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Jocopd
Member

USA
180 Posts

Posted - Mar 23 2019 :  1:59:09 PM  Show Profile  Reply with Quote
So I go to my local Wally world to get my Advair which I get a few times a year since I fill in with ADC mostly. My normal co pay is $27. Today it was going to be $90. I asked what!!! Pharmacist said its the generic version that came out and showed me the full cost which was close to the same as Advair - $380

Not sure who made the substitute since I did not get a letter from my insurance telling me they would no longer give me name brand. Or if Wally world did it just cause my script did not say "name brand only" which the pharmacist kept repeating. Well if Advair did not have a generic version when the script was written then it would not say that. Duh. Then the pharmacist turned around looking to see if she had any Advair in stock and said would fill it with Advair but did not have any - said she would get it refilled tomorrow.

I asked her if I should call the insurance company about this and she replied nah you don't need to bother them. But after we were all done she tempered that to say "well, you can call them if you want" and shrugged.

To me this sounds like the pharmacy switched it. There is no $90 co pay in my drug list for Advair. And no Generic Advair - although it is new they do update the website often. And generics are way lower. I read the manufacturer is only going to charge around $120 and looking this up on Goodrx it shows I can get the generic one for about that price with no insurance.

Somethings fishy in Denmark.

So I will call the insurance company Monday and try to find out what happened. Not sure if I should pick up the name brand one before then cause they might make me pay the difference at the insurance company. Cigna did that one time.

Dave-OH
Administrator

USA
4233 Posts

Posted - Mar 23 2019 :  2:35:41 PM  Show Profile  Reply with Quote
Do you have an annual deductible and is this the first fill of the year?

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Jocopd
Member

USA
180 Posts

Posted - Mar 23 2019 :  2:57:41 PM  Show Profile  Reply with Quote
No deductible at all. And not the first of the year.
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gms
Member

USA
103 Posts

Posted - Mar 23 2019 :  5:16:25 PM  Show Profile  Reply with Quote
It definitely sounds like the pharmacy switched it. I usually get my drugs from Sams club... and when it came time for my 90 day refill on advair last month, the pharmacist asked if I wanted advair or the generic. I stayed with advair.

I always get a notice from the insurance company if there has been any change in drugs that I'm taking, name brand vs generic, and they always give me a 30 day supply of the name brand even after the change, just in case I didn't know about the change so I and my doctor can discuss the change and appeal the change if needed.

In your case it sounds like the co-pay for the generic is more then the advair price.... did I understand that correctly..?
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fatpuppy
Member

181 Posts

Posted - Mar 23 2019 :  6:24:07 PM  Show Profile  Reply with Quote
I DID receive a letter from my insurance (Cigna) about the switch to the Mylan Wixela Inhub generic. I had an appointment last Thursday with my pulmonologist and he had no problem with trying the generic (exact same ingredients; different delivery system which might make a difference). I have the option of going with the generic or staying with the brand name Advair. There's a huge price difference. The last time I got my Advair prescription filled, it was $1063 for 3 months or $354/month. The same 250/50 Wixela Inhub is $116/month.

ďAs democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day the plain folks of the land will reach their heartís desire at last and the White House will be adorned by a downright moron.Ē H.L.Mencken 1920
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Jocopd
Member

USA
180 Posts

Posted - Mar 23 2019 :  8:08:32 PM  Show Profile  Reply with Quote
GMS - Yep you understood right - co pay for Advair is $27. Co pay for Generic was $90. I would have no problem with the generic version if it were price like the articles say it is going to be which was $100-$150 to insurance providers then our co pay would be for generic - about $10/month.

Like I said I can walk in and buy the generic with no insurance - just using one of those prescription cards you can get free and only pay $125.

No letter was sent from my insurance company but I can understand that getting overlooked but just the way the pharmacist acted was odd.

Fatpuppy I cannot believe your paying that for your meds! That is the amount my insurance pays then I pay the $27. They are sticking you for the entire $354/month?

Edited by - Jocopd on Mar 23 2019 8:09:04 PM
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fatpuppy
Member

181 Posts

Posted - Mar 23 2019 :  9:09:12 PM  Show Profile  Reply with Quote
quote:
Originally posted by Jocopd


Fatpuppy I cannot believe your paying that for your meds! That is the amount my insurance pays then I pay the $27. They are sticking you for the entire $354/month?



I don't pay that. That's what the insurance company is billed. I usually hit my maximum out of pocket within a couple of months so I don't even have a co-pay

ďAs democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day the plain folks of the land will reach their heartís desire at last and the White House will be adorned by a downright moron.Ē H.L.Mencken 1920
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Jocopd
Member

USA
180 Posts

Posted - Mar 25 2019 :  10:27:21 AM  Show Profile  Reply with Quote
So for those of you who are interested in this - I called the insurance company today. They advised that they do not have the generic version of Advair (Wixlea) on the approved drug list and they are not the ones who told the pharmacy to switch it. The name brand Advair is still covered with a $37 co pay.

