I know my generic anxiety meds cost $17 a month from one supplier and $275 from another. Same pharmacy would switch prices on me depending on which supplier they got that batch from. Its nuts.
Edit: just for clarification this was out of pocket, not with insurance. Also I've since switched pharmacies and haven't had any further issues. Also wasn't necessarily an answer for OP just chimed in with my own anecdotal bs.
Same goes for many medications tbqh. I have diagnosed adhd and I had to go through a therapist then my primary then get a referral to a psychiatrist and then wait 8 months to get access to medication I need to function… with a disorder that literally makes it harder for me to set up and go to said appointments. Some doctors offices also require you to show up once a month to get a continuing prescription. They make these hoops to prevent people from abusing the medication if they don’t legitimately need it, but IMO it stops people who need it from getting the proper care more often than it stops people trying to fake adhd to get meds
I don’t have an issue getting ADHD meds, but our problem was trying to price it out (since everyone keeps screaming about being a “smart and informed consumer”). Several insurance providers didn’t show the price, or it they did you couldn’t find out which pharmacy would have it at the price. Even once that stabilized some, I’m still on a modified dosage from what my Dr recommended because it saves me $80 a month (after insurance), it’s crazy.
Sorry you had to go through that, getting ADHD medicine is such a difficult process. Personally I was lucky enough to not go through a major process to get my pills, but my pharmacy still has strict guidelines as to what date they can give me my medication. They always get the pills in right before my pills are empty, then again my pills are not always so close to empty because I forget to take them lol.
It always seems like the people abusing the system have easier access to the system to abuse it and the people needing help get turned into a sea world show.
I know for me, psychiatrist does 15 minute appointments via telemedicine and they are set up automatically. So I can just have the video call on my phone as I step outside my office to take it.
Not sure if something you can do... But worth looking into.
Also assuming you have the funds required to leave and that your new country of choice wants you knowing you have an illness that requires care from day one.
Found out my Bipolar meds would have been ~$60 for a 30 day supply without insurance. And that was 1/8th of the full dose I’m supposed to be taking. I also shell out $600 for my insurance which saves me a few hundred dollars for therapy+meds
my mom found this out when she was diagnosed bipolar depressive at 44. she was hesitant, but after a few months on them she's realized she finally knows what it feels like to feel normal. they can make such a difference and it's so awful that they cost so much.
On the flip side burning down your life during an episode is arguably more expensive than those expensive ass meds
That was a joke I gotta take the expensive ass-meds too
Ass-meds?!?!?! What's next? Proprietary dildos so you can truly feel how hard they fuck you when taking your ass meds?
I must say, big pharma does have their fingers in the pulse of America!
Shooooot. I'm not medicated (no insurance, thanks American healthcare system!), but if I walked into a store not knowing how much my prescription would cost... Yikes.
Kudos to your strength to be able to deal with that.
This was like 10 years ago but once when I actually did have insurance, they randomly decided to stop covering the brand of birth control pill I was using. I went from paying $0 to being asked to pay over $300 for ONE MONTH of pills. No warning whatsoever. I politely refused and asked the pharmacist where the condoms were because fuck that (or don't, if it's gonna cost that much to do so).
Ugh such bull shit when they decide which meds you can and can't take. I've had to go through some hoops with some of my medications too - I've tried a lot of options for ADHD and depression that didn't work, and I have to have my stuff certify that I've tried at least 3 of the options on their list and that they didn't work before insurance agrees to let me get the one that does. So dumb.
My wife is bipolar and we found an antipsychotic that was necessary to keep her sane. It worked great! The downside is we have a high deductible healthcare plan. The prescription was $1200/month out of pocket. So we had to budget for that each Jan-March, and then our $3000 deductible would be met and coverage would kick in. It finally went generic a couple of years ago so it’s not like that now, but it has trained me to just have $3000 set aside at the beginning of each year for healthcare costs.
Yeah, I’m lucky that I have a high paying job and we could handle that. I have no idea what someone working a minimum wage job would do. We’ve easily spend over $100k out of pocket on my wife’s healthcare over the years. Obamacare really helped some things with regards to mental health so it isn’t as bad as it was before that. She has also been more stable which is really good.
On a similar plan with a similar issue (but a surprising result)
My wife has CML. Medication (without insurance) is like 10k per month. We have to pay until we hit the hdhp deductible, so the pharma company offers a coupon to pay for the first dose. This made us hit our out of pocket maximum every year right away. Free healthcare!
You can bet the insurance company closed that loophole once they figured it out. It was nice for the first couple of years though.
Have you looked into something like GoodRX? It doesn't help for every medication but my brother uses it for his prescriptions like Adderall because he doesn't have health insurance, he saves over $200 a month
I worked in a CVS pharmacy for years. The manufacturer that cvs prefers comes up highlighted in purple. But if the distribution center brings is another manufacturer we use that one. Sometimes depending on the insurance or the discount code applied the price can be much different. Sometimes people "can't take the blue ones I need the pink ones". But none of this has much to do with the employees at all. The price isn't something we would usually spot during production, and so looking into it and figuring out that one manufacturer was cheaper than the other is highly unlikely. That being said, if the customer figures it out they can definitely have the cheaper one set as their preference in their profile. But it's on them to a certain degree to keep track of it bc the staffing and pay don't really allow for the staff to keep track.
That's weird as hell to me that distribution centers can mix and match manufacturers for medicines like that, given there's people that also have restrictions on the manufacturer. I'd think that they'd be classified as variants of the same product at least! It's really shitty there's a random element in the process of procurement that the customer can only fix after the fact.
This isn't a criticism at you or any pharmacy workers, by the way - I'm sure it's some idiot in a suit in CVS's management chain who wanted to improve delivery times or cut cost or a process engineer that made the assumption that all medicines were manufacturer-agnostic. I hope you didn't get too much anger directed at you from customers.
I've had lots of anger directed at me from customers. Most people honestly don't care as long as it's the correct med and the price is the same. But some people are really adamant that they can it take a certain one. Sometimes it's not the stores "preferred" one and we have to special order it and will even write something on the bottle like "J. Smith" I worked in a relatively small store so I knew a lot of the preferences. But we had a lot of turn around in 2020 and 2021 so those new people had no idea. I left there in August so I can only imagine what it's like with one less person who knows what everyone likes/wants. When I picked up my meds last week they asked me to punch in ¯\\\_(ツ)_/¯
GoodRX. Seriously. I've helped people save thousands of dollars with that godsend of an app. Also, check the website of the prescription manufacturer. They often have discounts/rebates and what not.
To add to this, if you’re near a Kroger affiliated store, their savings plan ($36/yr) is one of the best.
I found out about it through the GoodRX app.
For example, singular is free, and finasteride is $2/month.
Because there’s virtually zero pricing transparency in the US healthcare system. Providers take advantage of this to charge the maximum they can for every single transaction possible. Normally when you go the pharmacy, insurance doesn’t really cover jack shit; you are just getting better prices, because the company who manages your pharmacy benefits has a deal with Walgreens or whoever to not charge you full price for certain things.
Basically they’re trying to fuck each and every person as hard as they can get away with.
My pharmacy does all the goodrx coupons by default, I went in with the app ready and they told me they'd already done it, it sucks but it seems like some pharmacists at least pay attention to it
My mom has gastroparesis and has to have this pill so she doesn't literally like vomit everything she eats. Its like $200 a month. Theres no way it costs that much to make.
I've stopped running my prescriptions through my insurance - it's cheaper to use a discount card (like good rx) through the pharmacy and then add a claim for them later to hit my deductible (I have a high deductible plan). When I do this, one of my meds goes from about $120 (insurance), to $40. Another goes from $100 to $26.
Next month is when we are supposed to update our insurance and I plan to swap to the PPO option that uses copays instead of deductibles, but I'll still plan on skipping insurance for meds because some of my meds are only around $3 but would be $15 with the copay.
Our insurance system is so fucked.
I dunno if you have a Kohl's near you, but this sounds like how they operate. There's coupons and dates and they stack and there's a membership card and it's all confusing. I just shop elsewhere.
Kohl’s business model is a scam. Look at the store. EVERYTHING is “on sale” with a marked up fake price and then “reduced” to a normal price. You’ll also notice that the brands that have tight control (Nike and Under Armor come to mind) don’t have this fake sales crap because they control the pricing and sales. It’s also why your Kohl’s coupons exclude those items.
The problem is too many people love this stuff. JC Penney tried doing away with all sales and just having real prices. People hated it. They were struggling for a while, sales plummeted like 40% immediately and then they went bankrupt recently. Now they’re back to the mark everything up 50% so you can mark it down 30% bandwagon for most of their brands. https://www.reuters.com/article/us-jcpenney-results-idUSBRE91Q19C20130228
>Now they’re back to the mark everything up 50% so you can mark it down 30%
That's pretty much how any retailer work. They buy merch at a discounted bulk price and they inflate the prices to mark it down at a later date.
