Tresiba Cost

The price of Tresiba was raised since I bought it 3 months ago when we paid 90.00 for 3 months. We have excellent insurance. Today my husband paid 220.00 for the same amount of insulin. This is immoral in my book.

if you have private insurance go to the Tresiba website and download their coupon. Max you will pay is $25. Iā€™ve used this coupon for the last 3 years. Every year I just reapply. Good luck.

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So your insurance doesnā€™t cover your medication? Nancy50

Well I pay $25.00 for 3 months worth of Novolog. Tresiba is just really expensive even with excellent pharmaceutical coverage.

I take tresiba ,pay $30 for 3 months.

Nancy Matulis
ACBMaine

When was the last time you had your prescription filled?

Try the co pay discount card. Iā€™ve been using it for a few years. It worksā€¦no matter what your insurance co pay is, the card drops the co pay to $25 per 30 day supply.

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It all depends on your medicare / insurance plan. My copay for this year is $30. But anything could be off the formulary next year. Nancy50

I donā€™t use Medicare for prescriptions but use my excellent Regence/Blue Cross coverage.

The pharmacist said that Tresiba raised their prices drastically just recently. I had misquoted what my husband paid. 3 months ago we paid $90.OO for a 3 month supply. Yesterday he paid $280.00 for the same amount of insulin. We can afford this, but many cant. I was paying $18.00 for one pen and now I am paying $56.00 per pen. I really doubt this is just a boost by the insurance company. I will be calling them tomorrow,

Is it an issue of it being on a non preferred tier with your plan? If your same plan covers novolog at a much more reasonable cost if may be an issue of it being a non preferred med on the planā€¦ might be something to look into

FYI the pharmacist has no idea how your plan works or what meds are on what tier if itā€™s a tiered planā€¦ thatā€™s the patients responsibility unfortunatelyā€¦ the list prices of novolog and tresiba are very similarā€¦ so that makes me wonder

I pay very, very little for Novolog, I havenā€™t been notified that there has been a tier change for my Tresiba, and the insurance company never fails to inform me when they are changing tiers. This is a small, community and we have university coverage, so our local pharmacy is pretty up on our coverage, since the university is the biggest employer in the area.

I find it very easy to think that the makers of Tresiba have raised their prices since insulin prices have climbed so much in the past few years.

I will find out for sure soon.

I


Sam19

    September 20

Is it an issue of it being on a non preferred tier with your plan? If your same plan covers novolog at a much more reasonable cost if may be an issue of it being a non preferred med on the planā€¦ might be something to look into

FYI the pharmacist has no idea how your plan works or what meds are on what tier if itā€™s a tiered planā€¦ thatā€™s the patients responsibility unfortunatelyā€¦ the list prices of novolog and tresiba are very similarā€¦ so that makes me wonder


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In Reply To


Marilyn6

    September 19

Well I pay $25.00 for 3 months worth of Novolog. Tresiba is just really expensive even with excellent pharmaceutical coverage.


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It is very easy to think thatā€¦ but that doesnā€™t make it the case (same maker as novolog for whatever its worthā€¦) look on goodrx to compare costs. Itā€™s priced similarlyā€¦ but that doesnā€™t mean your plan negotiated their coverage of that cost similarlyā€¦

The costs are so muddledā€¦ in our dysfunctional insurance system the ā€œpriceā€ is almost meaningless because the insurer doesnā€™t negotiate the ā€œpriceā€ they negotiate the rebate for the list priceā€¦ and therefore itā€™s a protected contractual secret how much their bottom line payment actually was after the rebateā€¦ thatā€™s why weā€™ve managed to see ever increasing ā€œcostsā€ while ever increasing profit margins to the insurers but actually decreasing profit margins for the manufacturersā€¦ all the while list prices skyrocket indefinitely because their only market pressure is upwardā€¦ because the payer doesnā€™t care at all what the ā€œpriceā€ isā€¦ because it bears no relationship in reality to what it actually costs after the negotiated rebateā€¦ and the users are caught in the middle of all the bs

That makes one depressing sense Sam. I am just wondering why Blue Cross wouldnā€™t have informed of us of a tier change since they always have in the past. Maybe the letter is on the way.

I asked my husband to clarify this a bit more and he said that the pharmacist at Rite Aid just didnā€™t want us to think the cost was their fault. The pharmacist did not actually say why Tresiba suddenly costs so much more.

You can be sure that I will be trying to find out some answers in the morning. :blush:

I am trying to track down information about why there is an increase in the cost of my Tresiba. In April, I received 4 pens to last 88 days. The U& C cost was $536.99. I paid $24.99 total cost

Just the other day I got 5 pens because I had the prescription raised to cover priming. The U&C is $670.99 and I was charged $234.90. Not quite as much as my husband remembered.

I am not getting clear answers from my insurance company or my pharmacy.
The insurance company said that there had been a price increase of $3.00 a pen.

The insurance co. also said that I must be using a coupon. The pharmacy said that I have never used a coupon for Tresiba.
I will now try to get a coupon. This is terribly confusing and does not seem correct to me.

I would recommend looking into if your pharmacy has better copays (remember, the ā€œpriceā€ is a made up bs numberā€¦ the copay is all that matters) if you go through mail order.

I pay 30% of the ā€œpriceā€ if I pick up at a pharmacy for a 30 day supplyā€¦ (which is based on the ā€˜pretendā€™ list price plus whatever the various pharmacy prices it at) so thatā€™s somethint like $130 for one box of pensā€¦

If I use the same insurances mail order I get a 90 day supply with the price capped at $75ā€¦ so thatā€™s 3 boxes of insulin for $75 instead of one for $130ā€¦ vastly better deal. Iā€™m not sure if yours works anything like that but one thing I have become aware of is that many peoples do and they arenā€™t aware of itā€¦

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I picked up my box of 5 Novolog pens from my old pharmacy a few days ago and my co pay was $20.00 which is a great price. That is about what I am used to paying for my Novolog and Tresiba.

Yesterday I received a letter from my insurance company saying that it has come to their attention that one or more of my claims for a self administered medication was underpaid by the insurance company.

They fail to mention the name of the medication, the amount, or the provider. They say that I will be receiving a new Explanation of Benefits and ā€œYour health care provider will adjust their billing account for the claim(s) for the medication. Once this adjustment is complete you may be owed a refund from your provider or facility.ā€

So I will wait for the Explanation of Benefits and then I have to call the provider and try to get a refund. The insurance company is also talking to the provider.

I am hoping this is for the Tresiba overcharge, although that would be a very quick correction. Hopefully it is not just some tiny overcharge.

I think I will wait to do more about the Tresiba overcharge until I hear again from the insurance co.

Thank you for the info Sam.

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