Avatar universal


My insurance company recently switched fentanyl from Tier 1 to Tier 3. Their claim is that there are cheaper (to them) drugs available. I use a 100 and 25 patch plus "break out" drugs. Any suggestions?
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760862 tn?1243097304
I am assuming that your insurance won't pay for the prescription any more, is that right?  First off welcome to the forum.  Do you have a tolerance to narcotics in pill form is that why you are on the patch?  If your insurance won't pay for the prescription anymore do you have a way to pay for them out of pocket?  I do not have any experience with the patch and unfortunately I do not know how much they cost.  Have you talked to your doctor about the situation?  

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547368 tn?1440541785
Hi Jlwhipple,

Welcome to our Pain Management Forum. Insurance companies.....don't get me started!! I understand that they are simply businesses. It is frustrating when you hurt and one medication works well in controlling your pain and your insurance company either won't cover it or covers only a fraction of the cost.  

Yes Fentanyl Patches are expensive as compared to most other opiates. My insurance too only covers a fraction of the monthly cost. Unfortunately I am very allergic to the adhesive and can not use Fentanyl......or fortunately if you consider the cost.
MS Contin is much less expensive but it is not as effective for some ppl and it is less potent than the patch.

Some insurance companies will allow an "appeal" in the form a a written letter from your physician but don't count on it. Usually if they cover any part of the cost they will not entertain an appeal but it's worth looking into.

Good luck in your search for an affordable replacement. Your physician and pharmacist should be able to offer better options for you. Please let us know your progress and take care, Tuck
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972076 tn?1248267832
Hey, The cost of drugs are out of control. My insurance does not cover office visits or prescriptions. I did find this helpful search engine called Medtipster and use it to find the generic equivalents of my medicines. They will locate a pharmacy within your zip code where you can go to get $4 generics. Maybe this will help?

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