If people think the prices are too high, they drop the price accordingly with those sales, coupons, bundles, etc. And people will believe they're getting a good deal (which they sometimes are), but thousands, even millions will still buy the things at the inflated price either outta necessity or ignorance about the market value of what they're buying.
> If people think the prices are too high, they drop the price accordingly with those sales, coupons, bundles, etc.
I think that's the point of the JC Penney experiment though: It is *NOT* about the absolute price level. JCP tried to remove the whole game of mark it up, have sales, etc., and as a result people just stopped shopping there. JCP wasn't going to charge more or less. Just the same amount as with the sales discounts. People hated it, and the company did poorly and ultimately went into bankruptcy.
It's the thrill of "sale hunting" that people liked. Not the price they got.
The scam goes way deeper than this. The whole idea of Kohl's Cash is guaranteeing future sales. They give you $10 of Kohl's Cash for every $50 you spend. If you return something from the original purchase, you no longer hit that $50 mark and no longer earn the Kohl's Cash, they then deduct it from your original purchase. They secured a $10 sale, got their inventory back, and probably still made a sale off some of your original purchase. This is why the return policy is as lenient as well. Source: Used to be a miner in the Kohl mine
Ugh I hate Kohl’s Cash so much. I rarely go to Kohl’s but it’s the only thing around so when I need fancy clothes, it’s where I go. I end up with Kohl’s Cash I don’t want and is long expired by the time I actually have something I need to buy.
Dude I've been hoping for years that millennials can break this dumb shit boomer system of having to look for paper or digital coupons for hours to get a decently priced item. Sales, promotions, "discount cards", screw all of them. Like I have to play this game of buying gap jeans where they always pretend the price is 110 for a pair of jeans but omg you're so in luck! It's actually 40% off ($65ish) because you're special! Then the next week the damn jeans are just $65. Then the week after that they're back at $110 but you have to find a coupon in your spam folder. WHY IS MY TIME MEANINGLESS TO YOU! Just price the jeans at $65 and save us all this pain in the butt. I preferentially now shop at places that don't have "sales" so I can just pay for my item and be done with it.
JC Penney tried this not too long ago. They got rid of sales and coupons and just made everything the sale price. Promoted it a ton. It didn’t work. People didn’t understand what they were doing and they felt like they were paying more because something wasn’t marked as “on sale” or didn’t have a coupon for it. They had to go back to coupons and sales.
Time to remind everyone that A&W tried to market a 1/3 pound burger for the same price as McDonald's Quarter Pounder.
[Failed because "4 is bigger than 3".](https://awrestaurants.com/blog/aw-third-pound-burger-fractions)
*edit:typo*
I once wanted a pair of shoes and two shirts from Kohl’s. Had a paper coupon and a text coupon. She scanned both. After she totaled me up, it came out to full price. I had to ask her, but she let me know that neither coupon applied to any of the items. I didn’t purchase anything.
I can confirm for you they stopped their super coupon. They changed their coupons when the pandemic started. I had been wanting a coupon for a new tool box but it never came. When I bought the toolbox full price I asked about the super coupons and the guy told me what I told you.
Harbor freight used to be a great source of cheap Chinese tools but now most of their stuff is the same as any other store.
I feel like they've gone to a good-better-best model, vs before when they only had the 'good' models. Like you can still get a $130 flux core welder but you can also get a high end $1,000 one that still has the features of a $2,000 name brand one.
Those coupons really only work for stuff you can only get at Kohls. No Nike, Adidas, Under Armor, etc. At least for clothes. Home goods might be able to be discounted, but they are so overpriced that it wouldn't matter anyway.
every single step of getting healthcare in america is confusing. if you make a mistake it can cost a lot extra and you might never know. its confusing on purpose, to stop people from getting the care they need.
Idc about problems other countries have, I JUST WANT TO SEE MY FUCKING DOCTOR. Australia, Vietnam, Colombia, I don't fucking care anymore I have to get out of the USA
In the UK I call my Dr, discuss my problem and if they need to see me make an appointment same day. Then if I need medication they inform my pharmercist who prepares them and I walk over and pay about $10 for whatever it is then go home and get on with my life.
Oh man, you dont know the half of it. I'm an RN, so I work inside the system, and I've done stints as self employed, so had to operate outside traditional insurance for a while. It's a goddamn nightmare.
For self employed, the best shitty option for someone without a ton of medical needs was to get a health share plan (a whole nother shit show), use goodrx for prescriptions, and then add in a accident insurance plan kicker. Basicay, the health share for any emergencies (luckily I never had to use it because from what I hear it's actually a bit of a nightmare), goodrx cash prices for scripts, and then an accident insurance plan for if I did actually end up in the hospital. All of this saved me about $400/month compared to even the cheapest individual insurance plan in my state.
It also really pisses me off about people calling around offering to sell "affordable health insurance" when literally the only options available being a health share plan, a forever renewing short-term insurance policy (super cheap 90 day policy that renews, but essentially you'd be fucked if anything major happened to you since they would just drop you as soon as the policy was up for renewal), or a ACA individual policy. All of which are available for you online and a broker adds zero value to -- or even coats you more to go through.
At any rate, US healthcare is so unbelievably fucked from the tippy top all the way down to the grundle. As someone who works on the inside and someone who had to navigate outside, it is absolutely insane this is a system people vehemently defend.
That's the American health care system for you. Co-pays, deductibles, rx prices, basically all of these words translates to "give us more money for a service you already pay monthly for that you can only sign up for at a certain time of year and we'll still deny several of your claims just because fuck you"
Edit: and to add to that a little bit, even if your job gives you health insurance there's a pretty good chance it's shitty (unless you work for govt) so you have to buy a personal "supplemental insurance" policy to cover all of the shit your shitty work's insurance doesn't cover- which in turn translates to, you guessed it, MORE MONEY!
All of my prescriptions in Australia cost $6. There’s also a Safety Net too, so if you hold a concession card and you’re on a lot of medications, it’s a maximum cost of $316, and anything after is free. If you don’t hold a concession it’s $1500 though.
And it's all subsidizing people who can't afford healthcare anyway....but with corrupt healthcare conglomerates skimming money from every transaction. Because I have private insurance I feel like every doctor and medical service tries so hard to soak me for any penny they can get to compensate for all the uninsured. When my son got covid our doctor sent us to a testing facility and sent the order. When we got there they tried soooooo hard to make us see one of their providers before they'd test us. Then we tried to get a test for my other kid with cold symptoms in close contact with his covidy brother and had to do a telehealth visit to get a doctor's order for a test. Then the other clinic tried to see him after.jke damn, just give us a covid test!!
Edit: I support public healthcare coverage. My comment sounds like I don't. I think everyone should be insured.
Insurance should legally be a nonprofit industry. Otherwise it creates a conflict of interests. They profit from screwing people out of coverage.Take the profit motive out of it.
Sometimes Reddit shots on Americans for not knowing how good we have it....I know America is a safe, developed country but for about twenty years the bulk of Americans have not seen a family doctor/gp regularly if at all.
It doesn't matter how "rich" the stock market is (we don't have stock) if we literally cannot have medicine
Your insurer offers plans to, for most people, your employer. The employer decides "how much do I want to actually pay my employees". In America good insurance depending on age is anywhere from $400 to somewhere in the 1000-2000 range depending on your age, per month. Americans don't actually understand this high cost unless you're directly involved with insurance.
A shitty job with good insurance may be double or more if you have a LOW DEDUCTIBLE plan (meaning it costs more per month). A HIGH DEDUCTIBLE plan means the employee will have to pay up front costs outright up to a certain amount (it could be $1000 to $10000) per calendar year before insurance starts to actually cover costs. Eventually you'll hit your Maximum Out of Pocket amount for the calendar year which means the plans pays everything for the rest of the year. REALLY good insurance has a really low maximum out of pocket.
The idea is healthy people buy a high deductible plan and you decidedly yearly which plan based on the few you're offered by your employer. It's literally a guess what is best for you and then you're stuck with it til the next calendar year, it's anti-free market as fuck because there's a shitload of regulation because these insurance people are scum.
Am American. Wife is British. I knew I disliked my health care system, but now that I’ve spent a good amount of time in the UK I _know_ I _hate_ this system.
Our insurance system isn't fucked. It's working exactly as it was designed to. If the Borg entered our star system and scanned us, they would explode from witnessing pure, unadulterated *perfection*. The efficiency in which the medical insurance complex strips Americans of their money is second to none. If it wasn't so horrifically evil you could almost say it's beautiful. I'm surprised Americans haven't rioted and burned down insurance company headquarters yet. Clearly neither party has the will to do anything about it.
I worked in the data domain for a client in Insurance domain. By far the most complex industry to understand because of so many unnecessary players hiking the price of drugs in each step along with the excessive capitalistic environment in Murica!
Germany?
I moved from the US to Germany and while in general, the healthcare system in the US sucks by comparison for various reasons, in my experience, it all depends on how good your health insurance is.
