Deleted
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May 18, 2024 5:25:48 GMT
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Post by Deleted on Apr 22, 2020 21:46:57 GMT
We don't get a lot of prescriptions but 4 of them over the past couple of years have had to be filled at *a special pharmacy* They are different types of prescriptions - a cream for a rash, a topical anti-inflammatory, a couple of different tablets and all from different providers that otherwise have no problem prescribing from a regular pharmacy. They aren't compounded drugs and they aren't something that can't be filled somewhere else. They are very expensive drugs but from what I can see, the price from these *special pharmacies* aren't really any better. They are usually somewhat local and will either deliver it or mail it next day.
I don't get it. Why are providers starting to do this for certain medications? I had an RX for one of my kids being called in today and the doctor's nurse called me back and said it was going through one of these special pharmacies because it would be less expensive (I guess we will see when they call me about it.) It caught me off guard because I was literally online at that moment starting to research the drug a little and Good RX shows that it is widely available locally (although definitely expensive - in the $200 per month range, although it looks like i can go directly through the drug company itself with an RX much much cheaper than that, so unless the special pharmacy has that same price I'm going to tell them to keep it.)
They aren't controlled drugs, they aren't all the same type of formulation, they aren't compounded, it's not the same provider or the same *special pharmacy."
WTF is this new trend?
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snyder
Pearl Clutcher
Posts: 3,956 
Location: Colorado
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Post by snyder on Apr 22, 2020 21:51:01 GMT
If they are expensive, that is why they are through a specialty pharmacy. Since they are expensive, they don't want to have every pharmacy carry them and sit on the shelf until someone needs them or expire, so certain pharmacies will carry these more expensive and more rare type drugs.
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Deleted
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May 18, 2024 5:25:48 GMT
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Post by Deleted on Apr 22, 2020 22:02:35 GMT
If they are expensive, that is why they are through a specialty pharmacy. Since they are expensive, they don't want to have every pharmacy carry them and sit on the shelf until someone needs them or expire, so certain pharmacies will carry these more expensive and more rare type drugs. That makes sense. I didn't think of it not being well stocked at most pharmacies. That actually makes me feel better about it. |
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Deleted
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May 18, 2024 5:25:48 GMT
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Post by Deleted on Apr 22, 2020 22:08:27 GMT
We changed over to a pharmacy that picks up our Rx's and delivers them! We met them at a dinner for our complex about 6 months ago and the owner/pharmacist was very knowledgeable and informative, so it cinched the deal for me. The fact that they deliver (even daily if you need it!) was a big plus since we're always at a doctor's office, hospital or DH is getting chemo........ This is a huge help.
They do compounding and they have all of my pain meds (except for 1, which I have to still get at Publix). I'm happy! It's a chain pharmacy, so it's not like it popped up out of nowhere. Also, I could just text my pharmacist with what I'm low on, and he can handle it. Very convenient!
ETA: The prices are better than at other bigger chain pharmacies. DD has no insurance so she uses GoodRx, and this pharmacy checks around for the best prices for her. Same meds, nothing hinky about it. Our meds are always a fixed price thru our Medicare/special needs plan.
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jeanninem
Junior Member
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Post by jeanninem on Apr 22, 2020 22:33:32 GMT
It's not a new trend. Specialty pharmacies have been in existence for years. Most likely, your insurance is dictating to the provider that the prescription must be sent to a specialty pharmacy and also what pharmacy they must send it to. Provider offices usually have very little control over prescriptions once the insurance company steps in. As you mentioned, the prescribed drugs are expensive. Your insurance wants to keep control of whether or not you really need it, despite what your provider thinks, a prior authorization may even be needed, and for inventory control as another pea previously said.
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Deleted
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May 18, 2024 5:25:48 GMT
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Post by Deleted on Apr 22, 2020 22:43:05 GMT
It's not a new trend. Specialty pharmacies have been in existence for years. Most likely, your insurance is dictating to the provider that the prescription must be sent to a specialty pharmacy and also what pharmacy they must send it to. Provider offices usually have very little control over prescriptions once the insurance company steps in. As you mentioned, the prescribed drugs are expensive. Your insurance wants to keep control of whether or not you really need it, despite what your provider thinks, a prior authorization may even be needed, and for inventory control as another pea previously said. Maybe. But they don't care about other prescriptions. It is CVS-Caremark prescription plan and we can get prescriptions filled anywhere normally. |
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Post by Baseballmom23 on Apr 23, 2020 1:09:30 GMT
I'm on a daily chemo pill and it comes from the CVS specialty pharmacy. My regular old asthma medication comes from the regular CVS pharmacy. I can't image my CVS on the corner stocking every possible pill. And this is extremely expensive.
Are you sitting down.....the price on my chemo pill paperwork reads $16,666.98 (per month) Thankfully my insurance pays for most of it and the drug manufacturer pays the rest.
