Duncan Roberts

It could be many things but the deductible sounds unlikely based on what you said. Usually with the deductible you will have to meet it before anything is covered which wasn't the case. It looks like you are paying about 20% which isn't bad, that's my retail generic co-pay for instance. Other possibilities are the formulary changed and the drug is in a different pricing tier this year, it's a new prescription and the doctor noted not to substitute generic if available or unlikely but possible, the pharmacy messed up, the drug went up in price, if it's an employee plan the employer may have added some restrictions to get the plan price down or it's a different medication. The only way to find out for sure is to call the insurance company.

Manc

yes

you live in America.

another bloody yank

Everybody bitches about the ins. companies, and not without cause. But can someone tell me why 12 pills are $280 in the first place? Solid gold would be cheaper.

Dan725

Because everyone needs their cut in the greatest fraud scheme that was ever devised in the history of mankind.

another bloody yank

Oh.

Duncan Roberts

Possibly because the cost of developing and manufacturing the drug are a lot but the market for the drug is in is not large. One of those lifesaver drugs for the people who need it but there are not a lot of people that do. If drug companies cant make money off a drug while it's under patent then there is little motivation to develop the drug in the first place.

cindyabs

once a medication becomes OTC, rather than a prescription med, then I wonder what the profit margin is for the developer?

Duncan Roberts

There are still large costs for them, especially when it's generic, but they make a tidy amount and have a bigger target population.

Elvira

Melly was referring to a migraine med!!

The reason it is so expensive is because the manufacturer needs to recoup the insane amounts they spend on marketing to doctors and on direct-to-consumer/patient advertising.

(btw, I hope the one Melly is taking isn't the one where they simply added generic naproxen to the now generic migraine med. Now that is pretty close to daylight robbery!)

Duncan Roberts

The market for migraine is pretty small compared to other markets, the total spend in the US on all migraine treatments is well under (about half) the sales of lipitor for instance. That doesn't leave a lot of room for all the different companies to get their money when the costs to develop and market a migraine drug and liptor are not much different. Even though I have no idea I would assume that if you are suffering from a migraine or frequent migraines and a pill can help get rid of it, that would count as a lifesaver. Lifesaver means quality of life as well as life or death.

I'm not saying it's not a problem or the marketing isn't adding to the cost but when companies stop researching and developing treatments because there is no money in it we will all lose out long term.

Giantaxe

Imitrex is now off patent and the only thing on my insurance's formulary at a reasonable price. You can get the generic in "pure" form.

This article suggests that mixing with an anti-inflammatory is actually more effective:

http://www.healthcentral.com/migraine/news-36000-5.html

mellybrown

I havent refilled my imitrex yet - I need another prescription so i guess we will see if that went up!!! The one i was trying to get is Maxalt - one of those nasty melt in the mouth thingys that work wonderful on migraines - but not that wonderful that Im willing to cough up so much money!!!! Im gonna go back and ask for a generic - dont much fancy calling the insurance people!

Giantaxe

You'll probably need a new presecription - I don't think there's a generic for Maxalt yet; it's a newer drug than Imitrex. If I was you I would call your insurance and find out what they actually cover at what cost. That's one of the positive things about my insurance:- all this info is online which saves a lot of hassle.

Duncan Roberts

Did you change from the tablet to the melt tab? With my (limited) tools it looks like the price drops dramatically between for the 5mg tablet compared to the 10mg one or the melt tabs.

cindyabs

The first patents for Maxalt and Maxalt MLT currently expire in 2012