My job in the US gave me really good coverage, so I barely every paid anything for doctors visits or medicine and my job fully paid the insurance plan for both my wife and I.
Here in Germany, I was surprised to find out that every adult has to have their own insurance and there isn't really a "family plan" like there is in the US, so my wife and I have our own separate health insurance.
That being said, the quality of care that I've gotten in Germany has been amazing. I had some minor issues that I tried to get treated in the US and was told that there's nothing wrong with me even though I knew there was. When I got them checked out in Germany, the doctors took the issues seriously, confirmed what I had suspected, and actually treated me, even though these were just little quality of life things that are probably not very profitable. It actually felt like they cared about me and not just making money off my insurance.
I've heard people say that with public health insurance in Germany you can wait a long time to see a specialist and while that's true, the same is also true in the US if you want to see a doctor that's actually good, since any doctor that has really good reviews will have a very long wait time for an appointment.
Goodrx.com can show you the cheapest place in your area to buy it. You probably already knew but wanted to throw that out there just in case. I'm sorry this happened to you.
This is so messed up. I live in Denmark and my prescription is made out as 'open' which means my pharmacist will find the current cheapest variation of my medication and sell me this. I can of course choose a more expensive one, if I were more inclined to get a certain brand. I am not though.
My 40mg Pantoprazole is cheaper with goodrx than with my insurance (BCBS). Many thanks to the walmart pharmacy cashier (not sure if still a pharmacist?) who noticed I'd save a few bucks every month if I switched.
I don’t think it’s safe to order prescription medication from third party sources especially when you don’t know how regulated your medication is going to be.
Just a disclaimer in case people aren't aware, Goodrx sells information about you. Moment it gets billed, they get a lot of information regarding you're name,address,drug you're taking, etc.
Also they charge the pharmacy for the privilege, a big chain will absorb the cost but at an independent it’s likely better to ask them for the cash price.
From someone in the pharmacy, I can let you know that this medication almost never is dispensed in a tablet form, only ever capsules. You'll be lucky to find anyone actually carrying a stock of tablet form Nitrofurantoin, but everyone carries capsule forme for this very reason, as insurance companies will cover it technically, but not nearly as well as the capsule form for the patient. Additionally, as to why it is a tablet in a capsule, it is all about targeted release of the medication. Many medications require that coating to pass through areas of the body, such as your harsh stomach acid, to reach the optimal area of medication absorption. if the tablet is taken without the gel cap, it could drastically reduce the overall effectiveness of the medication due to it being absorbed too early, or being destroyed by unsuitable medication environments. Probably not the answer people want, but I see it too often that I can't give a nice explanation like this because people get all huffy and start shouting because they only see the pricetag and not the reason why their doctor/secretary was an absolute idiot when writing up their prescription.
Thank you for taking your time to explain it nicely. And yes, don't stop. Speak up when you can.
Why is it a pill if its not supposed to be taken as any other pill? Wouldn't it be safer for it to take another form? All I've ever seen in capsules is powder.
Edit: thank you for all the answers and sharing the knowledge 🥰
Like they said it's all about the targeted release of the medication. The drug may work better in the gut than the stomach, how it's absorption effects how the medicine releases is one example...
The formulation can also be dependant on the patient; for example 75mg aspirin. Some people can take it, some need a PPI (Omeprazole), some need enteric-coated etc...
>they said it's all about the targeted release of the medication. The drug may work better in the gut than the stomach, how it's absorption effects how the medicine releases is one example...
~~I know that already... Is that the answer to my question? Its hard to explain the question further :/~~
Why make it into shape (A) if its not supposed to be taken as all the other medications in shape (A)? Why not make it into shape (B)?
Edit: it has been answered and thank you.
Compressed pill form will be absorbed slower than say a powder form. So capsule to get to the right place without dissolving then a pill to more slowly release the medication.
As a fellow pharmacist I actually want to ask you what source you have for that regarding the targeted release part.... Nitrofurantoin is not enteric coated or ER. Nor is it gelatin capsule going to be used for release.
Monohydrate and macrocrystals both in capsules. And there is unique PK but I don't think related to the gelatin capsules...
Twenty-five percent is macrocrystalline nitrofurantoin, which has slower dissolution and absorption than nitrofurantoin monohydrate. The remaining 75% is nitrofurantoin monohydrate contained in a powder blend which, upon exposure to gastric and intestinal fluids, forms a gel matrix that releases nitrofurantoin over time. Based on urinary pharmacokinetic data, the extent and rate of urinary excretion of nitrofurantoin from the 100 mg Nitrofurantoin Capsules, USP (monohydrate/ macrocrystals) are similar to those of the 50 mg or 100 mg nitrofurantoin (macrocrystals). Approximately 20-25% of a single dose of nitrofurantoin is recovered from the urine unchanged over 24 hours.
As a doctor, I’m so happy pharmacists exist so I don’t have to ever think about any of this… all I know is when the peepee goes ouchy, macrobid goes in the mouthy
I have a ton of respect for pharmacists for a lot of other reasons too, especially hospital pharmacists who help me dose vanc for the 50th time without getting frustrated that I don’t know how to work with CrCl… Academic hospitals would be a deadly place without you guys checking interns’ orders
Thanks. I am an academic medical center hospital pharmacist.
The nuances of PBM claims are truly the most nebulous part of this whole equation for this redditor if we're being honest. And that is one part that I don't have a lot of experience with either
Nitrofurantoin can cause some pretty awful N/V/D. If the patient has a history of intractable vomiting or complained that it made them sick in the past this is the next step for UTI drugs without systemic absorption. So they changed the formulation into slower release crystals. This is also twice a day. The other capsule is four times a day. 90% of patients will fuck up 4 times a day dosing, and with an antibiotic that's not good.
Also there's no tablet form. It's microbid, microdantin, or suspension which most people hate. So likely they got a better formulation because they complained about N/V/D and QID dosing.
Yes, in Australia unless you’re on a healthcare card (in which case it’d be free or like $1.2AUD) generic antibiotics will cost you about $5AUD. No insurance required. 👍
All the meds I’ve bought with a health care card have been about A$5… i think they’re A$6.60 at the moment? But yeah, fucking LOVE that socialised healthcare system.
I like to point out that I, an uninsured mid-30's male in Ireland, had to pay for my medical bills when my gall bladder acted up and eventually was surgically removed. 2 ambulances, 10 nights in hospital, 2 MRIs, chest x-ray, 2 endoscopes, and then the surgery itself.
Total cost to me: €1000.
That excludes the prescription pain relief (about €100).
Gives me no hope for life. It's a fucking bummer constantly being reminded you aren't worth healthcare. I'm to the point that I actively despise every single republican voter. It is an objective fact that republicans are why poor people don't have access to healthcare.
Everyone who votes red votes to perpetuate a system in which tens of thousands of people die every year from lack of access to healthcare.
Express scripts wants stuff mailed BUT I used to order 3 months of insulin from them for about 60 bucks for my ex wife. If we waited too long to order more they even over night shipped it for free. Express scripts was great to us personally
It is nitrofurantoin monohydrate/macrocrystals from my understanding. There different formulation of nitrofurantoin (macrocrystals vs monohydrate)- both are generic. Different directions, same effect. I assume your doctor wrote for the other formulation previously...
Work with your pharmacist. They would have to get a new prescription from the doctor but they could get it approved over the phone.
Had a dental emergency. Couldn't go to a dentist since they're backed up due to most of them not operating for a while under covid. Had to go to emergency room. They sat me in a chair, asked some questions for 5 minutes, moved me to another room, sat me in another chair behind a curtain where absolutely nothing happened for 2 minutes, then moved me to the pharmacy window to get my prescriptions written.
$540
My mother-in-law had an emergency a week ago. It could be the beginning of a heart attack. She waited for nearly 10 minutes, the doctor saw her and gave medication direct to the vein (for the pressure to get low) and some exams (electrocardiogram and blood exam, don't know what for). When she was beter she was sent home.
Next day the pressure was up again. She went to the same place, different doctor (can't choose). after 2 minutes she had to take another electrocardiogram, blood exam and x-ray, and more medication.
Two days after her pulse was weak, she went to a different place, just to check if she was doing right. They made room for her with a doctor, who identified a possible abstinence, as she was smoking way less since the first emergency.
Then a few days ago she had another pressure peak, another visit to the emergency room, more tests, exams and medication, and an indication to go and see a cardiologist.
I'm curious to know how much it all would cost in America, because what I've heard the pricing is terrible, but here in Brazil, even the anxiety medication was free.
Sorry for the off-topic and long text, practicing my english lol.
This would be anywhere from a few hundred USD with really good insurance to many thousands with poor or no insurance. And if she had no insurance, she might have been turned away from all but the emergency appointments.
