29 replies to this topic

[Dom]

In a separate thread, I pointed out that Imatinib (400) in march cost 2073.01 (love that extra penny), and then in April it dropped to 1062.90.  And it has been at 1062.90 ever since.  Theses are the prices from Walmart using Express-Scripts as my Part D.

 

I was on the Medicare.gov site to see if I could get a better deal with an Advantage plan.  And I saw that Express Scripts was giving different numbers.  Now Imatinib (400) starting in August is $9,768.86.  Can this be right?  Or should I assume that Medicare.gov got it wrong?

 

And a second question:  Can you change part D plans in mid-year, or is there a special time for that?  Because if Express-scripts is not charging close to $10,000 for imatinib, I want something else.

[Buzzm1]

Dom, from your previous posting:

 

Imatinib 400 (30 pills)       1914.17        976.23

Imatinib 100 (60 pills)       1062.90        416.71
(For April)                                           1392.94

[Dom]

Yes, I got the 100s and the 400s mixed up. So really, the price went from 2073 to 1914. And it has stayed at 1914. Now Medicare is giving the cost at nearly 10,000. And my co-pay went from about 210 to about 850. So I still have the original question. Did the price change or did Medicare get it wrong?

[Buzzm1]

Dom, if you are out of the donut hole, your monthly copay should be 5% of  (1914.17 + 1062.90) = $148.85

 

If not, something has gone wrong.

 

I think the numbers you are getting out of Medicare.gov are as if you are just joining Medicare, and beginning the Rx.  

[chriskuo]

Are you comparing generic to generic or is the higher price Gleevec?

The amount you pay depends on the insurance plan, whether you have reached donut hole or catastrophic, and whether the
drug company raised prices mid-year.

[Dom]

I'm comparing generic prices from Walmart for express scripts part d. Everything is the same. The problem is, when I got express scripts, Medicare said the cost of imatinib was about 2,000. Now they are saying it's 10,000.
That's the raw cost, irrespective of the Medicare phase.

In a few weeks I'll renew. And I'll see what happens. I'm expecting the catastrophic cost to be just 280. Medicare now says it's over 800.

[Buzzm1]

In a few weeks I'll renew. And I'll see what happens. I'm expecting the catastrophic cost to be just 280. Medicare now says it's over 800.

Dom, how much was your July renewal?

 

As I mentioned above, now that you are out of the donut hole, your cost should be 5% of (1914.17 + 1062.90) = $148.85

Why do you think your cost should be $280?

[Dom]

Because I have a lot of other medication. BP, related heart, cholesterol. But you're right, now that I think of it. The 280 was based on the cost of imatinib back in march when I got express scripts. It's dropped since then. So your price is probably closer.

Except, of course, that Medicare now claims the cost of imatinib just jumped to 10,000.

[shweflen]

I have Express-Scripts and buy my prescriptions at the local Wal-mart.  The insurance company price I have been shown is $1593.82 for 90 - 100mg imatinib each month of which I pay the percentage dictated by Medicare Part D for a generic drug.  I think, I have seen on the paperwork from the pharmacy accompanying the prescription a notation that says the cash price is something just over $7000.

 

I think you can only change Part D plans from sometime in October thru sometime in early December. 

 

I would assume that the insurance companies negotiate a price for a particular drug for the year before establishing their premiums so I'm not sure why or how it would change.

[Buzzm1]

10/20/2016 BCR-ABL:ABL = 81.622

01/11/2017 BCR-ABL:ABL =   8.028

04/12/2017 BCR-ABL:ABL =   0.157

07/07/2017 BCR-ABL:ABL =   0.000

Congratulations on reaching undetectable shweflen

[Dom]

Thanks for the info, shweflen. Your prices compare to mine, except I'm getting imatinib 400, but the prices are not out of line with yours. What bothers me is that, when I returned to the Medicare site to look for supplemental plans, I noticed that everything was different for express scripts compared to the paperwork I printed out back in March.

Maybe you have hit on something though. Maybe my prices, and your prices, are locked in because of when we started Medicare, and what I'm seeing now are the new prices for people who are joining in August. I'll have to see what I pay next month. I hope nothing changes next year -- for you and me.

[chriskuo]

My cost for Bosulif went up about 5% mid-year

[cmljax]

Same for Tasigna - up 5% at mid-year

[shweflen]

I have Express-Scripts and buy my prescriptions at the local Wal-mart.  The insurance company price I have been shown is $1593.82 for 90 - 100mg imatinib each month of which I pay the percentage dictated by Medicare Part D for a generic drug.  I think, I have seen on the paperwork from the pharmacy accompanying the prescription a notation that says the cash price is something just over $7000.

 

I think you can only change Part D plans from sometime in October thru sometime in early December. 

 

I would assume that the insurance companies negotiate a price for a particular drug for the year before establishing their premiums so I'm not sure why or how it would change.

Now that I think about it, I wonder how the insurance company negotiates prices.  Before I selected Express-Scripts last fall I checked their prices through their captive mail order pharmacy and the prices at their "preferred" provider, Walgreen, and both were much higher than the prices at Wal-mart.

[shweflen]

Congratulations on reaching undetectable shweflen

Thank you.  I feel very lucky, minimal side effects and 0's.  My hematologist after getting the latest test results, without prompting from me, said that he had been looking at information about cessation and that we could begin discussing it after an appropriate interval with 0's.

[kat73]

Hapy news, Shweflen!

[Dom]

Yes Shweflen, I'm jealous. It happened pretty fast for you too.

Express-scripts still sends me mail asking me to buy my meds through mail order, or at Walgreens, even though the prices are much higher for them and me both.

[Buzzm1]

Thank you.  I feel very lucky, minimal side effects and 0's.  My hematologist after getting the latest test results, without prompting from me, said that he had been looking at information about cessation and that we could begin discussing it after an appropriate interval with 0's.

shweflen, lucky you,  you have a very forward-thinking hematologist.  With your having achieved undetectable in a short time, on only Gleevec 300mg, and considering your age, you are a great candidate for an early attempt at cessation.

[chriskuo]

What kind of insurance do you have that you can choose the supplier? I have options for regular drugs but for
specialty medications, my insurance administrator limits me to its subsidiary which specializes in specialty meds.

[Dom]

Chriskuo, have express-scripts and so does schwerlen. Are you sure you are limited, or is the insurer just making a strong suggestion? My pre-Medicare insurance didn't make me buy from mail order, but the copays were much cheaper that way.