Ironically, there are two newer formulations and the older soon to be authorised generic. My PBM in their infinite wisdom doesn’t want to cover the cheaper one. My doc has yet to get a PA approved for anyone for the newest version, so I’m stuck with the version they foisted upon us as soon as original exclusivity expired “because sodium raises BP,” and the newer one is salts with other metals.
Funny how they didn’t figure that out years ago……
Unfortunately not an option for specialty and niche drugs. Wish it was, I’d rather him get a cut than a certain PBM
I’m mildly curious to see what happens in the next month or two, as I’m about to hit my OOP max. Never ran into that combo of scenarios before.
The one I’m thinking of has a couple months “bridge” program for uninsured/just started new job/etc, but very time limited and an even bigger hassle as they’ll only send out two weeks instead of a month supply with each shipment.
IIRC, if I had insurance and it explicitly excluded the drug, the card would cover it, but it’s been a couple years since I left that job so memory isn’t clear.
None of is trustworthy. Mine is $$$$, and they know damn well insurance won’t pay it all. Of course, if the FDA didn’t require a single source pharmacy to ship it with all the infrastructure that entails, it would help, but only marginally.
Nightmare of a system even for relatively healthy folks. The older I get, the angrier I get because the people who most need the help are the ones either in enough pain they can’t nav the system, or old enough they don’t know where to start
Nobody is buying the med I have in mind out of pocket, in any world. Orphan drug, rare condition, and six figures a year.
Not to suggest your scenario doesn’t happen - it absolutely does. But I’m more curious about why I have to deal with a tiny company when they’re already eating a couple of grand a month on it.
It’s not a physical card always, it behaves like a secondary insurance payor, and if a $5k drug is covered for $2.5k by insurance, the card writes down the difference to $5 (as far as the patient is concerned).
Not unlike goodrx in principle, but specific to a drug.
As long as the reports that the C-suite gets look pretty, that’s all that matters. Have seen that one from both sides.
“I need five developer hours to implement a UI for this manual process that is time sensitive and exposes us to significant risk if we screw it up. Oh, and I’m the only one who knows how to do it in prod, so we have a bus problem.”
“Nah, I want reports…. Wait, why did we write an HO4 policy in Corpus Christie, AFTER the hurricane warning was issued?”
“See above, and prioritise things that matter.”
I don’t disagree, just not sure why there’s always a cost associated with it. No one benefits from the $5 net I pay, and it’s just one more (costly) admin step.
If your needs are fairly low on the processing side, you can snag a cloud VPS on LowEndBox for five or six dollars a month. Quality is highly variable ofc, but I’m reasonably my happy with mine.
No AWS, etc (though I don’t know offhand where the actual box lives), SSH access defaults to a key, and the rest (firewall, reverse proxy if you like, and all the other best practices) are but an apt-get away and a quick searxng to find and dissect working configs.
Incidentally, searxng is a good place to start- dead easy to get rolling,and a big step towards degoogling your life. Stand it up, throw a pretty standard config at nginx, and do a certbot —nginx -d search.mydomain.com - that all there is to it.
YMMV with more complex apps,but there is plenty of help to be had.
Oh…. Decide early on if anonymity is a goal,or you’re ok tying real life identity to your server if someone cares to look. Register domains and make public facing choices accordingly.
Either choice is acceptable if it’s the right one for you, but it’s hard to change once you pick a path.
I’m a big fan of not hosting on prem simply because it’s one more set of cables to trip over, etc. But for a latte a month in hosting costs, it’s worth it to me.
I pay around 600 for myself and my wife, and that’s with my employer continuing to pick up a significant share of the cost of health insurance that I literally never see a deduction or bill for.
1,800 a year beats hell out of $7,200, a $5k deductible, 20% co ins, and $11k OOP max.
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