Two words for you: clonidine patch
I am looking at this product in my system and it doesn’t show there is such a commercially available product. (Only tablets) So that would be why they have to compound it. I wondering if their insurance changed (either different plan or the insurance rules changed) and that is why it is no longer covered?
Dr. Heist: I used to see this dentist, who’d wait until I was in the chair with his tools in my mouth, then b!tch about the drugstore across the street. They wouldn’t let him call in cipro for his daughter even though it was to treat a UTI caused by the antibiotics he’d already given her for an abscessed tooth…that kind of thing.
Yup, currently on the PA side, dealing with lots of Vyvanses due to a formulary change which makes no sense to me.
I understand that with Vyvanse. I'm just going to give my patients info to pay cash for it. I don't care if responses are sympathetic. I just wanted info and I got it.
The insurance letter says compounded meds may not be
…ok
pretty typical of insurance companies unfortunately, if only there was a way to get them out of the business of screwing with healthcare - hmmmm. I know a few countries that could help....
I’m sorry wasn’t trying to be mean. Apologize if it came off that way.
The insurance letter says compounded meds may not be
<redacted> pharmacist wrote the letter to the family saying that compounded medicine is not approved by the FDA. That's literally what the letter says.
I don’t understand the point of your replies but I would be very curious to read that letter for myself. Saying that compounded medications are not approved by the FDA is like saying that home cooked steaks are not approved by the FDA. It’s…not untrue, strictly speaking.
That's what it said. Thats their excuse for not paying. Whatever.
Mods, please edit this post. Heist, that’s just nasty. I worked prior auth for years and one of my responsibilities was dealing with physicians just like you. The pharmacist you doxxed is doing his job, enforcing the limitations of the insurance that your patient’s family or their employer paid for. Everyone complains healthcare costs too much; this is how costs are kept down.
The mods don’t read every thread so it’s better to use the report link to bring things to their attention.
She only showed me one page of what they sent. That page didn't say anything about how to appeal. Looks likes starting Jan 2023 they don't cover any compounded meds.
"I wrote a prescription for a drug that doesn't exist! Why did this pharmacy compound it?!?
People who have kids that have medical issues requiring specific meds. Pharmacists for their own families. Responsible people. People who have been burned by their insurance before.
Talk to someone?????? The audacity!!!
The tablet isn't where the cost comes in. Guanfacine is very cheap.
what dose are they getting? If a multiple of 1mg or 1/2 a mg- can they just crush it and take with applesauce of something?
Everything about OP confuses me. Imagine telling pharmacists which medications are cheap or expensive, what is or is not commercially available, how insurance works, etc. Why even come and ask us for information if you will be so hostile to all the replies? Like it is genuinely baffling to me.
It's pretty much on par with any other time s/he posts here
I use goodrx for price. It's not the extended release. It's dirt cheap.
My favorite is the human centipede episode
Crushing and putting in applesauce? I put the name to give it more legitimacy as one poster was doubting that what I wrote was true.
Apple sauce is okay, but has more of a risk for missing some of the dose depending on how much it is mixed in. Usually we recommend no more than single spoonful.
I will default to @KidPharmD for the best vehicle, but I have done applesauce or pudding for adults all the time. I should have said make sure the amount is small enough the pt takes it all. In the ED we will often out some injectible decadron or zofran into a small amount of juice of formula (depending on the age of the child).
I was gonna write a long and detailed post, but your posts here make it clear that you would just oink at the pearls being cast before you.
Genuinely curious what you mean by this.
GoodRx doesn't have any incentive to provide accurate drug pricing without their discount card, so they generally don't. Their discount card also really cuts into the margins at the pharmacy. They actually pay very little and mostly just have a negotiated rate lower than the cash price. Big pharmacies deal with it to keep up volumes but some are starting to refuse to deal with GoodRx.
Fair enough.
I mean... GoodRx if you absolutely have to. Look at things like the Walmart $4 list, help them get registered for Medicaid if they qualify, look for brand name options that have patient assistance programs, if it's long-term medications - the walgreens prescription savings program might work for them. Ultimately - vote for representatives who support literally any plan better than what we have now for healthcare costs in the US.
They basically hit the nail on the head. I could also illustrate another couple points:
So first, I prescribe my own medications. I'm way too anal to let anyone do it for me.
Fair enough 👍.
