Sunday, May 20, 2012

Prescription drug "benefit" that defies any logic

We stopped at CVS today to pick up my prescription for a sleep aid. Yeah, I really do need one to get a good night's sleep and I'm sure everyone can understand why that might be necessary. My doctor calls in the RX for 60 7.5 mg capsules of Temazepam (Restoril) with instructions to take 1 or 2 as needed for sleep. I usually take just one, and until last week I wasn't taking them every night. The pharmacist checked our insurance coverage and learned that Express-Scripts (who is our pharmacy plan manager) allows only 15 capsules every two weeks, for the same co-pay as a monthly supply. We asked what the cost would be if we paid out of pocket for the full one month supply - $430!!! But get this, if my prescription is for 15 mg capsules, the cost is $14.50 for a 30-day supply, even without insurance coverage! How dumb is this? I wanted to stay on the lower dose, and take two capsules once in a while if I really need the additional help. But it's 30 times less expensive to accept the 15 mg strength...apparently hardly anyone uses the half dose capsules. The helpful pharmacist will call my doctor tomorrow and they'll figure out whether to call Express-Scripts and get an exception approved, or just go ahead and give me the stronger dose. Apparently, it's not impossible to shake the capsule, remove some of the drug, then put the capsule back together. Maybe I'll buy some empty capsules and split the dose and make my own 7.5 mg capsules. You gotta be kidding!

3 comments:

  1. Just cut the pills in half and send a note to the insurance company that says, "screw you, nitwits!". ;)

    Lori E.

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