Wednesday, December 11, 2013

We need healthcare reform to pay for Solodyn?

Mrs. Solodyn comes to get little Freddy's Solodyn prescription. Freddy is 14 and like most teenagers is dealing with the throes of puberty, including acne. 

Mrs. Solodyn hands me a manufacturer coupon from the makers of Solodyn. It says that the first prescription will be paid by the manufacturer. I load the information for billing into the computer and send it off. REJECT! "Maximum ONE voucher per patient." I explain this to Mrs. Solodyn.

"I never received a FREE one! I never got one before!" she blurts out.

I look on the computer log. Little Freddy has had several prescriptions for Solodyn over the course of the last year. Plus his older sister has had Solodyn too. 

"Perhaps you had one for Fred before that you don't remember, or maybe Rebecca had one in the past and the company looks at it as one free voucher per family. If you'd like, I can keep it here on the shelf until YOU call the 800 number on the card and straighten it all out..."

She cuts me off, "How MUCH is it?"

I reprocess the claim. "It's $35. There's a message that your normal co-pay is being reduced by the manufacturer via electronic coupon loaded into the system..."

She cuts me off, "Wait! I have another card here." She hands me a card that says YOUR COST $0 with this card. I look at it. As normal, there is the usual asterisk by that phrasing but you know, customer service is king at Goofmart Pharmacy so I start to type in the information into our state-of-the-art Deep Blue computer. I hit <ENTER> and the computer tells me that information is already on file. So I send off the claim again (each time we do this it costs money, in case anyone didn't know this) and it comes back with a $35 co-pay and the same phrase about the co-pay being reduced blah blah blah.


I tell Mrs. Solodyn that the co-pay is $35. 

"NOOOOOO. It says right here, ZERO co-pay!" 

People walking by are startled. A lady that works in the meat department, wearing a large white smock covered with blood, walks by, waves, and says, "Crazy, how ya doing ta-day?" She knows I'm not a happy camper with Goofmart and never fails to try and dig it in.

"Well, let's look at the card. See this asterisk? Those are never good," I say.

I look at the fine print. "If co-pay is $35, you must use our mail-order service to..." blah blah blah. Basically she has to mail the prescription to a mail order service to get it free. I try to explain that to her.

"How MUCH IS IT?" she belts at me again. The co-pay of $35 has somehow left her memory.

"It is $35, which considering the retail price is over $900 that's not...."

She cuts me off AGAIN, "You know, this is exactly WHY we needed healthcare reform! Obamacare is going to take care of crap like this! The insurance companies are going to get their's!"

At this point I shut up. She pays the $35 and leaves.

So let's review ALL the things wrong with this transaction:

1. Coupon cards from the manufacturers SUCK. STOP printing coupons with asterisks and make it the pharmacist's job to give the bad news.
2. $35 is NOT an unreasonable price for a brand-name medication, especially one that is for cosmetic use.
3. Yelling at the pharmacist or technician is COMPLETELY unreasonable.
4. This really has NOTHING to do with her insurance company or Obamacare.
5. Mrs. Solodyn thinks that this horrible, incredibly overwhelming $35 co-pay should be paid for by you, me, and everyone else through socialized healthcare.
6. Solodyn is merely extended-release Minocycline. If little Freddy can just remember to take the generic twice daily, NONE of this would be an issue and the cost would be minimal.
7. Manufacturers that re-brand old medications in extended release formula and charge huge prices SUCK. How about you invent something NEW for a change?

More thoughts on Manufacturer Coupons and Discount Cards

1 comment:

Mrs_R said...

But craaaaaazy...if that airhead hot piece of ass pharmaceutical rep doesn't have a stack of coupons to offer up at her next visit to the doctor (which, as you likely know, her employer tracks by buying data from the pharmacy to see which doctors are prescribing this wonder drug, reflecting nicely on her "ability" to pimp uh I mean market the drug) then just HOW is she going to meet her quota and get her bonuses?

You know, because it's more important for the pharma rep to get the hook up and boost productivity than it is to offer a more long-tern cost-effective treatment to the patient...