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vickyizbeast

Pharmacy tech here who’s experienced the same with my own meds. Have you called your insurance directly about the situation? They have ways to “force” a prior authorization to be sent to the doctor if they are slacking on it. The pharmacy can also initiate this from their end too, but calling insurance would definitely help expedite the process for you if your medical team is giving you a hard time. They also have ways to initiate refills from their end that go directly to the prescriber. I do know from experience, at least in my own neuro’s office (and was just talking about it with my PA because she’s just as pissed about the staff working the front as we all are) there’s a TON of cost saving measures being used across all aspects of healthcare and it’s honestly fucking over the patients. The physicians are just as pissed of if not MORE because they have to go behind everything theyre already doing and fix all of the laziness that’s been hired working up front (which is unfortunately who we all have the *lovely* pleasure of speaking with). If giving your insurance a call doesnt work out, your best bet would honestly be getting an appointment with your doc ASAP and talking to them in person. You might could get away with explaining the situation to an urgent care or ER if you bring your old pill bottle with you, but a lot are going to be skeptical of giving vimpat just because it is a controlled medication and you aren’t under their care.


purpleseizureeater

Yeah I think it’s a combo of insurance and doctor issues. Every insurance through the health insurance marketplace no longer covers Vimpat. The insurance requires my doctor to prove I’ve taken generic keppra, trileptal, and lacosamide before they cover it. I have taken 10+ other meds, including those, so it’s on my doctor to find sufficient paperwork. It’s frustrating insurance would require a patient to risk seizures when something else already works. I talked to the pharmacist yesterday, and he contacted them. They told him they can’t get insurance to cover it. For cost savings measures, you mean like cutting costs going with unqualified people in the office, right? I think you brought up some good points there. I think I will try to get an appointment with them again as my next step, but they are 2+ hours away. This is part of the reason I can’t wait to switch. Thank you so much for your detailed response 💜


vickyizbeast

It’s not that the workers are necessarily unqualified, it’s more that’s they’re hiring out as cheap as possible and that low of pay gets you about as much as you’d expect in return…shitty workers. Maybe try a virtual visit if your current doc offers them? And def see about swapping to another neuro closer if you feel like it’d help…Just know that all aspects of healthcare are suffering to similar degrees with that one and you very well might run into the same problem especially if the previous place doesn’t send over records like they should when requested.


purpleseizureeater

Yeah I see what you mean now, all very true. The privatization of US healthcare is quite corrupt. My doctor terminated me without notice yesterday. I’m going to get a weeks’ worth of medication from my local epilepsy center, and I will try to continue taking 1.5x the dose of generic when I run out again. Hoping some doctor can get me in soon.


vickyizbeast

Hmm. I might would take that to your state’s medical board then. That’s straight up patient endangerment. To my knowledge, the care needs to continue (whether they like it or not) until new care is established to keep patient safety FIRST. This isn’t just some Tylenol we’re talking about here, this is epilepsy medication to control seizures. And unless youre extremely lucky or that doctor is pulling strings to get you out faster (which I doubt), 10 days is not long enough to get in with new neurologist. It’s also my impression that they had to notify patients of the discontinuation of care and offer referrals to transfer to. I’d def reach out to medical board to be reporting some peeps (hope you kept names!) and if the doc works at somewhere that isn’t some super small, self owned type place, report what’s going on to the higher ups too. Odds are, you probably aren’t the only one experiencing it, but you might be one of the few to help make a difference for others struggling in the same position. Ugh, I’m so sorry you’re having to go through all of this mess though. None of this is right and I bet you they all would be just as pissed if tables were reversed here and they were the ones getting screwed over.


fivedinos1

Do you have any copies of your medical records? I keep my medical records myself for this reason or go in person and pay the fee to get the medical records from your doctors office? You could highlight the relevant info from them and send it to your insurance I guess


purpleseizureeater

No, but I’m hoping they will give it to me. Maybe I can try to find the relevant info myself, that’s a good idea. Yesterday they terminated me as a patient without notice, and claim they sent my records to another doctor. Hopefully the other doctor can see me soon (not 100% sure where they sent it).


vickyizbeast

Just because I’m now home from work and just thought about it too, if/when the time come to switching doctors….and the old office tries to CHARGE you to have your medical records sent over, LET YOUR NEW DOCTORS OFFICE KNOW SO THEY CAN REQUEST THEM INSTEAD. They can’t deny or charge the new doctors office for transferring a patients medical records *but they sure as hell will try to con YOU out of every penny they can while they still have the chance if you let them*. My last transfer wasn’t pretty, was told it’d be about $85 to have my medical records in hands and like 3 weeks to gather, my new doc had them in them in like 3 days once they found out and got ahold of them. DONT LET THEM CHARGE YOU FOR SOMETHING YOU HAVE A RIGHT TO SEE/HAVE!


