ADHD Medication Costs

[GhostOrchid]

Is anyone else seeing big swings in medication costs month to month? I try not to stress over the price of medications because I consider them to be necessities. They help my son feel better and as a result, our family time is more peaceful on most days. Instead of stressing over the price, I tell myself we will save money on the other things. We are very fortunate to be able to afford these medications and I'm grateful for that. However, the price swings I see from month to month are driving me crazy because I can't see any rhyme or reason for them! (I undoubtedly have undiagnosed ADHD myself which isn't helping. LOL!) Last month the Guanfacine was $25.50 and this month it is $47 and Focalin XR (generic formula) was $148 and now $120. Same dosage. Same count. We have private insurance and we haven't met our $3000 deductible yet, so it shouldn't be insurance-related adjustments. I'm wondering if anyone else has been seeing price fluctuations like this? Does anyone have tips for saving money? Last year when my son first started Focalin it was $50ish in January which would have been before we met our deductible, so we have seen a sizeable price increase over the year. His dosage has increased, but with most other medications the price doesn't typically double with the dosage. Maybe it is different for these?? Anyway, before I go down a rabbit hole and lose hours of my life researching this, I thought I'd see if this is what everyone else is seeing too, or if there is something goofy with my son's Rx/Insurance/pharmacy that I should be looking into.

[msm0nster]

Yeah I watched something on the news that said certain med costs would be going up. Everything from insulin to adderall went up. I stopped using my insurance because my sons guanfacine and adderall would've cost way more and now I use the goodrx app. Way cheaper than insurance. Guanfacine was 75 with insurance, now 21 dollars without insurance and with goodrx codes, adderall dropped down to 45 dollars as well. It's ridiculous though.

[Shamasamdrew in reply to msm0nster]

I second the GoodRx app. It can sometimes drop a prescription’s price down $40 or more.

[GhostOrchid in reply to msm0nster]

I picked up one of the GoodRX cards at the pediatrician's office yesterday, but haven't had a chance to look into it yet. Is there a catch to using it? Do they sell my phone number or something? It seems weird that a free card anyone can get would give me cheaper rates than my expensive insurance without some kind of catch. I definitely plan on looking into it!

[MaudQ]

I’m sorry you’re experiencing this. Is switching insurance an option? We have United Healthcare and shop at CVS and consistently pay around $10. Our kid is on four meds, so $40 total. We haven’t met our deductible - but I’ve never had that influence the co-pay, just the cost of certain procedures or providers. If switching insurance isn’t an option, I wonder if you could ask your pharmacist and psychiatrist about it. Maybe there are cheaper generics - or sometimes they have insight into insurance from their perspective.

[GhostOrchid]

No, I can't switch insurance. I work for a tiny company (<10 employees) and we don't have insurance options. Our policy is through my husband's employer and the Rx part is through Caremark so we have been using Caremark for Rx through mail or CVS since Caremark is a CVS company. Apparently, our deductible is for medical and prescription. I don't mind needing to meet a deductible, it is the inconsistent price fluctuations that is bothering me. One month it is $148 and the next $120. It used to be $50. I'm sure I can get the doctor to prescribe something more budget-friendly, but we are chasing a moving target! I wasn't sure if that was just going on with us and our pharmacy or if everyone is experiencing something similar.

[MaudQ in reply to GhostOrchid]

So I was curious and looked up GoodRx and found this article. It turns out that my insurance company partners with OptumRx which is a discount company like GoodRx. That’s why we’re paying so little for our meds. I actually had no idea (!) It does sound like GoodRx was busted a few years ago for selling customers’ private information but they say they have stopped doing that. The article also has some other useful info: dallasnews.com/news/watchdo...

[GhostOrchid in reply to MaudQ]

Thank you. I knew there was a catch somewhere. I will research both OptumRX and GoodRx a bit more. Based on the article you linked, it looks like AARP has a deal with OptumRx. I've been laughing at my husband for getting an AARP card in the mail recently. Maybe we need to be more serious about looking into a membership instead of seeing it as a reminder we are getting old!

[blues_22]

Sorry to hear that. I haven't experienced monthly differences with my sons medication but it did go up $60 at the beginning of this year from $320 to $380. Luckily my copay is only $50 now. We used to pay the full $320 a month when he was under my husbands insurance. He's on Quillivant. Other than GoodRX, I have been told by the pharmacist to go to the drug manufactures website and see if they have programs you can qualify for. I tried for the Quillivant but it wasn't available in my state. Good luck.

[GhostOrchid in reply to blues_22]

My husband has had good luck with a manufacturer's coupon with one of his meds (cholesterol, I think). There is a coupon on Focalin's website, but it looks like they max out their contribution at $700ish per year. It looks like that would max out after 2-3 months, so not worth the switch.

[Aspenanddusty]

We use Good rx Gold. For $10 a month we can fill any meds for up to five people and or pets. Saves us thousands of dollars a year. Anyone can get this. Be sure every time you get the refill that your pharmacy knows that you would like to use good rx gold or for free you can get the good rx. We just save more using the gold. Also, you can look up costs for a certain prescription and know what you will pay. Usually under $15 and which pharmacy is cheapest. It will give your a list for your area. Hope this helps!!

[Aspenanddusty in reply to Aspenanddusty]

And no there isn't any catch to using the good rx. I've used them for years. Sometimes the cost fluctuates but nothing to expensive. Sometimes the insurance is cheaper but usually not

[GhostOrchid in reply to Aspenanddusty]

Thanks for this info. I didn't realize there was a free and paid version of Good Rx. I guess I need to get a list of all the family's Rx so I can sit down and compare my options. I hope to keep all our Rx with one pharmacy so I have someone qualified to alert me if a combination of meds will have adverse effects. I always try to check before anyone starts a new medication, but when life gets hectic I can be forgetful! It seems like life gets more and more hectic as the kids age.