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612551 tn?1450025775

Anxiety prescription cost enough to cause anxiery

Being early in the year when my wife refilled her 90 supply of Ability anxiety medication we had not yet paid anything into our insurance medical deductible of $1,250.  When we picked up the prescription it cost $1,290.00 Wow, looking into the issue I see the medication is listed at over 1,600 for 90 pills, or over $18 per pill.  This is enough to cause anxiety by itself. We paid our $1,250 plus our per prescription copay of $40. Happily we will pay only the copay  for future refills this calendar year.  These numbers are not exact, I don't remember the exact change and resolution between the $1,290 and the list price.

I have private medical/prescription insurance and with this example I wonder what one can do (who can afford to pay the list price?).  Is this a medication that one 65 and over could purchase Medicare Part D?  I suppose that insurance also had a deductible, and if not a premium that reflect that cost.  

These things boggle my mind.  I understand and support private sector selling at a price that will recover their investment cost, but $18 a pill for a medication that is supposed to calm one down seems "over the top".

My anxiety in the cost is greatly reduced by the fact unfortunately we have sufficient medical expenses every year that we pay the full deductible, I've just never seen it all in one transaction before, in one charge on my credit card.  I think she started the medication last year after we had paid the deductible so we saw only the copay amount, no zero but well under $100.
6 Responses
Avatar universal
Many promising drugs fail at later stages after many tens of millions are poured into research and clinical trials, so any successful company requires the few new drugs that work out to be priced enough to cover the failures too.

You might try calling the  Ability anxiety medication people to see what plans are available to help defray costs. They are in the business of making sales so should be up on where the subsidies and medical plans to help are.
Avatar universal
Maybe there's help -- if you mean Abilify, it's not an anxiety medication.  It's only approved use is as an adjunct medication when nothing has worked for depression.  Just who prescribed this as a stand-alone drug for anxiety?  There are many anxiety meds that aren't still on patent that are much cheaper.
612551 tn?1450025775
Thanks, my error not doubt... depression is the key difficulty.  It may be the driver of anxiety - she is being treated for both.  But, depression is the long term condition and has been diagnosed in several of her blood relatives.  She has 4 siblings, all older, who have not demonstrated depression problems, but nephews, and nieces of hers - maybe it is common to skip a generation.  That said our son was diagnosed with depression before my wife was.  I think aging in now a major driver, I find it difficult to deal with myself.

Modify my subject's first and last words to say Depression.

Not seeking sympathy on the cost, just venting what I consider an outrageous cost.  As said our medical/prescription cost is covered by insurance with the usual deductible and once that is met,  it now is  with this one renewal,  the major portion of the cost is paid by my insurance.  I don't like high prices regardless of who/how it is paid:  insurance, local or federal government, whoever/whatever.  Still I wondered about Medicare Pard D, I think it is, for those who are over 65 and need insurance for this type of prescription cost.  I have not myself made a comparison of Medicare Part D verses private insurance, I prefer private insurance as I do not believe government does a good/efficient job compared to private sector.
480448 tn?1426952138
No worries, Jerry, I would be venting too!  It's just a shame that some medications are so outrageously expensive, it shouldn't be that way.  I'm with you and am all for people making a profit, healthcare IS a business after all, but within reason.  It IS mind boggling, for sure.  I'm NOT a supporter of Obama's healthcare plan simply because I don't feel it's the answer and I don't think it was well enough planned out, but without a doubt, something needs to change with healthcare.  I'm hoping his plan with yield positive outcomes.

Has she been on it a while, or is a new prescription?  Abilify, usually when used concurrently with another med (typically an antidepressant) has been effective in treating both anxiety and depression.  Is there maybe another medication she could try?  There are so many choices out there...and if she could find a med that's going to work as good as the Abilify, for much less, then it would be worth it!

If it is really helping her and you guys don't want to look into a different med, I would recommend calling both your insurance provider, if you don't have much luck there, you can always call the manufacturer of the Abilify.  The name of the manufacturer will be right on the pill bottle.  All of these companies offer different programs and plans to help make Rx's more affordable.  It's worth a try anyway!

So sorry about the stress...it's almost ironic isn't it?  Here's a med that's supposed to help with her anxiety, and the cost of it is causing more anxiety!  Kind of crazy!

Let us know what's going on and if you find anything out, okaty?
612551 tn?1450025775
Thanks, we're on the same "page"... I think health care reform is needed, that's not what is going on.  

To the point of my post, which was not a call for sympathy as I am "covered the old fashioned way - private insurance" , when I see this med and the "list price" on most things medical I wonder:  Why does it cost so much.  Yes, I know part of the answer is bill those who can pay, but why do I get an in network rate (or now a Medicare rate - as long as that works, I'm not optimistic)  and the folks who have jobs and work hard to EARN their place at the table and shelter and medical care but don't have insurance not only get billed, they get the "list price".  I don't need to look for an example as I can recall many cases where I see a bill of $1,000, say, where Medicare disallows $800 and pays 80% of the $200.  Here it turns out my biggest benefit is not that Medicare paid 80% but that Medicare gets (for now) an 80% discount. What about the working guy who is expected to pay out of his life-blood income the full $1,000.  I don't know if competition can solve this, but removal of most regulations on insurance competition and formation of groups/co-op negotiated rates or the like would help more working people.  The people on the welfare (call it what you like) don't need any help.
480448 tn?1426952138
Ahhh..okay!  I see what you're saying.  You know, God love you...because a lot of people would see the cash price and think, "Whew, thank God I'm covered!".  You're one who actually cares.

SUPER inflated costs are just one issue, and that's not going to go away with the ACA, I fear if anything, it will even get worse without the competitive drive of the private insurer (decreased anyway).  When I was in the hospital a few years ago, I was appalled when I got my itemized bill (which I asked for..silly me).  

As a nurse, I SOMETIMES see the prices of medications and supplies, but not always...as a consumer, it was even MORE of an eye opener.  I mean, really???  They charged my insurance company close to $15 a tylenol!!!  I could buy two+ BOXES of tylenol.  It's just outrageous.  Even more outrageous, they PAID it!!

Oh and Medicaid and Medicare...sheesh, don't even get me started, lol.  The things I've seen with Medicaid make my skin crawl.  It's SUCH a mismanaged and corrupt system it's disgusting.  NO wonder so many doctors, hospitals and nursing homes won't even ACCEPT it anymore, they have to fight to get paid...and IF they get paid, MC decides what the check will be, even if the provider was compliant with MC billing parameters.  It's terrible.  And HOW will ALL of the uninsured people under the ACA be covered?  Medicaid!  Yay!  Make an already broken system bigger, yeah...that makes sense.

Ahh Jerry...can you tell this is a sore spot for me?  LOL.  Just so nice to see that other people care too.  I'm not sure what can be done going forward with the ACA in place, but I'm very very worried about the state of our healthcare.  I sincerely hope it's nothing but a smashing success...but knowing what I know, and seeing what I've seen, I cannot help but to be pessimistic.  Sigh.
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