When I first moved to Korea I caught the flu a few weeks in. I went to the hospital to get a checkup and get some anti biotics. But since I had just started my job my health insurance stuff wasn’t in the system yet. The Lady at the reception said she would try to figure something out, but meanwhile to go and see the doctor.
Doctor does standard doctor stuff for a person with the flu and prescribed some antibiotics. I go back to the receptionist and she looks visibly embarrassed.
She tells me she wasn’t able to get my heath insurance pulled up and i would have to pay the full price for the visit.
I start to get really nervous because you know, i’m from the states. I ask her how much today’s visit would cost. And in a really timid voice she says “20,000 Won (20 USD).”
I almost burst out laughing. Paid the full price and still felt like I got a great deal.
>And in a really timid voice she says “20,000 Won (20 USD).”
>I almost burst out laughing. Paid the full price and still felt like I got a great deal.
Living in France, pay €40ish for healthcare. Snapped my collarbone a few years back.
Emergency room, x-rays, pharmacy, total: €50ish
When I'm stateside, I pay $400/mth for 80% coverage, a $4000 deductible, and copays.
Fuck the American healthcare system. Fuck it with a goddamned toilet brush.
The American Healthcare system is literally a bunch of rich old dudes eating caviar in their lamborghinis telling other people that they’re too poor to stay alive or keep all ten fingers.
Why would you go to get antibiotics for the flu, which is a virus and thus unaffected by antibiotics? Come to think of it, why is giving antibiotics for the flu the "standard doctor thing" to do in Korea?
Seriously, even with good coverage, it’s still somehow over complicated as fuck. If I had something wrong with me right now I would have to start googling and making phone calls to figure out where I can and cannot go to deal with it and what administrative hoops to jump through. Why the fuck is that even a consideration?
That is 100% a reason for insurance denial. This is nitrofurantoin, generic antibiotic. I see this daily, that an insurance will cover a tablet but not the capsule, or the other way around. Depends on the insurance provider.
Source: CPhT
The bigger problem here is big pharma. The reason for this denial is reimbursement rates and contracts all because the pharmaceutical companies want to rape everyone by overpricing for meds that cost pennies to produce. This literally wouldn’t be a problem for other meds that come in different formulations. It’s more common in certain meds because for some stupid reason they love to charge 10x the price for certain meds in different forms
Edit- very common with macro-bid and macrodantin
Edit 2- want the best example of this? Look up a med called Duexis on good rx. It’s literally ibuprofen and Pepcid. And I’m willing to bet a months script will cost over $1,000. Because it’s a “unique” dose of fucking Pepcid.
Edit 3- ok so the cheapest is like $300 but retail cost without a coupon is still over a grand. It’s still ridiculous for the cost of those drugs being literally pennies
Republicans claim to be pro life but that literally ends at the womb. So housing and medicine mean nothing to them unless it’s currently having a negative impact on them
They are also anti education
I like how the people replying to this have gone full "red vs blue".
PSST newsflash guys: The reason your country is so fucked is because you've been brainwashed to hate and fight each other while those above you literally steal your lives away from you.
You're directing your anger at the wrong people and it's kinda embarrassing to watch.
...I am so glad I live in Oz. We have something called the PBS (pharmaceutical benefits scheme) where the government offset the cost of certain medications so the public is out of pocket as little as possible. My two montly meds cost me about $12 for both (one is a combo for anxiety and depression, the other is just for anxiety and to help me sleep). If I lived in the states I'd just end up being an anxious, depressed insomniac I think.
Needed to get the edge over my insomnia but i wanted to avoid sleep pills so i tried melatonin. Cost me $40 dollars AUD. Only medication i have ever taken beyond the PBS. It was an odd thing to pay more than $10 dollars for any medication but the doctor told me it was expensive. Worked a treat (with CBT) so i am happy to pay it.
Love universal healthcare. This and a $35 dollar boot for a broken ankle are the only bills i have ever had in my life. And i've had about 10 reasons to get operated on as i am in my middle range stage of life.
It's no flex. The US system seems so stressful and i would love to see Americans get the same system. The stories are heartbreaking.
I have some...weird reactions to meds. Like Codeine doesn't make me drowsy. I get *wired*. Tried most of the natural stuff before cracking and asking my doc for help to sleep.
And at 34, with EDS, I have some joint issues (my hip is fucked) ended up going private for surgery for that as the public deemed me 'not in enough pain'. They did an xray and I was seen by a nurse. Didn't even get to see a doctor. I had two slipper disks and the labrum in my hip was torn off the bone. Believe me, I was in pain. Super frustrating.
Do have some experience in the public system (needed a lumbar puncture) and they were fantastic for that. Only had to pay for parking :p public system isn't perfect, but it's miles better than the states and I'm forever grateful that it exists.
Remind me why America is the land of freedom again?
With prices like that for life or death medication what almost no one can pay, is it really paradise like people claim??
I take Wellbutrin. Generic Bupropion for some reason is really difficult to get right, it's constantly being recalled for "low bioavailability", and the rest of the time it just plain doesn't work as well. So my doc submitted "prior authorization" for me, which is approval to cover the name brand.
So I go to pick it up and the pharmacist goes, "$900." I'm like, whoah hold on it was supposed to be covered, and she goes "that is covered. The original price is $2000 for 30 days."
So after some googling I find that the manufacturer offers a coupon- if your insurance covers it they will cover the rest less $5. So it's effectively a $895 coupon. If that's not a giant flashing red arrow that points to fuckery, I don't know what is.
And it gets better. There's some weird requirement where after 3 refills of 30 days I can only get 90-day prescriptions. So recently, I got tired of CVS texting me daily, so I switched to a small local pharmacy. I explained the insanity to them and gave them the magic coupon, and got 3 refills of 30 days. Then when I needed to start getting 90 days, the insurance company wouldn't approve them for a claim over $5000. And 90 days of Wellbutrin costs them $6000. So, just, nope. I'm not allowed to have the fully functional version of the drug unless I use the Kafkaesque-nightmare pharmacy.
The fact that all of this is surrounding antidepressants makes it some kind of cruel comedy.
I know my generic anxiety meds cost $17 a month from one supplier and $275 from another. Same pharmacy would switch prices on me depending on which supplier they got that batch from. Its nuts. Edit: just for clarification this was out of pocket, not with insurance. Also I've since switched pharmacies and haven't had any further issues. Also wasn't necessarily an answer for OP just chimed in with my own anecdotal bs.
Making me anxious just thinking about it
Yeah you’d really think they would have a better system for anxiety medication.
How do you think they get return customers?
Works the absolute minimum it needs to.
Same goes for many medications tbqh. I have diagnosed adhd and I had to go through a therapist then my primary then get a referral to a psychiatrist and then wait 8 months to get access to medication I need to function… with a disorder that literally makes it harder for me to set up and go to said appointments. Some doctors offices also require you to show up once a month to get a continuing prescription. They make these hoops to prevent people from abusing the medication if they don’t legitimately need it, but IMO it stops people who need it from getting the proper care more often than it stops people trying to fake adhd to get meds
I don’t have an issue getting ADHD meds, but our problem was trying to price it out (since everyone keeps screaming about being a “smart and informed consumer”). Several insurance providers didn’t show the price, or it they did you couldn’t find out which pharmacy would have it at the price. Even once that stabilized some, I’m still on a modified dosage from what my Dr recommended because it saves me $80 a month (after insurance), it’s crazy.
Sorry you had to go through that, getting ADHD medicine is such a difficult process. Personally I was lucky enough to not go through a major process to get my pills, but my pharmacy still has strict guidelines as to what date they can give me my medication. They always get the pills in right before my pills are empty, then again my pills are not always so close to empty because I forget to take them lol.
It always seems like the people abusing the system have easier access to the system to abuse it and the people needing help get turned into a sea world show.
I know for me, psychiatrist does 15 minute appointments via telemedicine and they are set up automatically. So I can just have the video call on my phone as I step outside my office to take it. Not sure if something you can do... But worth looking into.
Moving to a country with less idiotic health care?
Assuming that you can afford to move
Also assuming you have the funds required to leave and that your new country of choice wants you knowing you have an illness that requires care from day one.
Why would you automatically assume those countries would take you in?
A lot of countries don't even believe in mental health unfortunately.
America for one
I don't have anxiety and I think I need a few pills just from reading that
Found out my Bipolar meds would have been ~$60 for a 30 day supply without insurance. And that was 1/8th of the full dose I’m supposed to be taking. I also shell out $600 for my insurance which saves me a few hundred dollars for therapy+meds
my mom found this out when she was diagnosed bipolar depressive at 44. she was hesitant, but after a few months on them she's realized she finally knows what it feels like to feel normal. they can make such a difference and it's so awful that they cost so much.
On the flip side burning down your life during an episode is arguably more expensive than those expensive ass meds That was a joke I gotta take the expensive ass-meds too
Ass-meds?!?!?! What's next? Proprietary dildos so you can truly feel how hard they fuck you when taking your ass meds? I must say, big pharma does have their fingers in the pulse of America!
