National Headlines

Why a patient paid a $285 copay for a $40 drug


Why a patient paid a $285 copay for a $40 drug

Listen NOW … There’s Innovation Happening In Private Pay Medicine and Pharmacy. From Precision Medicine, Wholesaling to Compounding and more, We Unpack It All In A New 3-Part Series FOR DPC. © 2018 CMTs DocPreneur Podcast

By Theo Thimou | August 22, 2018 3:01 pm

It’s usually taken on faith by health care consumers that you can save big money on prescriptions when using your insurance company’s mail-order pharmacy program. But there are some instances where it’s a heck of a lot of cheaper to pay cash for a medication at the pharmacy counter, rather than to order it through your insurer’s pharmacy benefits manager program.

Two years ago Gretchen Liu, 78, had a transient ischemic attack — which experts sometimes call a “mini stroke” — while on a trip to China. After she recovered and returned home to San Francisco, her doctor prescribed a generic medication called telmisartan to help manage her blood pressure. Liu and her husband Z. Ming Ma, a retired physicist, are insured through an Anthem Medicare plan. Ma ordered the telmisartan through Express Scripts, the company that manages pharmacy benefits for Anthem and also provides a mail-order service. The copay for a 90-day supply was $285, which seemed high to Ma. (READ FULL STORY on PBS NEWS HOUR …)



Categories: National Headlines