Hi, I feel your pain ... or at least, your terror.
Insurance companies have done this to me before, a couple of times (allergy/asthma meds and abx). Thanks to helpful doctors and pharmacists, I was able to keep getting my meds covered. In large part because other meds -- the ones the company was still covering -- had been tried and failed.
Three suggestions: Er, more than three:
1) Talk to your pharmacist - succinctly. Take in a note with your doctor's name, insurance company name, the name of the med that works, a list of all the ones that haven't (that you can recall off-hand). Maybe a brief note ' about how disabled you were before. Ammunition. Give the same note to your doctor's office. Make it easier to advocate for you.
2) Apply for the Lyrica patient assistance program, at WWW.rxhope.com, under the Hardship Exemption, if you meet the fairly generous income criteria. (If approved, this might work out well for you. Rx should be for a 90-day supply, refillable x4.)
3) See what the prescription price would be with this free
( ... )
You may want to check out mail order pharmacies, both in the US and Canada, for better prices. For that matter, it is worth calling local pharmacies to check out prices. In my area a general merchandiser, Meijer Thrifty Acres, has a pharmacy that does not charge for some commonly used generic prescriptions. Lyrica probably does not fall in that category, but it is an indicator how prices may vary from place to place.
Lyrica is definitely not generic, but I take your point. :) I did the check-around-the-area bit when I was desperate over a different way this insurance company tried to screw me over a couple of years ago (I so want to get away from it, but the pre-existing condition means nobody else will take me). I'm fairly confident I'm at the place with the best discount plan in the region, but I haven't done as much research into the mail-order places as I should, and I'll add that to the list.
*sigh* I was busy before this came up. Things I Did Not Need... (and now I stop feeling sorry for myself and get my butt moving).
I know you've tried many many things, but just to make sure: have you tried gabapentin? You may know it as Neurontin. This is a drug that binds to the same receptor on the same nerve cells in the same way that Lyrica does. Most plans that don't cover Lyrica do so on the basis that gabapentin is extremely similar and much cheaper. (Lyrica was developed when gabapentin's patent was about to run out, so that Pfizer could keep making brand-name money off the same drug effect after gabapentin went generic. It's just different enough to get a fresh patent, but acts almost identically in the body.) If you haven't tried it, or tried it but didn't get up to a high-ish dose, it might be worth a go - both for the hope that it might offer you similar relief, and because if you pursue an appeal, the first thing the insurance company will ask is "Have you tried gabapentin?" and you need to be able to say "I did, and it didn't work, and here are the details" before they'll ever cover Lyrica.
Thanks for the suggestion! Yeah, I have tried it... for precisely the reason you just described; because last time my insurance company pulled this crap, and I needed to argue with them about it, I had to tell them that I'd tried gabapentin. So I did... and it did nothing except make me mildly nauseated. Hey at least that's one of the necessary hoops which I've already jumped through, so I don't have to this time, right?
I won't be off the formulary till July 1, but whether I can get more than one round depends on whether I can reach my doctor by then, who is notoriously hard to get to call back. (He's a good doctor but incredibly busy.) Actually, I *am* going away, for most of July, but I'm going to hope to get August's at the same time, just before June ends.
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Insurance companies have done this to me before, a couple of times (allergy/asthma meds and abx). Thanks to helpful doctors and pharmacists, I was able to keep getting my meds covered. In large part because other meds -- the ones the company was still covering -- had been tried and failed.
Three suggestions:
Er, more than three:
1) Talk to your pharmacist - succinctly. Take in a note with your doctor's name, insurance company name, the name of the med that works, a list of all the ones that haven't (that you can recall off-hand). Maybe a brief note ' about how disabled you were before. Ammunition. Give the same note to your doctor's office. Make it easier to advocate for you.
2) Apply for the Lyrica patient assistance program, at WWW.rxhope.com, under the Hardship Exemption, if you meet the fairly generous income criteria. (If approved, this might work out well for you. Rx should be for a 90-day supply, refillable x4.)
3) See what the prescription price would be with this free ( ... )
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*sigh* I was busy before this came up. Things I Did Not Need... (and now I stop feeling sorry for myself and get my butt moving).
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