Just getting started…

Posted by marianq @marianq, Sep 27, 2021

Good morning. I was just diagnosed with osteoporosis so I’m a bit overwhelmed. My endocrinologist suggested a few medication treatments for me based on my overall medical situation.
One medication that was covered by my Medicare Part D prescription insurer is Tymlos - tier 5 in my plan (never heard of tier 5!). I got a script for this and cost is $584 a month - which I really cannot afford. Manuf drug coupon says doesn’t cover Medicare due to gov’t regulations. Anyone else dealing with this? Any suggestions?
The other possible medications doctor suggested were Evenity or Forteo. Neither are covered currently in my plan however doctor could request a prior authorization to be added to my formulary list. But even if she got one approved, don’t you think these will be even more expensive?? Should I try getting a script for one of these - assuming I could get PA approved?

I don’t want to get on a soapbox here but why are seniors on Medicare penalized by drug companies or why do govt regulations not allow Medicare use these coupons. I probably won’t qualify for “help” but doesn’t mean I can afford. Thanks so much listening. Just looking for any advice.

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goodness12 | @goodness12 | Feb 17 11:02am

Try GoodRX. Google how to obtain a card for free. There are other companies similar to them. Then shop pharmacies willing to process your prescription. Most pharmacies will but the cost of your prescription will vary by pharmacy. We were given this advice by a grocery store pharmacy chain in the Midwest. It has saved us $$$. Hope this will help you immensely.

goodness12 | @goodness12 | Feb 17 11:08am

In reply to @tsc "@marianq, I'm sorry to hear of your diagnosis. I just received this email from AARP today..." + (show)

@tsc

@marianq, I'm sorry to hear of your diagnosis. I just received this email from AARP today about the high cost of drugs:

Possible vote this week?
Call 1-844-259-9352
And tell Congress to lower drug prices!

We’ve said it before, and we’ll say it again: medications can’t work if people can’t afford them — and right now, too many Americans are being forced to choose between paying for medicine or putting food on the table.

Last week, our community showed up and made waves. Over 13,000 people called Congress to make it known that we won’t stand for unfair drug prices anymore.

But our work isn’t done yet. Congress could be voting THIS week. There’s still time to beat our goal and tell Congress that there is only one acceptable option: vote to allow Medicare to negotiate lower drug prices. Let’s make sure that every lawmaker hears our demands to lower Rx prices!

Dial 1-844-259-9352 NOW
We’ll connect you to your lawmaker.
Tell them: It’s time to lower drug prices.
Prices are over 3x higher in the U.S. than in other countries for the SAME medicine. But Congress is considering a critical proposal that would FINALLY allow Medicare to negotiate lower drug prices. That would help save Medicare hundreds of billions of dollars — AND help lower costs for everyone.

What are we up against? Big Pharma, who is desperately trying to protect its billions in profits. Even during the pandemic, drug companies increased the price of over 1,000 drugs, including those for chronic conditions people over age 50 depend on. Now, they’re spending millions to push misleading claims to scare lawmakers from passing Medicare negotiation into law.

That's why we need you in this fight. Make the call before Congress votes and help drive 5,000 more calls TODAY. Tell Congress it’s time to lower drug prices, NOW.
Dial 1-844-259-9352 to call Congress.
We’ll connect you to your lawmaker and give you a script to guide your call.
Our week of action might be over, but the work isn’t done. We can’t thank you enough for the hard work you’ve put into this fight already.

Thank you,

— The AARP Grassroots Advocacy team

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Thanks AARP Advocacy
I just saw this so I’ll call.

babs10 | @babs10 | Feb 19 10:07am

These are considered "specialty drugs" and, as such, are ridiculously price and out of reach for many. For me, Forteo would be over $1900 a month and it's an approved drug on my plan - this is the co pay. After reaching the $8000 cap there is no cost, but good grief. I haven't made any commitments to it yet because the price is only one of my concerns. I don't quality for any assistance. Good RX was even more expensive - don't ask me why.

I have become cynical about healthcare in the USA so keep that in mind when I say that I suspect there is more money in rehab than in medication.