Wal-Mart Pharmacy Changes

As you may know from prior postings on this subject or as a matter of common knowledge, last January Wal-Mart started offering deep discounts on hundreds of commonly used generic prescription medicines at $4/month or $8/3 months.

As of this January, the following changes have been made:

1. 3-month (90-day) prescriptions are $10.
2. New prescriptions have been added at $9/month or $24/90 days:

• Ventolin HFA, the asthma inhaler
• bupropion ER, the equivalent of Zyban for stopping smoking
• alendronate/Fosamax, the osteoporosis weekly pill
• tamoxifen, the breast cancer chemotherapy pill
• several birth control pills

Otherwise, the other medicines are still $4/month.

As previously mentioned, I'm not a big Wally World fan. However, I have to say these prices on hundreds of the most widely used medicines are probably saving lives in a time when lots of folks have to make food/medicines/housing/heating decisions all the time.

The increase from $8 to $10 for 90 days worth is still an unbelievably good deal; particularly with the addition of the aforementioned medicines!

I imagine the reason they continue to offer these discounts is that folks spend an average of $35 whenever they walk in. If you don't want to buy anything else, then don't. But that's a pretty unbeatable deal on medicines if you need them.

Medicare Part D

You still have time to add prescription drug coverage to your Medicare!

Open enrollment ends at the end of this month.

Until then, you can go on-line or call 1-800-MEDICARE to get help adding this to your Medicare Part A and B (these cover hospital and outpatient medical care).

Basically, these are commercial insurance plans that meet or exceed standards set by the federal government. They are used for covering the costs of you medications.

There are lots of choices, and lots of differences in cost. The last time I looked, there were over 50 plans in California and the average premium was about $45/month.

DO. NOT. PANIC.

First of all, if you have very little money (make less than $14,355/year yourself, or less than $19,245/year as a couple at last count) you may be entitled to Plan D at no cost to you at all as long as you pick a plan that does not exceed the average premium cost for California.

Second, use the available resources to narrow your search:

• You live in California. Only look for plans offered in California.
• Most generic drugs are not a real issue. The ones that aren't generic are the ones that will cost you (such as Actos and Avandia for diabetes, brand name insulins like Lantus and Humalog and ARB's for blood pressure and heart failure like Diovan, Cozaar and Atacand). Generate a list of your expensive drugs, and then look for plans that cover them.
• If you already have Part D and always end up having to pay full cost on you pills before the end of the calendar year, this does not mean that your insurance no longer covers it! This means you've hit the "donut hole" for the year.
• This means Part D has covered $2,250 for the year and that you are on the hook for the next $2,850. If you go past that for the year, then Part D picks up for the rest of the year.
• If this keeps happening to you, pay a bit more for a plan with "donut hole" coverage!

This link shows all the plans available for 2009 in El Dorado county in nice neat columns showing what they are called, how much they cost, whether they are free to low income folks and whether they have gap (donut hole) coverage or not.

It also provides links to the plans so you can see all the details, and toll-free numbers for folks who prefer telephoning.

Use it or lose it!

Mail Order Pharmacy

Mail order prescription services are known to your medical insurance companies as Pharmacy Benefit Managers (PBM's).

PBM's are middlemen that obtain contracts with pharmaceutical manufacturers ("drug companies") for discount prices on large sales volumes for the insurance companies. In theory, this is supposed to be a win-win situation for everyone. The insurance companies save money on cost of medications, they incentivize you to participate by lowering the out-of-pocket cost of your pills, and otherwise pass on the savings to you.

Of course, you could reasonable ask why your premiums keep going up, but that's a topic for another time. You might also ask what that's doing to your friendly and trustworthy local pharmacist, but I guess the idea is that it's a tough old world out there.

If you want to use your PBM, and would like our help in making it work for you as smoothly as possible,

• They will usually send you a renewal form for each of your medicines when your yearly prescription is up.
• Please let us use these for renewals. Using hand written prescriptions for renewing already existing prescriptions is very confusing to them.

• PLEASE, PLEASE USE YOUR LOCAL PHARMACY FIRST FOR NEW MEDICINES OR FOR CHANGES IN DOSES ON MEDICINES!
• It's not unusual to start or change a medicine, only to find that you have to switch to something else because of side-effects, or that you have to make another change in dose at the follow-up visit.
• Because of this, it's a good idea to make sure that the medicine and it's dosage is right for you before getting 3 months worth for a year!
• Yes, we know it's cheaper to do mail order.
• Yes, we know a few dollars is a lot of money these days, especially if you are on a fixed income.
• The problem is that serial mail-in prescriptions reflecting changes in medications and/or dose changes can lead to confusion as to your medications.
  

Cheap Drugs (Inexpensive Prescription Medications)

Times are, as they say, tight.

While I'm no particular fan of Wal-Mart, they are offering $4/30 days on over 360 commonly prescribed medications. That's mighty tough to beat. Yes, that's $4.00 for up to 30 days on normal dosages which is 13 cents a day.

Cash paying patients should compare this to other large operations such as Rite-Aid and Long's where the average mark-up on medications is 5-6 times the Manufacturer Suggested Retail Price (MSRP).

If you have prescription drug coverage including "mail-in" pharmacies (Phamacy Benefit Managers, or PBM's) this still might beat the co-pays.

Furthermore, these are real every day widely used medicines and not oddball rarely used ones.

Check it out.