Almost none of them are, and so they rely on their broker to be their guide. The problem is, the majority of the brokers don’t have a clue either. Their primary focus is on the healthcare benefit, because that’s where 70 - 80% of their commission is generated.
My company spends a TON of time, money, and effort attempting to educate brokers on the complexity of the pharmacy benefit. Some of them appreciate the information, and genuinely want to learn and understand. The majority want to take the easy way out and just use a pricing spreadsheet comparison when providing options to their clients – sometimes based only on a handful of medications.
So far, so good. I set up an account, wrote my doctor, got an email from Mark Cuban etc. saying they had the prescription, and have just paid for it. 180 pills from them with no insurance is a little cheaper than 90 pills from Express Script with insurance. Go figure.
As others have pointed out, I think I could have gotten it from Express Script, I’d just need to order it 8 times a year. If I hadn’t still been upset at them for refusing to fill the prescription a few years ago, I’d probably have just done that. But this saves me a couple of bucks, introduces me to a new option, and generally seems like a win.
I don’t know… they do usually throw both of my prescriptions in the same bag as well. All I was pointing out is that Express Scripts has been trouble-free for me. CVS Caremark was great on the prescription side as well, but their IT stuff got wonky for me because I had an account from a previous employer with the same email address. That irked me more than anything prescription related.
I agree that it’s probably your employer/their broker dictating some of those limits to the insurance carrier. I’m always a little bit surprised what level of control over things I’d consider to be medical decisions the employer/broker have. Stuff like what is and isn’t covered by the pharmacy plan, for example. Your carrier might cover a drug like Zepbound in general, but your employer may choose not to have it covered for their specific plan. How craptastic is that? I’m not at all surprised that they may choose to impose weird limitations on bottle size, name brand, alternatives, duration, etc… if they think it’ll help them save a buck somewhere.
See, i don’t really think that’s how it works. I think Express Script says, “oh, you want to trim the price a little? Here are some restrictions you can impose and if you do that we’ll reduce the cost by 3¢ per employee.” Because any list of bottle size, duration, etc. is something that the PBM knows and cares about, and the employer doesn’t.
I’m simply asking if you have noticed any difference when you switch brands of the same drug. Like, has your heartburn been any worse when you have just switched to a new brand?
I’ve actually had issues with that with some medications. It’s like they’re ever so slightly different, and my body has to adjust. I’m just curious if you have had the same.
I was actually about to warn you that your heartburn might get worse when you switch to this new place who may use a different generic brand. But then I realized that might just be a thing with me, and not everyone, so I thought I’d ask if you’d ever experienced it before.
No. I’ve used several brands of Omeprazole, and two brands of Esomeprazole, and never noticed a difference when i changed brands. Well, one brand of omeprazole actually gave me a weird “aftertaste”, which i assume was from the inert ingredients, but they’ve all worked the same for my heartburn. From the photo, this may be the same brand as the first brand of Esomeprazole i was on.
I’ve never noticed a brand difference with NSAIDs, either.
But i use an estrogen patch, and the generic simply didn’t work. I got hot flashes even when it didn’t just fall off, which it often did. The funny thing is that there are two common “brands” of generic estrogen patch on the market, and the other one is fine, indistinguishable from the brand name version (climara). I am grateful that my local pharmacist is willing to shop around and get me the slightly more expensive generic, which works.
Just a clarification: the differences I noticed were always transitory. I’ve not run into that problem where one generic didn’t work. It’s more akin to what happens if you miss a dose. It’s like your body needs to get used to it.
@puzzlegal I’m glad you were able to get the right generic from your doctor, and wonder what the actual difference was. One thing I know is that generics are tested for equivalent effect rather than focusing on exact ingredient amounts.
The actual difference is that the two patches are totally different. One is a thin sheet of plastic with stickum on one side. I’m not certain whether the drug is embedded in the plastic or in the stickum. The other is a little bit of foam rubber imbued with drug, which is held on (badly) by a larger circle of sticky plastic sheet around it. And it was the pharmacist who found the right one for me, although my doctor supported the effort.
No, I’ve never noticed any difference with different brands of PPIs, and use them interchangeably. Like, if i have some older ones in my overnight kit that haven’t expired, I’ll use them when I’m traveling. And i have used several brands.
I take omeprazole daily. I used to take it twice a day but was able (with a doctor’s advice) to go down to one a day. I have a prescription but I don’t use it.
It’s very important for me to take it. Not because of acid reflux itself, but because it triggers my eosinophilic esophagitis. And that can cause my esophagus to close. I can breathe and stuff, but I can’t swallow anything including water or my own saliva (and ain’t that fun, literally drowning in your own spit if you fall asleep). I had to have an emergency endoscopy once because it threatened my life (it turns out you need to ingest water to live, who knew?).
So for me it’s pretty important. I had a prescription and took it to Walgreens which is the closest convenient pharmacy. But first of all it’s kind of a pain to have to wait until you get notified your prescription is ready, then head to the pharmacy and wait in line and then pick it up, and sometimes oops, they made a mistake and it’s not ready, sorry come back later. Then they said the insurance doesn’t cover it anymore. Wait, maybe it does, no, I guess not, but maybe if you…
I said fuck it. This is available OTC. How much would it cost on Amazon? Huh, it costs less than it cost me before even with the insurance paying for some of it. And I can get it delivered to my door. And I can schedule a recurring order that delivers it regularly as a subscription so I never run out, and I get a discount for doing that. I never looked back.
By the way, I’ve noticed sometimes they try to cost the pills in a fruit flavor so you can dry swallow or take with water and you won’t taste the bitter medicine. So that might be why some brands give an aftertaste. That might be intentional.