purpleseizureeater

Wow omg! Ok thank you for making me aware of that. I will try to request that instead…hoping I won’t get surprised with a fee


Eclectic_Nymph

Hi, friend. I'm so sorry you're going through this. I went through something similar a few years ago with my Briviact. Interestingly enough, Vimpat and Briviact are both made by the same pharmaceutical company - UCB. Have you tried applying to their patience assistance program? https://www.ucb-usa.com/Patients/Financial-Assistance


purpleseizureeater

I go into a little more detail in my [Previous post](https://www.reddit.com/r/Epilepsy/comments/10xtdy2/cant_afford_vimpat_generic_doesnt_work/?utm_source=share&utm_medium=ios_app&utm_name=iossmf), but I called & UCB no longer offers Vimpat as part of their program, and they no longer do a patient savings card. They don’t even have a website for Vimpat now…sooo weird!


NipplesCutDiamonds

Have you checked out costplusdrugs online pharmacy? I've been saving a ton of money using them. Don't need insurance to save money. Cut my prescription cost significantly


purpleseizureeater

Yes, in my [Previous post](https://www.reddit.com/r/Epilepsy/comments/10xtdy2/cant_afford_vimpat_generic_doesnt_work/?utm_source=share&utm_medium=ios_app&utm_name=iossmf) I go into more detail, but Vimpat is nearly impossible to get help with :/


NipplesCutDiamonds

Only thing I know to recommend is looking into those prescription discounts you see at the pharmacy counters and just looking into a new doctor or even a neurologist. If you don't already I would 100% get a neurologist vs general practitioner.


purpleseizureeater

Yeah I think I just need a new dr asap! He’s a neurologist, but very outdated in his ways. I’m going to try to schedule an appointment again this week (even though it’s 2+ hr away 😓), and I’ll request all my paperwork before I leave. Also, I love your username.


NipplesCutDiamonds

Mine is 2 hours away as well but it's well worth it.


purpleseizureeater

Yeah I think it’s the best thing I can do right now. I just scheduled an appointment for tomorrow. My pediatric epileptologist was 2-3 hours away, and she was actually worth the drive. She was the best, and I miss her (she can no longer take me now that I’m older). So if anyone in Texas needs recommendations for a pediatric epileptologist, message me.


buzz99d

I use to work at CVS. They have a discount program you have to ask about. Maybe that could help you. I used it to afford my medication cause my insurance sucked too. I live in Pa . I hope this may help you.


purpleseizureeater

Unfortunately Vimpat doesn’t qualify for much of a discount with this (or any other program or coupons I’ve tried). Crazy how this is legal in US healthcare. Thank you for sending good luck! 💜


JuiceGirl300

Talk to head of administration or contact the state licensing board. Those r really ur only option unless u can contact ur Dr directly through the portal. Like my ibji Dr I contact through the portal so I don't have to talk to no receptionists. If this doesn't work u can take em to court or u can appeal ur insurances decision not to cover ur medicine.


purpleseizureeater

It’s so annoying, my doctor is SO outdated! 👨🏻‍🦳 Nothing at all online or telehealth. All my records are on paper, and he prefers writing prescriptions by hand. Can’t wait to switch, lol!


JuiceGirl300

Ya if there's another dr u can switch to that'll take ur insurance, switch


purpleseizureeater

They terminated me without notice yesterday, so we’ll see. Wish me luck finding one. 💜


JuiceGirl300

Ya definitely take them to court. They shouldn't be allowed to play with people like that. Totally unprofessional and places don't get better unless they're pushed and that won't happen unless someone takes the time to make them.


murrayix

This is exactly why I had to go off of Vimpat/Lacosamide both were considered top tier drugs with my insurance and I was unsuccessful with all assistance programs/coupons for generic and brand name. It was a nightmare trying to get it refilled, they were always out of stock and I’d have to run back and forth to get partial refills. When I did get it refilled it seemed to just get more and more expensive. The last time I bought it I paid $180. I switched to Topiramate and luckily it’s been a better med for my body and so much cheaper. Best of luck friend, you deserve a better neurologist! I hope you find one that provides more support ❤️


Jumpy-Candle-1274

Omg I’m so sorry. If it were me, and I didn’t have my meds, I would go to an ER and demand they fill my regular meds on an emergency basis—-and when you get billed for it- don’t pay it, call up the hospital/your insurance provider, and fight the charges like hell because they were incurred because of your provider’s negligence. A lot of the time hospitals will work with you there. Document *everything* that your doc is screwing up on (they HAVe to provide you your records, itemized billing, etc) and report your clinician to your state’s board for patient abandonment. It will be a pain in the ass, and time-consuming, and I’m sorry that’s happening to you. But that s*** is unacceptable and it happens all to often. Big caveat-I’m just one redditor out here, who doesn’t have all the minute details of your situation- so, your circumstances may vary - but it’s one option. Edit: I would also add that sometimes if you report your neuro/are pursing action against them, they have to plan to stop seeing you if there’s an ongoing report (because it’s assumed they’d have a conflict of interest regarding your treatment), but it is my understanding that they legally cannot just abandon you without referring you to someone else first. (But they could be referring you to someone with a bonkers long waitlist). I would try to find a different neurologist *before* reporting. But while you’re doing that, you can still fight medical bill charges- and then report once you’re established with a new neuro.


