Insurance company denying Flector patch!
 

Before I got the good suggestion on using the pain cream, I had called for a refill on my Flector patch. Was told by my pharmacist that beg. Jan. 1 my insurance will no longer pay for Flector patches. She wanted to know if I just wanted to pay cash for it...glad I asked for the price before I said yes. She said, "Oh, it's $500.00 for a month's worth and $1467.00 if you want the full 90 days". Can someone say knock me over with a feather:eek::eek::eek:

I called my PCP who said I need to go through the appeal process, which he said could "take some time". In the meantime, he called in a rx. for Lidocaine patches. Again, my pharmacist calls me. I've got good news, she says. The ins. will cover this one. I ask about the co-pay and she says it's $135.00 for a month's worth of patches.

Holy heck...are these patches made out of pure gold or something??? It's not even like they are miraculous pain relievers...all they do is help take the edge off. Where oh where is our medical care going???

Thankfully I see the new pain mgmt. dr. in a couple of days so holding off on making any changes until I see him and get his opinion. Have enough Flector patches to last until then...

Ya' know, seems like it's always something...:Sinking:

Where do they get off!!
 

This is unbelievable Fiona! Somehow tho it doesn't surprise me. Big Pharma strikes again. It just continues to get more ridiculous. I get so very peeved when I see this. Nothing seems to make sense anymore.
Where is this so-called 'affordable healthcare' I keep hearing about!

There has got to be a better way. Why can't legislation put a 'cap' on what drug companies can charge? It's almost like a sick joke or something....and at who's expense? PAIN patients! :eek: People can't even hardly afford to PAY these insurance company premiums, let alone the out-of-pocket.

Grrrr....i need to go find a brick wall....
:Bang-Head::Bang-Head::Bang-Head::Bang-Head::Bang-Head::Bang-Head:

Hah!!!
 

Bonuses, Bonuses, doncha know?!?!?! Also called permissable recovery of cost of research, testing, clearing FDA and the like for new patented items, like the patented items my little start up company produces. Our company does not gouge. I fear pharmacology on the other hand is seriously into gouging.

Example- One of our sons was diagnosed with psychosis in early 20s. I was early in the "unemployed" category. He had no insurance due to his age, well nothing of any real help and no pharmacy coverage. He with his meds cost us $6,000.00 per month for two years before we could get Social Security to accept his claim for disability. Multiply that up and add it if you will. We had to pay cashola for his needs those two years. This is partly how our retirement funds became depleted to the point we had to sell our home a year ago, becoming renters. We still remember in our old neighborhood the so called neighbors of hoity toity dom, whose incomes we had surpassed for well over a decade since they all bragged how much they made as physicians and engineers treated us a lepers and the SHAMED once they learned we had to sell our home.

Amazing huh? The shameful lepers who no longer fit in with the jet setters who had second homes in ski town usa. Some of those very same people are among the physicians who hand out prescriptions for this and that. Tells you the fabric of some folks doesn't it?

Enough of this,
Mark56:grouphug:

People!
 

How can people BE this way?! :eek:

I just don't get it. I don't understand how they can get so very ugly!
GRRRRRR! http://dl5.glitter-graphics.net/pub/...hs80eos6wm.jpg <<---- when my pocket fuzz gets angry, watch out!!

Frankly
 

My belief is the example of which I wrote speaks to the lack of faith as a high priority guiding light in their lives.

That is my take,
Worship things, or worship God,
Seems I have read something before regarding the risks associated with laying faith in mammon, n'est ce pas?

Yup,
Mark56

Insurance companies do anything they can to avoid paying out any money to you IMO.

As far as Lidoderms go...they will soon be generic...so your copay may be less.
Some companies will not pay out for Lidoderm at ALL unless you have a previous diagnosis of shingles.

Typically the insurance companies want FDA approval before paying out anything. Hence the appeal process for off label non-approved FDA actions.

Flector had a recent warning about causing potential liver damage with long term use.
http://www.arthritistoday.org/news/d...-damage025.php

This particular NSAID is used in the patch (and in compounded creams) because it is more fat soluble than other NSAIDs...like naproxen for example. So therefore, it crosses the skin, which has a fatty membrane barrier better. But unfortunately, this drug is quite toxic in any form. So because of this, the insurance will be hesitant to approve...because you may then need treatment for liver damage which is even more expensive to THEM!

Then there is the "patch" factor. Patches are quite expensive to design and manufacture safely/correctly. Getting the drug to come out of them at a steady rate, is quite complex. So the cost reflects this. (for example --note all the recalls on fentanyl over the years!).

There is an effective OTC thing you can try... Salonpas Pain patch. These are approved by the FDA even for severe pain.
They have 10% methyl salicylate in them (as opposed to the others they make which have less), so are worth a try.
http://www.salonpas.us/products/salo...n-relief-patch
The large beige one on the front of the box, is the new one.

I've used the Salonpas original one for years for my arthritis with good results. I haven't needed the new one yet.

Thanks, everyone.

Mrs D.: I do remember my dr. talking about the difficulty of developing a patch and having it properly dispense the appropriate amt. of medication that has been put into it, and that it is not as easy as manufacturing a pill form. Didn't know, however about the patches possibly being worse than taking an actual pill. I was just focused on the the patches giving less side effects (at least from my perspective they do). NSAID's typically give me bad heartburn and cause a lot of fluid retention, which I don't find with the flector patch.

I will definitely look into the OTC patches you mentioned. Hopefully this new pain dr. will have some ideas. Thanks for the useful info.!!

And, yes, I remember the fentanyl recall. Was the first time I used this patch and it just had to be the time it was recalled. I was driving down the road with one on me, and had to keep slapping myself in the face 'cuz I felt I was so groggy and had to get home and get to bed :eek: That swore me off fentanyl patches... even if they are made correctly now!!

Hi Fionab
 

How I sympathize with you! I had no medical insurance and bacially fell apart. I had four years until I qualified for SSD and SSDI. My medicine was over 1,500 per month! I went on a protest train to Canada, something called the RX express. There I was interviewed. Our own country would not cover this expedition in the news. There were about 50 of us. My"3"month supply for the same medications were under $300. Now something is out of wack here. Why are the medications priced so moderately? Our country does not negeotiate with the drug companies to help us. This is a terrible problem for most of us, who were middle class, and now have joined ranks of the poor.
Many senior citizens as you know, and others of limited means cannot afford their medication. Write to your,Sentor,Consumer protection agency. It is a crime what is being done, and the drug companies are only getting richer.
The donut hole catches those of us on mediare/medicaid. I face that now. I just wanted you to know how unfair I think this drug business is to those that really need the medications. Protest, and ask your doctor to write to your insurance company and try to get a different decision. I wish you all the best. ginnie