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Post by mikklynn on Apr 23, 2020 1:17:18 GMT
I'm on a daily chemo pill and it comes from the CVS specialty pharmacy. My regular old asthma medication comes from the regular CVS pharmacy. I can't image my CVS on the corner stocking every possible pill. And this is extremely expensive. Are you sitting down.....the price on my chemo pill paperwork reads $16,666.98 (per month) Thankfully my insurance pays for most of it and the drug manufacturer pays the rest. Same for DH's cancer med. It's $23,000 per month. We have to pay $1000. |
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ModChick
Drama Llama
True North Strong and Free
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Post by ModChick on Apr 23, 2020 1:22:07 GMT
I thought it was because of compounding. At least here that was the reason for some of my sons meds long ago.
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Post by Baseballmom23 on Apr 23, 2020 1:23:23 GMT
I'm on a daily chemo pill and it comes from the CVS specialty pharmacy. My regular old asthma medication comes from the regular CVS pharmacy. I can't image my CVS on the corner stocking every possible pill. And this is extremely expensive. Are you sitting down.....the price on my chemo pill paperwork reads $16,666.98 (per month) Thankfully my insurance pays for most of it and the drug manufacturer pays the rest. Same for DH's cancer med. It's $23,000 per month. We have to pay $1000. The costs are crazy! My friend in Australia told me my meds would cost $40/month over there. |
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Deleted
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May 18, 2024 5:25:48 GMT
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Post by Deleted on Apr 23, 2020 2:05:22 GMT
I thought it was because of compounding. At least here that was the reason for some of my sons meds long ago. No, none of them were compounded or even really unusual drugs. Just expensive. All prepackaged in some way (blister packs or individual pill packs) by the manufacturer so they aren't even really dispensed. |
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Post by jenjie on Apr 23, 2020 2:12:49 GMT
I'm on a daily chemo pill and it comes from the CVS specialty pharmacy. My regular old asthma medication comes from the regular CVS pharmacy. I can't image my CVS on the corner stocking every possible pill. And this is extremely expensive. Are you sitting down.....the price on my chemo pill paperwork reads $16,666.98 (per month) Thankfully my insurance pays for most of it and the drug manufacturer pays the rest. Same for DH's cancer med. It's $23,000 per month. We have to pay $1000. Dang girls! That’s one thing, I have no idea how much dh chemo cost. I never saw a bill. He also had supplemental meds for which we paid minimal copay at the pharmacy. |
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Post by janniepea on Apr 23, 2020 2:16:45 GMT
I take an extremely expensive drug for osteoporosis and it comes through a specialty pharmacy as well. I love working with this pharmacy (CVS/SPECIALTY) as they are extremely helpful and very quick to respond to any questions I have. There hasn’t been one glitch since I started taking this prescription 16 months ago.
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Post by mikklynn on Apr 23, 2020 12:30:22 GMT
Same for DH's cancer med. It's $23,000 per month. We have to pay $1000. The costs are crazy! My friend in Australia told me my meds would cost $40/month over there. DH's oncologist is from India. He said the same drug would be $100 there. |
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Post by JustCallMeMommy on Apr 23, 2020 14:16:49 GMT
I don't know, but I have an interesting one - I pay the doctor's office as part of my visit, and they have an arrangement with the pharmacy. I just go pick up my prescription at a specialty pharmacy each month. This pharmacy separates compounded and regular prescriptions, and it is compounded, so maybe that is part of it.
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Post by dewryce on Apr 23, 2020 14:45:58 GMT
The only drugs I can remember being called in to those types of pharmacies were compounded medications and fertility drugs.
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Post by questioning on Apr 23, 2020 14:57:25 GMT
I thought it was because of compounding. At least here that was the reason for some of my sons meds long ago. No, none of them were compounded or even really unusual drugs. Just expensive. All prepackaged in some way (blister packs or individual pill packs) by the manufacturer so they aren't even really dispensed. Thank you for explanation, I was thinking compound too. My heart goes out to those with these huge expenses. Ours are normal now, and I dread the inevitable time when we face this. I wish more would realize this is an "us" problem, not a "them" issue and help solve the high costs. |
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Post by refugeepea on Apr 23, 2020 15:10:08 GMT
I don't think it is a trend. We had to get an anti seizure med that is sprayed into the nose. They told me of three locations. We had to go over 40 miles to pick it up. It had to do with mixing the med (I'm sure that's not the right term) and not everyone is trained in it or has that odd prescription available all the time.
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Post by refugeepea on Apr 23, 2020 15:10:58 GMT
Should have read the thread! That's the word I could not think of! |
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Post by bigbundt on Apr 23, 2020 15:25:57 GMT
This happened with me a couple of years ago at the orthopedist. Prescribed Vimovo (which I found out much later, is essentially a very expensive aleve/nexium combo) and told me that it would be coming by mail from a pharmacy up the road. Didn't even give me the option to have it filled at my pharmacy. Turns out that it is a somewhat complicated scheme to sell certain medications but cut out questioning from the patient by eliminating or drastically lowering their out of pocket costs or to preselect pharmacies that were favorable to payout. This article was basically my experience and makes complete sense. Excerpt from the article: Not sure if that is the same system for the chemo medications mentioned upthread but was certainly my case for a relatively benign prescription. |
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