I'm renewing my insurance. Currently I'm on a genric RX program. To change it to the other one is going to cost me $150 more a month (and my employer about $100 I think). Right now I don't have a need for anything but generic.

So say I do end up getting a dx for MS in the next couple months. And say they treat me with something. How many of these drugs are name brand only?

The only other benefit to the more expensive plan is that they pay 5% more of the fees for labs and whatnot. But if I ended up in the hospital, that might be a big difference. Something huge would have to happen to actually hospitalize me as I've had some bad experiences. I think even if I had ON I wouldn't want to actually be hospitalized.

Things are tight right now with money, but they'll get better by the end of the year. This doesn't kick in until 10/1 so have a little time to think about it. Please let me know what you think.

I think that it is entirely dependent on what you insurance plan is. I just got new insurance and spent a good deal of time on the phone with them trying to figure out what would be best for me.

Usually (again, check with you plan) if there is no generic available for the drug they charge you less than if there is a generic available. You can check about what their policy is for "specialty" medications, because that will offer you more insight than any of our guesses. The specialty meds normally fall outside of the typical Rx plan. I think the vast majority, perhaps all of the dmd's are brand name only. You could ask what your insurance would look like if you stick with your generic plan and need to start taking one of those.

Also, the drug companies know that their stuff is expensive and many have patient assistance programs. I'm on one for my Copaxone right now, and it is a HUGE help and required relatively little paperwork to enroll in.

One of the issues I have is that I live in California. I make more money then qualifies me for the discount programs, yet I barely scrape by. Our cost of living here is really high, I get paid more to make up for it, but it's just way more then the "average" American. I looked one up when I was switching off Gabapentin and I didn't qualify, made too much.

I think typing this out helped me think about it. I think I need to just up it and pay that extra amount. I can change it again the next year if I get through this coming year and find good meds that are all generic.

I use generic except for Synthroid. More than one doctor suggested years ago that he/she would use the brand name for Synthroid. I don't know if it is still necessary, but I do pay $25 extra a month on my plan for using that drug--I pay more for the drug in my co-pay than i would for generic. Thyroid is essential to life, as i do not have a thyroid gland now,
so I have thought it worth it. I don't know though.
I do have requests in to my pharma to use certain drug mfr's for certain drugs if I need them. Like I use only Dr. Reddy brand Augmentin, an antibiotic, but the pharma keeps that one on hand anyway; I got sick from the other brand which tasted like onions. I use only two companies for two other drugs because those formulas , both generic, agree with me better than the other ones. Often there are many generics for one popular drug.

All mine are generic. However, like Mariel, I can only use certain brand names of the generic.

Looking up what the tier levels are and what you will have to pay will help in your decision making process. Many places like Target, Wal-Mart, and Walgreen's have discount programs if you buy the generic. At one time, Target and Wal-Mart had the generics for like $5.00. It was a good program and I'm not sure if it's still in place or not. It may be worth checking in to.

And Mariel, I don't what it is about Synthroid but I know several people who are on it and only take the name brand, not the generic. Some started on the name brand and stuck with it and others switched back to the name brand.

Some of my meds are generic, some are not. Lyrica, for example isn't available yet in generic. I was taking Copaxone ($100 monthly co pay), and as far as I know, none of the DMDs are available in generic.

I believe in CA (I live here too) you should be able to receive non-generic drugs when none are available. I'm not sure if it is a law, or what. But that is my understanding. I think all I needed was the drs recommendation of the med. I have Anthem Blue Cross - HMO (a very good plan) and that's how they operate. Your insurance provider should be able to tell you what will be covered, but I know how hard it is to get a straight answer.

Good luck!

unless my MD gives me a good reason for using name brand version over an available generic {i.e. some seizure and thyroid meds}, I always opt for the cheaper generic. I tend to only use a name brand drugs when no generic is out on the market yet due to patent protections.

The generic Levothyroxine changed about 6 months ago. I know some people who've had to go on Synthroid after using generic for years.

I'm on Anthem PPO. It's not that I couldn't have the brand names, I'd just have to pay out of pocket. I looked at Lyrica before, and the pay out of pocket price was about the same as upgrading the insurance. It's more of the possible MS or other drugs to treat this horribleness that I worry about.

I'll call Anthem and talk to them about what would happen if I needed a brand name and didn't upgrade.

I also wonder if some of the drugs wouldn't be drugs, but would rather be treatments. Like if I got IVSM, it would be through the hospital, I'd assume I'd pay my percentage instead of the rx co-pay. Is this correct? I saw, for example, Tysabari I'd pay the percentage. But injectables, I'd have to pay the copay.

We don't have Targets with Pharms here. I hate WM and only go there if I have to.

I'm only on Prozac and LDN. Prozac is now generic and LDN is cheap.
I have had some bad luck with some generics in the past, though.
With all things NOT being equal.

Chaos, I think you are right that in-hospital IV's are charged by percentage rather than by co-pay. I have had two very expensive treatments for my Polycythemia Vera at Mayo. Medicare pays most of it, more than if I had to pay a drug co-pay. What I get is an IV "shot" which takes about ten minutes, but the drug itself is expensive. It is to reduce my number of platelets. My platelets and red cells seem to be holding steady right now....maybe I won't need to do this again. My cost is primarily air fare and motel for this, which I can take as a tax deduction...but it's still expensive to go for this treatment which is done at only a few places.