the only patient in my shrink's practice that is struggling to pay for prescriptions. They can't supply me with both meds month after month. Especially since the drug companies acted so unethically in the past with free-bees to MDs who heavily prescribed their drugs, that the AMA (American Medical Association) has greatly restricted what drug reps should be allowed to do in MD offices and many MD offices won't allow drug reps in the door any more, so there aren't a lot of samples out there and the demand for that limited supply is great.
I have an appointment with my shrink on February 1st and I'm going to have to switch to drugs that are generic. I don't know if they will work as well as what I'm currently on, but I can tell you this for sure: my insurance company doesn't really give a damn.