In the hole with part D
 

I recently found out that I am in the infamous "donut hole" as far as my drug coverage goes. In checking around I can afford all of my meds except the ones for PD! Stalevo. It's gonna run almost 800.00 a month! I have looked at assistance programs but with my SSDI and a pension I make too much money to qualify for them. Just when I was doing good, ya know. Add to that my neuro says they have NO samples and he won't even write for me to back on just the Sinemet! His response was "you'll have to find a way to get it." He's gonna get it all right. I'd better end this now. Thanks

You can get Sinemet on the net without a rx!
I purchased some when my insurance company prescription plan messed around with my discount rate.
100/25 one months supply $60


http://www.12buys.com/


the drugs are genuine sinemet and arrive in about 10 days

Jim, I began the donut hole back in April. Isn't the federal government a great thing to have design something so wonderful that over 90% of those polled are happy with it. Obviously, none of them has catastrophic illness or need for medications. Wonder how they picked them...all so healthy that they are completely sold on the plan. I retired from employee benfits. I have designed benefit plans. I can't imagine a corporation/company in the USA hat would design such a ridiculous plan. I can hear the employee outrage now!!

All kidding aside. I take it you don't care for generic. I have converted all that I can to generic, since my AARP Medicare RX plan covered only generics during the donut hole...I can do the $6 copay for them.

And, all too soon we will all have to begin doing the annual research for a new plan once again...November is on the horizon. And of course, there is also the usual increase in premium to endure.

Question
 

Isn't Stalevo nothing more than a combination of Siinemet and Comtan? I believe the pharmos advertised that it would save patients money to buy the combination of the two.

Carolyn, couldn't Jim order the generic of Sinemet 25/100 ?(A word to the wise: several different companies make the generic form of Sinemet and they are all different, so try a different one if the one your pharmacy gives you makes you ill.)

Doesn't Comtan come in a generic form too? Or would it be covered by Medicare because it is no generic form for it? Buy Comtan separately. Wha-la, Stalevo!!!!! And you don't even have to save money!!!!!!!!!!!!

The logic of our nurturing Pharmaceutical Company and FDA once more save the day.:winky:

Vicky.

Thanks
 

That I know of there is not a generic to comtan. I have gotten a rx for generic sinemet from my primary care doc. My neuro won't even write for that, since he wants me to stay with the Stalevo and as he put it "find a way to pay for it." so now instead of Stalevo every 4 hrs I am taking 1 -1/2 sinemet every 2 hrs. Oh well, if I can get through this next month or so I'm scheduled for DBS in October. Thanks for the suggestion on generics-that's all I've ever taken. The best I can find is a discount card but that would still cost about 500.00 a month. Thanks

Jim, you are the patient, you are the consumer, you SHOULD have a say in your personal care...whether your doc likes it or not...but I assume it is his right to choose what to script and what to not script. If you GP will script generic, I would get your PD meds from that doctor, even if it makes the neuro mad.

I do have two RX that my primary care and my psychiatrist both have one each they don't want me off. There is no generic for either. So, I get samples for these two because one is $165 a month...the other is $295 a month...yikes!!

Comtan is in generic form.
Generic Name: entacapone (en TAH cah pone)

I stopped taking Stalevo because of the side effect "abnominal pain."

Do you see a general practice neurologist of a Movement Disorder Neurologist. If the former, please know there is a medical world of difference between the two.

And, by the way, as I stated above I have been in the donut-hole since April. I received a statement from my AARP RX plan today, which only covers generics during this time for $6...which I am very grateful for.

Coverage Gap Limit for true out of pocket per calendar year $3,850.00

Your true out of pocket costs in Stage 2 (aka the donut-hole) $606.00
You have paid this much while in the Coverage Gap $219.54 (in copayments)
Your true out of pocket costs to date are $825.54

AARP Medicare TX Plan - Enhanced has paid this much $0.00 (due to donut-hole)

You have this amount to pay before you reach Catastropihic Coverage (which will never happen) $3,024.46

Caution: Considerations before having DBS surgery
 

Jim,

Caroline knows of what she speaks. Listen to her. The doctor is to serve his patients. The only reason I believe that he might insist on Stalevo rather than a combination of Sinemet and Comtan is because he is receiving kick-backs from the pharmaceutical company for each prescription he writes.

Caroline, is their any way for a patient to determine if a doctor is recieving gifts from a Pharmaceutical company for writing prescriptions for their product?

Jim, find a different doctor. Before you have DBS surgery, be aware that you will not be able to participate in many research programs. If you are recently diagnosed, that may rule you out for a cure in the future. The DBS will help your symptoms, however; as you age you will find yourself suffering from illnesses other than Parkinson's that may require an MRI for a diagnosis such as arthritis. Medtronic says it can be done and gives certain rules to follow to the treating physician, but ends their instructions with "We can not be held responsible for any adverse reactions to the patient, even if all the instructions are followed. The treating physician is responsible." Under these circumstances, with the cost of malpractice insurance, what doctor worth his salt is going to risk it?

Jim, get a second opinion!!!!!!!!!!!! I have had DBS and have no regrets. But the only reason I was finally allowed to have it was because I spent 3 days in ICU in a coma while they tried to flush my body of all the chemicals I was prescribed over the 15 years I had been diagnosed with the disease. My Parkinson's disease is the genetic kind which shows itself more by dystonia than tremors. My sister also has PD and has decided not to have DBS. She is a Master Degree Registered nurse. Medtronic is pushing as well as rewarding doctors to use their technology. DBS is a wonderful technology that can save lives. But it is not meant to be for everyone. Each surgery should be evaluated on a case by case basis. Also any doctor with stock in Medtronic should send his patient to another Movement disorder physician. His monetary interest in the company compromises his interest in giving the patient impartial treatment.


Vicky

Vicky, I don't know that there is a way to make this kind of discovery. Maybe someone else in the forum has some information to add.