Company charges nearly $60 a month for what you can do for free

#1

I am so irritated by this that I wanted to post it and put a heads up to people out there.

Came across a woman who was looking to get her medications cheaper. She got a form for the manufacturer’s patient assistance. Filled it out and sent it back in. Then she finds that she is being charged nearly $60.00 every month on her credit card.

After some sleuthing this is what I found out:
She inadvertently got herself signed up with a company that offers the “service” of trying to get your medication cheaper. They charge about $60 a month for this service.
From what I can tell: This “service” is provide you with the appropriate patient assistance form and mail it to you. After you have collected all the necessary documents and you and your doctor have filled out the form, you mail or fax it back. They in turn take what you faxed them and fax it to the patient assistance program.

Here’s what I find irritating: You or your doctor can easily go on line print off the same form, fill it out, and fax all the documentation directly to the patient assistance program yourselves. No need for a middle man that costs you $60 a month. Also, you only usually need to sign up for these programs, once (maybe twice) a year. So for about 5 or 10 minutes of work that they do for you once or twice a year, they charge you $60.

Granted, there MAY be a situation where a company like this could be helpful. I can’t think of one but I wouldn’t say it was impossible.

If you use one of these third party programs and you see a benefit to it…great!! In most cases though you can go directly to the manufacturer’s website for that drug and get any sort of information, copay cards, patient assistance, etc for free. Take it to your doctor for assistance if you need it have them fax in to the fax number on the form and keep your $60 a month.

#2

My pharmacy has a rack of discount cards with grand promises for cost savings! Just call the number, enter your birthdate, and if you’re over 65, the line goes dead—based on the assumption that you’re on Medicare. With the advent of the Affordable Care Act, hucksters did abound! Always read the fine print—“not available if you receive government assistance for healthcare coverage”, such as Medicare, Medicaid, VA benefits, etc.
No help for giant co-pays.

I agree, contact drug manufacturers directly for assistance on horribly expensive drugs—they will likely help, at least a little.

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#3

The whole thing about governmentally insured people not being able to use copay cards drives me crazy. From what I understand it has to do with the federal anti-kickback laws. It is “illegal” for pharma to offer any type of “payment” that may
persuade people to use a something that federal health care programs might pay for.
The theory is that the coupons can lead to unnecessary Medicare spending by inducing beneficiaries to choose drugs that are expensive.
The law is intended to prevent fraud, to prevent the coupon from steering Medicare’s business to a particular entity.

It may “entice” patients to use coupons to buy a “higher price” drug over a generic thus making the insurer’s cost more than they would typically have to pay.

Personally, I don’t think the law was intended for the copay cards/ I think that it predates them.

In my opinion their reasoning is faulty. I can only think of one drug that has copay cards available concurrently with a generic also being available.

The government could easily allow a provision that allows patients to use copay cards when it is a preferred product or if the product has been deemed medically necessary after clinical review.

Take insulin for example. If you aren’t using the preferred product your provider usually has to justify WHY you aren’t using the preferred product. It isn’t going to be covered at all if it is not deemed “medically necessary.” It’s not like you will be able to get the medication and have the plan pay for it WITHOUT that prior authorization (for nonformulary).

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