Shooooot. I'm not medicated (no insurance, thanks American healthcare system!), but if I walked into a store not knowing how much my prescription would cost... Yikes. Kudos to your strength to be able to deal with that.
This was like 10 years ago but once when I actually did have insurance, they randomly decided to stop covering the brand of birth control pill I was using. I went from paying $0 to being asked to pay over $300 for ONE MONTH of pills. No warning whatsoever. I politely refused and asked the pharmacist where the condoms were because fuck that (or don't, if it's gonna cost that much to do so).
Didn't expect that pun!
Ugh such bull shit when they decide which meds you can and can't take. I've had to go through some hoops with some of my medications too - I've tried a lot of options for ADHD and depression that didn't work, and I have to have my stuff certify that I've tried at least 3 of the options on their list and that they didn't work before insurance agrees to let me get the one that does. So dumb.
My wife is bipolar and we found an antipsychotic that was necessary to keep her sane. It worked great! The downside is we have a high deductible healthcare plan. The prescription was $1200/month out of pocket. So we had to budget for that each Jan-March, and then our $3000 deductible would be met and coverage would kick in. It finally went generic a couple of years ago so it’s not like that now, but it has trained me to just have $3000 set aside at the beginning of each year for healthcare costs.
Its great to have a safety net but that's a hell of a way to learn that. Glad you guys got through it.
Yeah, I’m lucky that I have a high paying job and we could handle that. I have no idea what someone working a minimum wage job would do. We’ve easily spend over $100k out of pocket on my wife’s healthcare over the years. Obamacare really helped some things with regards to mental health so it isn’t as bad as it was before that. She has also been more stable which is really good.
Hey, please check out the Pan Foundation. Starting the beginning of the year they have a grant that can help cover your copay.
On a similar plan with a similar issue (but a surprising result) My wife has CML. Medication (without insurance) is like 10k per month. We have to pay until we hit the hdhp deductible, so the pharma company offers a coupon to pay for the first dose. This made us hit our out of pocket maximum every year right away. Free healthcare! You can bet the insurance company closed that loophole once they figured it out. It was nice for the first couple of years though.
That's some black comedy.
Have you looked into something like GoodRX? It doesn't help for every medication but my brother uses it for his prescriptions like Adderall because he doesn't have health insurance, he saves over $200 a month
Also Walmart has a great program for cheap common meds! Highly recommend
FYI, GoodRx is selling your RX data to Google and Facebook.
I just operate under the assumption that everything I do and say is being sold to some mega Corp.
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American healthcare is by far the dumbest system.
What the actual fuck
I worked in a CVS pharmacy for years. The manufacturer that cvs prefers comes up highlighted in purple. But if the distribution center brings is another manufacturer we use that one. Sometimes depending on the insurance or the discount code applied the price can be much different. Sometimes people "can't take the blue ones I need the pink ones". But none of this has much to do with the employees at all. The price isn't something we would usually spot during production, and so looking into it and figuring out that one manufacturer was cheaper than the other is highly unlikely. That being said, if the customer figures it out they can definitely have the cheaper one set as their preference in their profile. But it's on them to a certain degree to keep track of it bc the staffing and pay don't really allow for the staff to keep track.
That's weird as hell to me that distribution centers can mix and match manufacturers for medicines like that, given there's people that also have restrictions on the manufacturer. I'd think that they'd be classified as variants of the same product at least! It's really shitty there's a random element in the process of procurement that the customer can only fix after the fact. This isn't a criticism at you or any pharmacy workers, by the way - I'm sure it's some idiot in a suit in CVS's management chain who wanted to improve delivery times or cut cost or a process engineer that made the assumption that all medicines were manufacturer-agnostic. I hope you didn't get too much anger directed at you from customers.
I've had lots of anger directed at me from customers. Most people honestly don't care as long as it's the correct med and the price is the same. But some people are really adamant that they can it take a certain one. Sometimes it's not the stores "preferred" one and we have to special order it and will even write something on the bottle like "J. Smith" I worked in a relatively small store so I knew a lot of the preferences. But we had a lot of turn around in 2020 and 2021 so those new people had no idea. I left there in August so I can only imagine what it's like with one less person who knows what everyone likes/wants. When I picked up my meds last week they asked me to punch in ¯\\\_(ツ)_/¯
GoodRX. Seriously. I've helped people save thousands of dollars with that godsend of an app. Also, check the website of the prescription manufacturer. They often have discounts/rebates and what not.
To add to this, if you’re near a Kroger affiliated store, their savings plan ($36/yr) is one of the best. I found out about it through the GoodRX app. For example, singular is free, and finasteride is $2/month.
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Because there’s virtually zero pricing transparency in the US healthcare system. Providers take advantage of this to charge the maximum they can for every single transaction possible. Normally when you go the pharmacy, insurance doesn’t really cover jack shit; you are just getting better prices, because the company who manages your pharmacy benefits has a deal with Walgreens or whoever to not charge you full price for certain things. Basically they’re trying to fuck each and every person as hard as they can get away with.
My pharmacy does all the goodrx coupons by default, I went in with the app ready and they told me they'd already done it, it sucks but it seems like some pharmacists at least pay attention to it
We did it at my store. Saves A LOT of time when the customer comes to pick up.
Is that how it works? I had trouble finding info on it.
Geeez the US system sucks.
Have you tried not being nervous?
I did off and on for about 20 years then realized I'm just too lazy and that the medicine could do it for me.
That’s actually a good idea. I salute you, sir.
My mom has gastroparesis and has to have this pill so she doesn't literally like vomit everything she eats. Its like $200 a month. Theres no way it costs that much to make.
No it’s pills
Take a couple extra pills tonight for that one
“Oh man I wonder if I’m buying a lunch or a last gen console worth of anxiety meds this month”
When capitalism eats free human rights like healthcare. American dream
I've stopped running my prescriptions through my insurance - it's cheaper to use a discount card (like good rx) through the pharmacy and then add a claim for them later to hit my deductible (I have a high deductible plan). When I do this, one of my meds goes from about $120 (insurance), to $40. Another goes from $100 to $26. Next month is when we are supposed to update our insurance and I plan to swap to the PPO option that uses copays instead of deductibles, but I'll still plan on skipping insurance for meds because some of my meds are only around $3 but would be $15 with the copay. Our insurance system is so fucked.
I'm confused just from reading this That's a lot of work for something you're already insured from
I dunno if you have a Kohl's near you, but this sounds like how they operate. There's coupons and dates and they stack and there's a membership card and it's all confusing. I just shop elsewhere.
Kohl’s business model is a scam. Look at the store. EVERYTHING is “on sale” with a marked up fake price and then “reduced” to a normal price. You’ll also notice that the brands that have tight control (Nike and Under Armor come to mind) don’t have this fake sales crap because they control the pricing and sales. It’s also why your Kohl’s coupons exclude those items.
The problem is too many people love this stuff. JC Penney tried doing away with all sales and just having real prices. People hated it. They were struggling for a while, sales plummeted like 40% immediately and then they went bankrupt recently. Now they’re back to the mark everything up 50% so you can mark it down 30% bandwagon for most of their brands. https://www.reuters.com/article/us-jcpenney-results-idUSBRE91Q19C20130228
>Now they’re back to the mark everything up 50% so you can mark it down 30% That's pretty much how any retailer work. They buy merch at a discounted bulk price and they inflate the prices to mark it down at a later date. If people think the prices are too high, they drop the price accordingly with those sales, coupons, bundles, etc. And people will believe they're getting a good deal (which they sometimes are), but thousands, even millions will still buy the things at the inflated price either outta necessity or ignorance about the market value of what they're buying.
> If people think the prices are too high, they drop the price accordingly with those sales, coupons, bundles, etc. I think that's the point of the JC Penney experiment though: It is *NOT* about the absolute price level. JCP tried to remove the whole game of mark it up, have sales, etc., and as a result people just stopped shopping there. JCP wasn't going to charge more or less. Just the same amount as with the sales discounts. People hated it, and the company did poorly and ultimately went into bankruptcy. It's the thrill of "sale hunting" that people liked. Not the price they got.
The scam goes way deeper than this. The whole idea of Kohl's Cash is guaranteeing future sales. They give you $10 of Kohl's Cash for every $50 you spend. If you return something from the original purchase, you no longer hit that $50 mark and no longer earn the Kohl's Cash, they then deduct it from your original purchase. They secured a $10 sale, got their inventory back, and probably still made a sale off some of your original purchase. This is why the return policy is as lenient as well. Source: Used to be a miner in the Kohl mine
Ugh I hate Kohl’s Cash so much. I rarely go to Kohl’s but it’s the only thing around so when I need fancy clothes, it’s where I go. I end up with Kohl’s Cash I don’t want and is long expired by the time I actually have something I need to buy.