So I think the pharmacy was up to something. Not sure what or why. But that little incident sure will make me keep a closer eye on my meds in the future. Don't have this problem with ADC lol. But I definitely think that Goodrx is a good way to double check pricing in the future.
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klm49
Member

USA
44 Posts

Posted - Mar 26 2019 :  6:12:30 PM  Show Profile  Reply with Quote
quote:
Originally posted by Jocopd

So I go to my local Wally world to get my Advair which I get a few times a year since I fill in with ADC mostly. My normal co pay is $27. Today it was going to be $90. I asked what!!! Pharmacist said its the generic version that came out and showed me the full cost which was close to the same as Advair - $380

Not sure who made the substitute since I did not get a letter from my insurance telling me they would no longer give me name brand. Or if Wally world did it just cause my script did not say "name brand only" which the pharmacist kept repeating. Well if Advair did not have a generic version when the script was written then it would not say that. Duh. Then the pharmacist turned around looking to see if she had any Advair in stock and said would fill it with Advair but did not have any - said she would get it refilled tomorrow.

I asked her if I should call the insurance company about this and she replied nah you don't need to bother them. But after we were all done she tempered that to say "well, you can call them if you want" and shrugged.

To me this sounds like the pharmacy switched it. There is no $90 co pay in my drug list for Advair. And no Generic Advair - although it is new they do update the website often. And generics are way lower. I read the manufacturer is only going to charge around $120 and looking this up on Goodrx it shows I can get the generic one for about that price with no insurance.

Somethings fishy in Denmark.

So I will call the insurance company Monday and try to find out what happened. Not sure if I should pick up the name brand one before then cause they might make me pay the difference at the insurance company. Cigna did that one time.



Just curious why you aren't using the generic from ADC?
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gms
Member

USA
103 Posts

Posted - Mar 27 2019 :  10:30:58 AM  Show Profile  Reply with Quote
quote:
Originally posted by klm49
Just curious why you aren't using the generic from ADC?



Thats easy... why buy the generic from ADC when he can get the name brand from the pharmacy with only a $27 copay.
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Jocopd
Member

USA
180 Posts

Posted - Mar 27 2019 :  11:02:17 AM  Show Profile  Reply with Quote
I do use the generic from ADC as its about $10 a month for the little capsule version which I prefer but I also buy the Advair stateside about 3 or 4 times a year to keep it active in the states and so the insurance wont require pre approval or so no other snags happen.

And I misquoted my co pay is $37 in states right now not $27.
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klm49
Member

USA
44 Posts

Posted - Mar 28 2019 :  11:13:43 AM  Show Profile  Reply with Quote
Maybe so. I was fine buying my Symbicort & Proair from the pharmacy with my Medicare until I hit the donut hole......Now I get them from ADC and changed to a cheaper Rx plan.
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Dom
Rookie

10 Posts

Posted - May 14 2019 :  10:51:32 AM  Show Profile  Reply with Quote
ADC is getting ridiculous with payment processing. I am not sending in any ID. I have found another place I bought from before some time ago and will try that now.
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Jocopd
Member

USA
180 Posts

Posted - May 14 2019 :  11:25:35 AM  Show Profile  Reply with Quote
Yes, I agree with how it has gotten for payments but thought it was only me cause I use a credit card. I had already submitted my picture id last year so did not have to wait for that. Although that did take twice - once to the payment company and once to ADC order dept. The good think is you can cover up some information on the ID.

Used to be I would place my order online and then do live chat and ask for the credit card link which I would get in a couple hours and then pay that way.

Last week I did my online order and online chat said they would send the link but instead I got a call with an attempt to leave a voice mail so I called them back and they said they had to confirm how I wanted to pay. Then I would get the link in 24-48 hours. Finally got the link 2 days later and its processing now.

What was your other company?


Edited by - Jocopd on May 14 2019 11:26:12 AM
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Dom
Rookie

10 Posts

Posted - May 14 2019 :  11:55:44 AM  Show Profile  Reply with Quote
https://www.inhousepharmacy.vu/ They have been above board before with me and a friend uses them too. They use some different brand names, so it took some poking around.

Yes, I had the same with ACD, they would send me a link and the name of the recipient, I'd call my card company and tell them to put it through and pay that way. I am not sending my ID anyplace, not going to happen. I have bought from ACD for years...
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Dom
Rookie

10 Posts

Posted - May 14 2019 :  2:32:02 PM  Show Profile  Reply with Quote
So, the payment to inhouse cleared overnight. I have a second checking account with a debit card. When I want to buy something online, I go to my bank online and transfer the money into this second account, it's instant. Then I buy whatever. Should the account/card be compromised somehow - there is never anything but a few dollars in it. That's how I stay safe buying online. I did some research on inhouse and it's on a sovereign island near Australia. They've been in business since 1996 and get good reviews all over the web. Delivery takes about the same time as ADC. I'll keep you posted, it's a jungle out there and hard to find trustworthy places.
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Jocopd
Member

USA
180 Posts

Posted - May 14 2019 :  4:14:45 PM  Show Profile  Reply with Quote
Does Inhouse require you send them the script? ADC allows you to skip that page - at least for now.
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Dom
Rookie

10 Posts

Posted - May 14 2019 :  6:10:25 PM  Show Profile  Reply with Quote
They don't even have a page for a script. At least I didn't come across one.
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