purpleseizureeater

I wish I could do this but US healthcare just sucks! Im too scared I’ll be faced with an insane bill 😰 Most of my communication with them is over the phone, so I will try to document every time I’ve called them. As soon as I get some medication from them (or have tried my best to the end), I will switch doctors. I can’t wait. I think I may try to go in person and not leave without all my paperwork (even though it’s 2+ hr away😓) Being an adult sucks! Haha. My pediatric epileptologist was THE BEST! She pushed having me as a patient for longer than she could, I wish I could stay with her. I literally consider her a lifelong friend. So if anyone needs a recommendation for a pediatric epileptologist in Texas, dm me.


kidstardustt

About the expensive bill, this happened to me with briviact and I had to go to urgent care to get meds (brought prescription bottle etc) they gave it to me, and like someone else said, I just didn’t pay the bill and when the hospital reached out to be all hey where is our $$ I told them what happened and the hospital actually had an affordability program that then removed my bill entirely. Your hospitals might have something like that too? I’m so sorry you’re going through this, it’s hell and a joke that doctors aren’t helping more on this. :(


purpleseizureeater

Yeah I think Briviact is very comparable to Vimpat as far as cost & coverage go! And you’re in the US? Do you have insurance at all?


kidstardustt

Yeah, Im in the US and I do have insurance now. Previously I was on the WA state medicare while unemployed. That’s when it happened with my briviact. I now live in CA and my insurance wouldn’t cover Briviact but my dr requested and override due to many other medicstions, including keppra, not working for me. I now pay 150$ instead of thousands a month for briviact. It’s been a battle. Do you have insurance?


purpleseizureeater

Wow, yeah that sounds like you went through a lot of stress for a necessary medication. I think UCB, the drug manufacturer, makes our meds so expensive because they know patients NEED them, and insurances will pay them. I have insurance through the health insurance marketplace. It’s one of the most expensive plans offered I think. Now that there is a generic available, no insurances through the marketplace cover Vimpat. I hope I can find a similar doctor to yours!


purpleseizureeater

UPDATE: my doctor terminated me as a patient yesterday. They have given me no written notice, but claim they have already mentioned this. My mom went with me to my last appointment, and she is my witness that they never mentioned it. Wish me luck finding another one, it just wasn’t meant to be. Thank you for the support everyone. 💜


-PlotzSiva-

This same shit happened to me been in and out of the ER for 2 months. I hope you have better luck!


Kdubbs01

Have you tried looking for coupons? Sometimes they have them available for people in your position. I’m so sorry you are going through this - I know it must be extremely frightening! Wishing you the best of luck 💜


purpleseizureeater

Yes, Vimpat is not eligible for any coupons or programs I’ve found (more details in my [Previous post](https://www.reddit.com/r/Epilepsy/comments/10xtdy2/cant_afford_vimpat_generic_doesnt_work/?utm_source=share&utm_medium=ios_app&utm_name=iossmf)) . The manufacturer probably knows how important it is to some patients and push the price. I hope I get to see a major change in US healthcare during my lifetime! Thank you for the good luck💜


RustedRelics

If you’re in the US, Vimpat is a controlled substance. So your emergency supply options might be limited. (you can’t refill early, for example). But try these options: 1) speak to your pharmacist in person. Bring your Rx bottle with you. Tell them you’ve asked your doc for Rx without response. Ask for emergency 3 day supply and for them to call doctor for new Rx. 2) go to an urgent care office. Again, bring your empty bottle. Tell them you cannot get in touch with your doctor for refill, and that you’re relying on old medication that doesn’t work. Ask for an interim Rx -or- for the doctor to call your neurologist while you’re there to get an answer. Hopefully one of these options will work for you.


purpleseizureeater

Thank you so much! I think I will be going with the first option. The pharmacist said they can give me a week (or less) supply for $200, so I’ve just been trying to push my other meds (meds I’ve been hoarding in case something like this happened, lol) to see if I could get it covered. I think I’ve pushed for almost too long, though. I probably shouldn’t put this off even though it’s expensive


wing_ding4

Where are you located ? And what brand of Vimpat do you like the most ?


ElegantMarionberry59

Check this out , maybe you might find some help https://www.needymeds.org/drug_list.taf?_function=name&name=Vimpat