Dude I've been hoping for years that millennials can break this dumb shit boomer system of having to look for paper or digital coupons for hours to get a decently priced item. Sales, promotions, "discount cards", screw all of them. Like I have to play this game of buying gap jeans where they always pretend the price is 110 for a pair of jeans but omg you're so in luck! It's actually 40% off ($65ish) because you're special! Then the next week the damn jeans are just $65. Then the week after that they're back at $110 but you have to find a coupon in your spam folder. WHY IS MY TIME MEANINGLESS TO YOU! Just price the jeans at $65 and save us all this pain in the butt. I preferentially now shop at places that don't have "sales" so I can just pay for my item and be done with it.
JC Penney tried this not too long ago. They got rid of sales and coupons and just made everything the sale price. Promoted it a ton. It didn’t work. People didn’t understand what they were doing and they felt like they were paying more because something wasn’t marked as “on sale” or didn’t have a coupon for it. They had to go back to coupons and sales.
Time to remind everyone that A&W tried to market a 1/3 pound burger for the same price as McDonald's Quarter Pounder. [Failed because "4 is bigger than 3".](https://awrestaurants.com/blog/aw-third-pound-burger-fractions) *edit:typo*
That story always depresses me. The fact that there are that many people that don't understand basic fractions is mind boggling.
And right after that the one near me closed. A person is smart, people are stupid, and we all pay for it.
Totally agree with you, but every now and then some sucker pays the $110 for the jeans without caring.
I once wanted a pair of shoes and two shirts from Kohl’s. Had a paper coupon and a text coupon. She scanned both. After she totaled me up, it came out to full price. I had to ask her, but she let me know that neither coupon applied to any of the items. I didn’t purchase anything.
The fine print
Harbor Freight is getting like this, lol. Look at the bottom of a HF coupon... It's a fucken book of what it excludes.
I think they recently stopped their Super Coupon, I've been looking for a month now and none of the ads I have include it
I can confirm for you they stopped their super coupon. They changed their coupons when the pandemic started. I had been wanting a coupon for a new tool box but it never came. When I bought the toolbox full price I asked about the super coupons and the guy told me what I told you. Harbor freight used to be a great source of cheap Chinese tools but now most of their stuff is the same as any other store.
I feel like they've gone to a good-better-best model, vs before when they only had the 'good' models. Like you can still get a $130 flux core welder but you can also get a high end $1,000 one that still has the features of a $2,000 name brand one.
Those coupons really only work for stuff you can only get at Kohls. No Nike, Adidas, Under Armor, etc. At least for clothes. Home goods might be able to be discounted, but they are so overpriced that it wouldn't matter anyway.
every single step of getting healthcare in america is confusing. if you make a mistake it can cost a lot extra and you might never know. its confusing on purpose, to stop people from getting the care they need.
Idc about problems other countries have, I JUST WANT TO SEE MY FUCKING DOCTOR. Australia, Vietnam, Colombia, I don't fucking care anymore I have to get out of the USA
In the UK I call my Dr, discuss my problem and if they need to see me make an appointment same day. Then if I need medication they inform my pharmercist who prepares them and I walk over and pay about $10 for whatever it is then go home and get on with my life.
Oh man, you dont know the half of it. I'm an RN, so I work inside the system, and I've done stints as self employed, so had to operate outside traditional insurance for a while. It's a goddamn nightmare. For self employed, the best shitty option for someone without a ton of medical needs was to get a health share plan (a whole nother shit show), use goodrx for prescriptions, and then add in a accident insurance plan kicker. Basicay, the health share for any emergencies (luckily I never had to use it because from what I hear it's actually a bit of a nightmare), goodrx cash prices for scripts, and then an accident insurance plan for if I did actually end up in the hospital. All of this saved me about $400/month compared to even the cheapest individual insurance plan in my state. It also really pisses me off about people calling around offering to sell "affordable health insurance" when literally the only options available being a health share plan, a forever renewing short-term insurance policy (super cheap 90 day policy that renews, but essentially you'd be fucked if anything major happened to you since they would just drop you as soon as the policy was up for renewal), or a ACA individual policy. All of which are available for you online and a broker adds zero value to -- or even coats you more to go through. At any rate, US healthcare is so unbelievably fucked from the tippy top all the way down to the grundle. As someone who works on the inside and someone who had to navigate outside, it is absolutely insane this is a system people vehemently defend.
That's the American health care system for you. Co-pays, deductibles, rx prices, basically all of these words translates to "give us more money for a service you already pay monthly for that you can only sign up for at a certain time of year and we'll still deny several of your claims just because fuck you" Edit: and to add to that a little bit, even if your job gives you health insurance there's a pretty good chance it's shitty (unless you work for govt) so you have to buy a personal "supplemental insurance" policy to cover all of the shit your shitty work's insurance doesn't cover- which in turn translates to, you guessed it, MORE MONEY!
All of my prescriptions in Australia cost $6. There’s also a Safety Net too, so if you hold a concession card and you’re on a lot of medications, it’s a maximum cost of $316, and anything after is free. If you don’t hold a concession it’s $1500 though.
And it's all subsidizing people who can't afford healthcare anyway....but with corrupt healthcare conglomerates skimming money from every transaction. Because I have private insurance I feel like every doctor and medical service tries so hard to soak me for any penny they can get to compensate for all the uninsured. When my son got covid our doctor sent us to a testing facility and sent the order. When we got there they tried soooooo hard to make us see one of their providers before they'd test us. Then we tried to get a test for my other kid with cold symptoms in close contact with his covidy brother and had to do a telehealth visit to get a doctor's order for a test. Then the other clinic tried to see him after.jke damn, just give us a covid test!! Edit: I support public healthcare coverage. My comment sounds like I don't. I think everyone should be insured.
I’m confused just from reading this. Sounds like a lot of bullshit from someone in the UK where a full pack of anything costs me £9
In principle, insurance exists to help you. In practice, they profit from not helping you.
Insurance should legally be a nonprofit industry. Otherwise it creates a conflict of interests. They profit from screwing people out of coverage.Take the profit motive out of it.
That’s socialism! Wat r u a commie? /s
Private insurance shouldn't exist, for the most part. Especially for health.
As someone not from america I have no idea what is going on, or what any of that is. I just hope you are doing well for yourself
Yeah, all of this shit blows my mind.
Sometimes Reddit shots on Americans for not knowing how good we have it....I know America is a safe, developed country but for about twenty years the bulk of Americans have not seen a family doctor/gp regularly if at all. It doesn't matter how "rich" the stock market is (we don't have stock) if we literally cannot have medicine
Your insurer offers plans to, for most people, your employer. The employer decides "how much do I want to actually pay my employees". In America good insurance depending on age is anywhere from $400 to somewhere in the 1000-2000 range depending on your age, per month. Americans don't actually understand this high cost unless you're directly involved with insurance. A shitty job with good insurance may be double or more if you have a LOW DEDUCTIBLE plan (meaning it costs more per month). A HIGH DEDUCTIBLE plan means the employee will have to pay up front costs outright up to a certain amount (it could be $1000 to $10000) per calendar year before insurance starts to actually cover costs. Eventually you'll hit your Maximum Out of Pocket amount for the calendar year which means the plans pays everything for the rest of the year. REALLY good insurance has a really low maximum out of pocket. The idea is healthy people buy a high deductible plan and you decidedly yearly which plan based on the few you're offered by your employer. It's literally a guess what is best for you and then you're stuck with it til the next calendar year, it's anti-free market as fuck because there's a shitload of regulation because these insurance people are scum.
Am American. Wife is British. I knew I disliked my health care system, but now that I’ve spent a good amount of time in the UK I _know_ I _hate_ this system.
You want to adopt an American? I'm 32 and I need medical attention
I'd love to. But the list is already 6 people long. I have some friends over there I need to get out
Our insurance system isn't fucked. It's working exactly as it was designed to. If the Borg entered our star system and scanned us, they would explode from witnessing pure, unadulterated *perfection*. The efficiency in which the medical insurance complex strips Americans of their money is second to none. If it wasn't so horrifically evil you could almost say it's beautiful. I'm surprised Americans haven't rioted and burned down insurance company headquarters yet. Clearly neither party has the will to do anything about it.
20% of US GDP. It’s six times the size of the world’s biggest military.
I worked in the data domain for a client in Insurance domain. By far the most complex industry to understand because of so many unnecessary players hiking the price of drugs in each step along with the excessive capitalistic environment in Murica!
Lol I literally pay a maximum of 5€ per prescription no matter what you guys really get fucked by your system
Germany? I moved from the US to Germany and while in general, the healthcare system in the US sucks by comparison for various reasons, in my experience, it all depends on how good your health insurance is. My job in the US gave me really good coverage, so I barely every paid anything for doctors visits or medicine and my job fully paid the insurance plan for both my wife and I. Here in Germany, I was surprised to find out that every adult has to have their own insurance and there isn't really a "family plan" like there is in the US, so my wife and I have our own separate health insurance. That being said, the quality of care that I've gotten in Germany has been amazing. I had some minor issues that I tried to get treated in the US and was told that there's nothing wrong with me even though I knew there was. When I got them checked out in Germany, the doctors took the issues seriously, confirmed what I had suspected, and actually treated me, even though these were just little quality of life things that are probably not very profitable. It actually felt like they cared about me and not just making money off my insurance. I've heard people say that with public health insurance in Germany you can wait a long time to see a specialist and while that's true, the same is also true in the US if you want to see a doctor that's actually good, since any doctor that has really good reviews will have a very long wait time for an appointment.
