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About 3 years ago BCBS denied my Copaxone prescription which I have been on successfully since my dx in 2005. My neurologist fought to keep me on it vs the generic and have been able to get a prior authorization each year since. I’ve had a $150 copay which Shared Solutions has helped with and it has always been seamless behind the scenes. Out of nowhere I got a bill for over $800 and when I looked into it I found that in October they changed my responsibility to over $3,000 vs $150. I had… read more
Jay,
I guess I am fortunate. My Doctors office workers are really good on finding me the best MS meds. They will write to the insurance companies to adapt to my financial needs.
That have also called the drug companies & helped my costs to go down.
Remember you don't have to buy their product but they have to sell you their product.
Same thing with your Doctors.if you aren't getting what you need they aren't the only Doctors.
Stand up for yourself.
Be well
@A MyMSTeam Member I have been going through this with another medication, I have been on for 20 years and now they are refusing to pay for the generic! I work in the Pharma/Biotech industry and as much as people think we are the evil empire, I really think it's the insurance companies. Viatris is a good company, former Upjohn and Mylan, I would have zero issues with their version of Copaxone.
@A MyMSTeam Member, you should probably feel very comfortable with the generic. Copxone is not that difficult to manufacture, what I would fight for is that you take the same generic, or if you have a relapse on the generic you are authorized to go back on the brand name drug. Biggest concern is switching between generics every few months. As for insurance changes, BCBS may have had a contract with Teva (Copaxone) that ran out which is why there is now a higher cost. @A MyMSTeam Member while most generics are essentially the same there can be some minor differences, such as using a different preservative, which can change how the drug works slightly. Bigger concern in pills.
Yow! there is much to discuss here. BCBS or any other insurer, your costs depend on your policy. Say you work for my ms team and have bcbs, and I work for say google and have bcbs. The policy for my ms team is likely different than the one by google. This is the difference in costs to the patient and sponsor. Another analogy, we live next door and have duplicate houses with the same homeowners company. Costs depend on how much we select etc. So your bcbs is different than mine (Yes we do have bcbs). Linda got ampyra brand for several years. Then one day our bcbs said they would simply not pay for brand meds only generics. It did come in a letter and a phone call so I give bcbs credit for that. As for the current expense I have no answers aside from trying for help with a patient assistance program. Years ago (and being nice which isn't always easy for me- LOL!)I talked my way out of a $5K mri bill after explaining to them kindly it wasn't my fault. Whew!
I have to tell you I was on Copaxone a while back. Liked it but told my Neuro I was really tired of sticking a needle on my leg. He switched me over to a pill.
Now I am waiting for whatever is coming down the road. Fingers crossed. 😋🤔🥴
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