Insurance Company Inflating Drug Prices

[insurance0707]

I've been trying to help my clients with prescription coverage for 2010. Some of my clients are sending me their printouts from the pharmacy showing the discounted retail price that a particular insurance company is giving and then what their copay is with that insurance company.

For example, Simvastatin, discounted retail price from xxx insurance company $ 218.99..... copay for client for 90 day supply $ 17.50

The company is applying the $218.99 towards their prescription benefit....

Simvastatin usually runs about $45 for a 90 day supply if you were to buy it yourself with no insurance. This company is pushing my clients into the doughnut hole way before they should be by their overinflated retail prices. I've had quite a few clients bring this up to me, so I know it's not just one client.

Any thoughts?

By the way on Medicare's website with this same insurance company is listing the discounted retail price for a 30 day supply through this company is $10.10..... on the actual pharmacy printout they have it listed as $218.99 for a 90 day supply

 

[policy doctor]

Perhaps it comes under the Fraud, Waste and Abuse complaint. See my thread.

 

[insurance0707]

thanks for posting that, i did get an email letting me know I needed to take that

 

[DS4]

FYI,
I just went to Costco's website.
SIMVASTATIN 10 MG, 20mg or 40mg
30 day supply $5.90
100 day supply $10.83

I would tell your client to pay cash and not use their PDP.

 

[insurance0707]

They're on some expensive meds, plavix for example is one of them, they don't seem to be overinflating that one, it's 176 retail price his copay is just 30

 

[somarco]

This isn't my market, but I was under the impression that CMS allowed the carriers and pharma to set pricing and therein lies some of the beef over Part D.

 

[retread]

FYI,
I just went to Costco's website.
SIMVASTATIN 10 MG, 20mg or 40mg
30 day supply $5.90
100 day supply $10.83

I would tell your client to pay cash and not use their PDP.

I have been telling my clients about this dirty little secret for the last 3 years. Make sure you tell them to keep their receipts.... if they find themselves in the donut hole due to other drugs they are taking, then submit these receipts at that time... it will help them get out a little sooner.

(Also... simvistatin is $4 at most WalMart and competing Rx- and $10 for 3 mos supply)

 

[DS4]

(Also... simvistatin is $4 at most WalMart and competing Rx- and $10 for 3 mos supply)

No longer on the WallyMart $4/$10 list as of @ 1 yr ago.

 

[Yoda]

Its time to to be honest and tell your clients that these drug plans and the companies running them have bad intentions. The future of these drug plans looks bleak. Our representatives in congress are nothing more then tools of corporate america and they have given the drug companies and the insurance companies the green light to screw over our clients. And whos going to get blamed for the raping of our clients. Us!..I will never sell another drug plan again.

 

[insurance0707]

Do you know what a pain these plans are to research....than you have CMS on your a** if you're not following their ridiculous rules. I'm not writing them either for 2010 but I will try and at least help my clients. It's disenheartening to see what some of the insurance companies are doing with the inflated prices that take away the $2,700 benefits that they're receiving for 2009. Some of my clients have been with me for 20 years....how do I tell them just figure it out....your on your own.