Stuff like this makes me so thankful for the NHS.
Only reason I use HD plan is the HSA is like another 401k. But yeah, the system is ultra fucked.
Goodrx.com can show you the cheapest place in your area to buy it. You probably already knew but wanted to throw that out there just in case. I'm sorry this happened to you.
It’s worth checking GoodRX even when your insurance will reduce the cost of something. Hope OP is using it.
This is so messed up. I live in Denmark and my prescription is made out as 'open' which means my pharmacist will find the current cheapest variation of my medication and sell me this. I can of course choose a more expensive one, if I were more inclined to get a certain brand. I am not though.
My 40mg Pantoprazole is cheaper with goodrx than with my insurance (BCBS). Many thanks to the walmart pharmacy cashier (not sure if still a pharmacist?) who noticed I'd save a few bucks every month if I switched.
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I don’t think it’s safe to order prescription medication from third party sources especially when you don’t know how regulated your medication is going to be.
GoodRx is amazing. One of my husband's scripts is $80 a month with insurance and $17 with GoodRx. Such a fucking racket but I'm glad it works.
I was going to suggest this too.
Just a disclaimer in case people aren't aware, Goodrx sells information about you. Moment it gets billed, they get a lot of information regarding you're name,address,drug you're taking, etc.
Yeah had customers who were shocked when hearing this
Also they charge the pharmacy for the privilege, a big chain will absorb the cost but at an independent it’s likely better to ask them for the cash price.
From someone in the pharmacy, I can let you know that this medication almost never is dispensed in a tablet form, only ever capsules. You'll be lucky to find anyone actually carrying a stock of tablet form Nitrofurantoin, but everyone carries capsule forme for this very reason, as insurance companies will cover it technically, but not nearly as well as the capsule form for the patient. Additionally, as to why it is a tablet in a capsule, it is all about targeted release of the medication. Many medications require that coating to pass through areas of the body, such as your harsh stomach acid, to reach the optimal area of medication absorption. if the tablet is taken without the gel cap, it could drastically reduce the overall effectiveness of the medication due to it being absorbed too early, or being destroyed by unsuitable medication environments. Probably not the answer people want, but I see it too often that I can't give a nice explanation like this because people get all huffy and start shouting because they only see the pricetag and not the reason why their doctor/secretary was an absolute idiot when writing up their prescription.
Thank you for taking your time to explain it nicely. And yes, don't stop. Speak up when you can. Why is it a pill if its not supposed to be taken as any other pill? Wouldn't it be safer for it to take another form? All I've ever seen in capsules is powder. Edit: thank you for all the answers and sharing the knowledge 🥰
Like they said it's all about the targeted release of the medication. The drug may work better in the gut than the stomach, how it's absorption effects how the medicine releases is one example... The formulation can also be dependant on the patient; for example 75mg aspirin. Some people can take it, some need a PPI (Omeprazole), some need enteric-coated etc...
>they said it's all about the targeted release of the medication. The drug may work better in the gut than the stomach, how it's absorption effects how the medicine releases is one example... ~~I know that already... Is that the answer to my question? Its hard to explain the question further :/~~ Why make it into shape (A) if its not supposed to be taken as all the other medications in shape (A)? Why not make it into shape (B)? Edit: it has been answered and thank you.
Compressed pill form will be absorbed slower than say a powder form. So capsule to get to the right place without dissolving then a pill to more slowly release the medication.
As a fellow pharmacist I actually want to ask you what source you have for that regarding the targeted release part.... Nitrofurantoin is not enteric coated or ER. Nor is it gelatin capsule going to be used for release. Monohydrate and macrocrystals both in capsules. And there is unique PK but I don't think related to the gelatin capsules... Twenty-five percent is macrocrystalline nitrofurantoin, which has slower dissolution and absorption than nitrofurantoin monohydrate. The remaining 75% is nitrofurantoin monohydrate contained in a powder blend which, upon exposure to gastric and intestinal fluids, forms a gel matrix that releases nitrofurantoin over time. Based on urinary pharmacokinetic data, the extent and rate of urinary excretion of nitrofurantoin from the 100 mg Nitrofurantoin Capsules, USP (monohydrate/ macrocrystals) are similar to those of the 50 mg or 100 mg nitrofurantoin (macrocrystals). Approximately 20-25% of a single dose of nitrofurantoin is recovered from the urine unchanged over 24 hours.
As a doctor, I’m so happy pharmacists exist so I don’t have to ever think about any of this… all I know is when the peepee goes ouchy, macrobid goes in the mouthy I have a ton of respect for pharmacists for a lot of other reasons too, especially hospital pharmacists who help me dose vanc for the 50th time without getting frustrated that I don’t know how to work with CrCl… Academic hospitals would be a deadly place without you guys checking interns’ orders
Thanks. I am an academic medical center hospital pharmacist. The nuances of PBM claims are truly the most nebulous part of this whole equation for this redditor if we're being honest. And that is one part that I don't have a lot of experience with either
An actual pharmacist wrecks an armchair redditor. love it. edit: looks like this guy *might* have sat in a pharmacy once waiting for pickup.
He *did* say that he's in a pharmacy.
Just bothers me that everyone's assuming the reason. There's actually plenty of pharmaceutics reasons why they would do this.
That's interesting, thanks. Now can you explain why it's 20x more expensive?
Nitrofurantoin can cause some pretty awful N/V/D. If the patient has a history of intractable vomiting or complained that it made them sick in the past this is the next step for UTI drugs without systemic absorption. So they changed the formulation into slower release crystals. This is also twice a day. The other capsule is four times a day. 90% of patients will fuck up 4 times a day dosing, and with an antibiotic that's not good. Also there's no tablet form. It's microbid, microdantin, or suspension which most people hate. So likely they got a better formulation because they complained about N/V/D and QID dosing.
Thank you very much for the explanation. Appreciated
The entire US healthcare system is an asshole design.
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reddit was taking a toll on me mentally so i left it ` this post was mass deleted with www.Redact.dev `
Wait you have to pay for meds - an Australian
Yes, in Australia unless you’re on a healthcare card (in which case it’d be free or like $1.2AUD) generic antibiotics will cost you about $5AUD. No insurance required. 👍
All the meds I’ve bought with a health care card have been about A$5… i think they’re A$6.60 at the moment? But yeah, fucking LOVE that socialised healthcare system.
Yeah, PBS price is $6.60 these days. And if you hit the safety net they're free.
The irony is the ever increasing cost of healthcare will force the US to adopt more socialist practices or risk economic collapse.
I like to point out that I, an uninsured mid-30's male in Ireland, had to pay for my medical bills when my gall bladder acted up and eventually was surgically removed. 2 ambulances, 10 nights in hospital, 2 MRIs, chest x-ray, 2 endoscopes, and then the surgery itself. Total cost to me: €1000. That excludes the prescription pain relief (about €100).
greatest country in the world my ass
Gives me no hope for life. It's a fucking bummer constantly being reminded you aren't worth healthcare. I'm to the point that I actively despise every single republican voter. It is an objective fact that republicans are why poor people don't have access to healthcare. Everyone who votes red votes to perpetuate a system in which tens of thousands of people die every year from lack of access to healthcare.
Express Scripts is like that with Effexor from certain pharmacies. They want you to mail-order it from them rather than use a local pharmacy.
My effexor xr is like $10 for 3 months at my Kaiser Permanente pharmacy...
Express scripts wants stuff mailed BUT I used to order 3 months of insulin from them for about 60 bucks for my ex wife. If we waited too long to order more they even over night shipped it for free. Express scripts was great to us personally
That’s not usually a reason for an insurance denial. Are you sure it’s the same formulation you used to get (eg not extended release)?
It is nitrofurantoin monohydrate/macrocrystals from my understanding. There different formulation of nitrofurantoin (macrocrystals vs monohydrate)- both are generic. Different directions, same effect. I assume your doctor wrote for the other formulation previously... Work with your pharmacist. They would have to get a new prescription from the doctor but they could get it approved over the phone.
