When I saw my OBGYN two weeks ago he gave me two weeks worth of samples of the pills he recommended I take pris.tiq, and said to take them before I made up my mind and filled the prescription he wrote out. That’s what I did, and despite the fact that I am still battling somewhat debilitating fatigue, I felt that the benefits outweighed the downsides and dropped the Rx off to get filled. I got an automated call from the pharmacy saying that there was a “problem” with my insurance that they were trying to resolve.
At first I didn’t think anything of this, but after about an hour I called them to find out what the deal was. Simply, my insurance doesn’t cover this drug and it’s $342 for 30 pills. Umm. No. They had sent a preauthorization over to my OBGYN and said after he fills it out it’s up to the insurance company to decide if they’ll cover any of the med, but it could take a while for them to decide and let us know.
At this point it’s 3:00 pm and I have no more pills. I take them before bed, so I needed to figure out a way to get a pill in my mouth before I went to sleep. I tried calling my OBGYN’s office but the receptionist refused to help me. I needed someone to check the cabinet where the samples were to see if there were any more I could snag because the pharmacist said in a serious voice that it would not be a good idea for me to go cold turkey without these after having been on them for a few weeks. But the receptionist wouldn’t check and she also wouldn’t go talk to the nurse. I knew that she herself could not actually touch the meds, I just needed to know if they were even there. My husband was right over by their office right at this time because the college he goes to is over there so I just needed to know if I could send him over to grab some before he went to work. But anyway, she was pretty adamant about not helping me. So I looked up the drug makers website and they did have a copay assistance program you could participate in.
I signed up and called the pharmacy to see how much it would help and they said I would have to come down with the email, that they couldn’t check over the phone. Okay. Fine. I loaded Charlie and I up and waited in line behind everyone getting off work, only to find out that the card was only going to take $100 off, so the drugs would still be $240 a month. Not something I can do, not at all. The pharmacy tech helping me seemed really sympathetic to my problem and started checking how much it would cost to sell me just one or two pills to get me covered until I could get ahold of the nurse at the OBGYN.
$17.00 for ONE. FUCKING. PILL. At this point, I don’t know who to be more frustrated with-the drug maker, the insurance company, the receptionist….I was frustrated with all of them. And starting to get a little panicked. I asked him to go ahead and fill the Rx for the one pill just to tide me over and as I was leaving I left a panicked voicemail for my nurse telling her what was going on.
She called me back a few hours later to say that they had two weeks worth of samples they could give me and hopefully that would be enough to figure out the PA situation. That’s all they have left or she said they would give me more-they gave me almost all of my diclegis when I was pregnant because it was so expensive. They’re so kind (other than the receptionist). She did say the PA could take a while to go through, but if we couldn’t get it worked out there was a generic drug that was fairly comparable to the pris.tiq, that she herself had taken it when HER insurance wouldn’t cover pris.tiq (seriously does ANY insurance pay for it?) and she felt like it would be okay for me.
I’m nervous about it. I’ve heard horror stories about messing with your mental health meds, and it’s taken me a while to even get this used to the side effects of this drug, but at this point all I can do is hope for the best and go by in the morning to pick up my two weeks worth of samples. At this point my OBGYN has given me $342.00 worth of free meds for my mental health and I’m so grateful.
Honestly, the most stressed I’ve been since taking the pris.tiq is today, trying to figure out how to get it paid for. Not cool.