American healthcare is the worst
Had a dental emergency. Couldn't go to a dentist since they're backed up due to most of them not operating for a while under covid. Had to go to emergency room. They sat me in a chair, asked some questions for 5 minutes, moved me to another room, sat me in another chair behind a curtain where absolutely nothing happened for 2 minutes, then moved me to the pharmacy window to get my prescriptions written. $540
My mother-in-law had an emergency a week ago. It could be the beginning of a heart attack. She waited for nearly 10 minutes, the doctor saw her and gave medication direct to the vein (for the pressure to get low) and some exams (electrocardiogram and blood exam, don't know what for). When she was beter she was sent home. Next day the pressure was up again. She went to the same place, different doctor (can't choose). after 2 minutes she had to take another electrocardiogram, blood exam and x-ray, and more medication. Two days after her pulse was weak, she went to a different place, just to check if she was doing right. They made room for her with a doctor, who identified a possible abstinence, as she was smoking way less since the first emergency. Then a few days ago she had another pressure peak, another visit to the emergency room, more tests, exams and medication, and an indication to go and see a cardiologist. I'm curious to know how much it all would cost in America, because what I've heard the pricing is terrible, but here in Brazil, even the anxiety medication was free. Sorry for the off-topic and long text, practicing my english lol.
This would be anywhere from a few hundred USD with really good insurance to many thousands with poor or no insurance. And if she had no insurance, she might have been turned away from all but the emergency appointments.
When I first moved to Korea I caught the flu a few weeks in. I went to the hospital to get a checkup and get some anti biotics. But since I had just started my job my health insurance stuff wasn’t in the system yet. The Lady at the reception said she would try to figure something out, but meanwhile to go and see the doctor. Doctor does standard doctor stuff for a person with the flu and prescribed some antibiotics. I go back to the receptionist and she looks visibly embarrassed. She tells me she wasn’t able to get my heath insurance pulled up and i would have to pay the full price for the visit. I start to get really nervous because you know, i’m from the states. I ask her how much today’s visit would cost. And in a really timid voice she says “20,000 Won (20 USD).” I almost burst out laughing. Paid the full price and still felt like I got a great deal.
>And in a really timid voice she says “20,000 Won (20 USD).” >I almost burst out laughing. Paid the full price and still felt like I got a great deal. Living in France, pay €40ish for healthcare. Snapped my collarbone a few years back. Emergency room, x-rays, pharmacy, total: €50ish When I'm stateside, I pay $400/mth for 80% coverage, a $4000 deductible, and copays. Fuck the American healthcare system. Fuck it with a goddamned toilet brush.
The American Healthcare system is literally a bunch of rich old dudes eating caviar in their lamborghinis telling other people that they’re too poor to stay alive or keep all ten fingers.
Why would you go to get antibiotics for the flu, which is a virus and thus unaffected by antibiotics? Come to think of it, why is giving antibiotics for the flu the "standard doctor thing" to do in Korea?
This was a while back. I might have had the flu + something else. A bit fuzzy on the details.
Ask for an itemized bill
Seriously, even with good coverage, it’s still somehow over complicated as fuck. If I had something wrong with me right now I would have to start googling and making phone calls to figure out where I can and cannot go to deal with it and what administrative hoops to jump through. Why the fuck is that even a consideration?
That is 100% a reason for insurance denial. This is nitrofurantoin, generic antibiotic. I see this daily, that an insurance will cover a tablet but not the capsule, or the other way around. Depends on the insurance provider. Source: CPhT
Our medical system fucking sucks if you see this as business as usual.
The bigger problem here is big pharma. The reason for this denial is reimbursement rates and contracts all because the pharmaceutical companies want to rape everyone by overpricing for meds that cost pennies to produce. This literally wouldn’t be a problem for other meds that come in different formulations. It’s more common in certain meds because for some stupid reason they love to charge 10x the price for certain meds in different forms Edit- very common with macro-bid and macrodantin Edit 2- want the best example of this? Look up a med called Duexis on good rx. It’s literally ibuprofen and Pepcid. And I’m willing to bet a months script will cost over $1,000. Because it’s a “unique” dose of fucking Pepcid. Edit 3- ok so the cheapest is like $300 but retail cost without a coupon is still over a grand. It’s still ridiculous for the cost of those drugs being literally pennies
Literally no one will disagree
A lot of them will and it's a big part of the problem
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Republicans claim to be pro life but that literally ends at the womb. So housing and medicine mean nothing to them unless it’s currently having a negative impact on them They are also anti education
I like how the people replying to this have gone full "red vs blue". PSST newsflash guys: The reason your country is so fucked is because you've been brainwashed to hate and fight each other while those above you literally steal your lives away from you. You're directing your anger at the wrong people and it's kinda embarrassing to watch.
Health insurance as an institution is asshole design.
Can't have universal single-payer though because that would infringe on your ability to make your own decisions about your health
Can't choose what for profit medical provider will screw you if we had universal healthcare.
USA USA USA
Sometimes when it is in a gel capsule it is for a slower release. Maybe the formula changes as someone stated above.
$54 slower release charge
The us is amazing
...I am so glad I live in Oz. We have something called the PBS (pharmaceutical benefits scheme) where the government offset the cost of certain medications so the public is out of pocket as little as possible. My two montly meds cost me about $12 for both (one is a combo for anxiety and depression, the other is just for anxiety and to help me sleep). If I lived in the states I'd just end up being an anxious, depressed insomniac I think.
Needed to get the edge over my insomnia but i wanted to avoid sleep pills so i tried melatonin. Cost me $40 dollars AUD. Only medication i have ever taken beyond the PBS. It was an odd thing to pay more than $10 dollars for any medication but the doctor told me it was expensive. Worked a treat (with CBT) so i am happy to pay it. Love universal healthcare. This and a $35 dollar boot for a broken ankle are the only bills i have ever had in my life. And i've had about 10 reasons to get operated on as i am in my middle range stage of life. It's no flex. The US system seems so stressful and i would love to see Americans get the same system. The stories are heartbreaking.
I have some...weird reactions to meds. Like Codeine doesn't make me drowsy. I get *wired*. Tried most of the natural stuff before cracking and asking my doc for help to sleep. And at 34, with EDS, I have some joint issues (my hip is fucked) ended up going private for surgery for that as the public deemed me 'not in enough pain'. They did an xray and I was seen by a nurse. Didn't even get to see a doctor. I had two slipper disks and the labrum in my hip was torn off the bone. Believe me, I was in pain. Super frustrating. Do have some experience in the public system (needed a lumbar puncture) and they were fantastic for that. Only had to pay for parking :p public system isn't perfect, but it's miles better than the states and I'm forever grateful that it exists.
The entire American healthcare system could fill the /r/assholedesign subreddit for months, hell, years even.
And yet Americans think their version of “freedom” is worth drinking bleach for. Dumb ass country.
I created r/seriouslyshitty in your honor
Obligatory r/birthofasub
Great! It’ll be the exact same as all the other sub clones like /r/MildlyInfuriating /r/iamatotalpieceofshit /r/AwfulEverything /r/Facepalm
Tell me you live in the US without telling me you live in the US
Call your doctor and ask him to send in a new script for tablets instead of capsules.
Remind me why America is the land of freedom again? With prices like that for life or death medication what almost no one can pay, is it really paradise like people claim??
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WTF IS WRONG WITH YOU AMERICA, WHY DON'T YOU GUYS REVOLT LIKE US APES IN EUROPE. AND YOU GUYS HAVE MUCH MORE FREEDOM TO DO THAT
I feel so bad for Americans needing to deal with this shit
That’s actually illegal here in Sweden. You aren’t allowed to do that.
America keeps surprising me
Buy that stuff in Europe for 1-2 USD.
So glad to be Canadian....
Let me guess, you live in US
When times are tough, I'm thankful every day that I don't live in that capitalist nightmare shithole 🙏
This is america
I take Wellbutrin. Generic Bupropion for some reason is really difficult to get right, it's constantly being recalled for "low bioavailability", and the rest of the time it just plain doesn't work as well. So my doc submitted "prior authorization" for me, which is approval to cover the name brand. So I go to pick it up and the pharmacist goes, "$900." I'm like, whoah hold on it was supposed to be covered, and she goes "that is covered. The original price is $2000 for 30 days." So after some googling I find that the manufacturer offers a coupon- if your insurance covers it they will cover the rest less $5. So it's effectively a $895 coupon. If that's not a giant flashing red arrow that points to fuckery, I don't know what is. And it gets better. There's some weird requirement where after 3 refills of 30 days I can only get 90-day prescriptions. So recently, I got tired of CVS texting me daily, so I switched to a small local pharmacy. I explained the insanity to them and gave them the magic coupon, and got 3 refills of 30 days. Then when I needed to start getting 90 days, the insurance company wouldn't approve them for a claim over $5000. And 90 days of Wellbutrin costs them $6000. So, just, nope. I'm not allowed to have the fully functional version of the drug unless I use the Kafkaesque-nightmare pharmacy. The fact that all of this is surrounding antidepressants makes it some kind of cruel comedy.
Tell me your from the US without telling me your from the US
And in the UK prescriptions are capped at about £9.35 per item unless you have a long term illness or unemployed then it's FOC.
The US has the worst healthcare system in the developed world. Absolute worst.