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Ampyra... GIC...unicare Indemnity Plan....sudden change in copay...

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    Ampyra... GIC...unicare Indemnity Plan....sudden change in copay...

    This is my plan in Massachusetts...it is the best plan offered retired college professors.
    This is a good insurance plan but I got a letter today that the monthly copay for Ampyra was changing from $25 a month to $65 a month. Change is immediate!

    Anyone had a similar experience? Something about the formulary they use to calculate. There is no generic for Ampyra. It is dispensed as a specialty drug. I missed the phone service to GIC by two minutes today so have to call back in the morning.

    I called Accorda which makes the drug and they are launching an investigation and will call me back. This is a drug you take every 12 hours or there is danger of seizure. But I have been taking it for 4 years and occasionally miss a dose and take the next dose at the next scheduled time and nothing happened. So I asked the person at Accorda if any people take it once a day instead of twice a day. Lo and behold! Some people do that.

    So tomorrow I will call my insurance company to argue the sudden shift in copay when there is no other drug to use.. But I will plan on using it once instead of twice a day. Anyone else on Ampyra? What do you think?

    I am just in shock.
    Linda~~~~

    Be the kind of woman that when your feet hit the floor each morning the devil says:"Oh Crap, She's up!"..

    #2
    I haven't taken Ampyra but this price increase sounds like a bit of gouging going on.

    I looked up the prescribing information and see that the way you've been taking Ampyra is the "maximum recommended dosage." To me that means that you can take less of it without harm.

    It might be less effective if you cut the dose to one a day but risk of adverse reactions would also be less, seems to me.
    SPMS diagnosed 1980. Avonex 2001-2004. Copaxone 2006-2009. Glatopa (glatiramer acetate = Copaxone) 12/20 - 3/19/24.

    Comment


      #3
      You have to stay on your toes around most drug companies. They do love profit. I often wonder if that's more important to them than their patients.


      Whatever happens around you, don't take it personally. Nothing other people do is because of you. It is because of themselves. -- Miguel Ruiz

      Comment


        #4
        I am on Medicaid, and I take no MS meds. But my other meds which used to be free through Medicaid, now cost. Not much, but with my SS income, it HURTS. SS just gave a raise, but the new meds cost ate it up, PLUS some.
        "Given the millions of billions of Earth-like planets, life elsewhere in the Universe without a doubt, does exist."

        Albert Einstein

        Comment


          #5
          Originally posted by Frog42 View Post
          You have to stay on your toes around most drug companies. They do love profit. I often wonder if that's more important to them than their patients.
          Actually, turns out it is not the drug company raising the price. It is the insurance companies raising copays's especially on "specialty drugs". I found articles as I researched last night. Since there is no choice but to take the one of a kind drug, it really is the first time in all these years that I have been stopped short like this.

          Thanks to Agate I will consider taking it once a day and see if that works well enough. This drug really helps me walk. I am lucky with it and now I am feeling a bit ashamed that I am complaining when my drug costs are enormous every year and insurance covers so much. Others have a bigger problem covering basic meds and I can shift things around to pay higher copays . But it has happened on my blood pressure meds too so the higher copays on all of them are rivaling my electric bills!
          Linda~~~~

          Be the kind of woman that when your feet hit the floor each morning the devil says:"Oh Crap, She's up!"..

          Comment


            #6
            Accorda has a copay assistance program where no one pays more than $40/month. Also missing a dose does not raise the risk of seizure. People with seizure disorders risk seizures if they take Ampyra. And if you are predisposed to a seizure disorder, it can show itself while on Ampyra...in which case the drug is stopped.
            Attached Files

            Comment


              #7
              So, there are lots of news stories nationally about the "specialty drug" situation. Insurance companies are raising copays. I guess I had not been paying attention as this farming season has gotten underway! It is a huge problem for lots of people now as copays are significantly higher.

              Drats.
              Linda~~~~

              Be the kind of woman that when your feet hit the floor each morning the devil says:"Oh Crap, She's up!"..

              Comment


                #8
                Sure is...

                Comment


                  #9
                  It is not just speciality drugs. My copay for a generic Lunesta (sleeping pill) went from $30 to $70 for no apparent reason. I don't have a very good insurance plan, Medicare D thing, but still, a 100% increase on a generic drug. And the generic Lunesta does not even work remotely as well as the brand name. Most of my drugs like the above I buy outside of the US for a lot less than the copays.


                  Originally posted by Lazarus View Post
                  This is my plan in Massachusetts...it is the best plan offered retired college professors.
                  This is a good insurance plan but I got a letter today that the monthly copay for Ampyra was changing from $25 a month to $65 a month. Change is immediate!

                  Anyone had a similar experience? Something about the formulary they use to calculate. There is no generic for Ampyra. It is dispensed as a specialty drug. I missed the phone service to GIC by two minutes today so have to call back in the morning.

                  I called Accorda which makes the drug and they are launching an investigation and will call me back. This is a drug you take every 12 hours or there is danger of seizure. But I have been taking it for 4 years and occasionally miss a dose and take the next dose at the next scheduled time and nothing happened. So I asked the person at Accorda if any people take it once a day instead of twice a day. Lo and behold! Some people do that.

                  So tomorrow I will call my insurance company to argue the sudden shift in copay when there is no other drug to use.. But I will plan on using it once instead of twice a day. Anyone else on Ampyra? What do you think?

                  I am just in shock.

                  Comment


                    #10
                    Copays for many oFfice visits and Meds have risen greatly. So have deductibles. This is a consequence of the ACA (Obamacare) law. This is how insurance makes up for all of the new freebies and coverages mandated by Obamacare.

                    Comment


                      #11
                      I hate insurance companies.
                      Since NY state made me choose one of two undesirable companies
                      as an antidote to waste and fraud! in the state, I have experienced
                      more BS than I have in over a decade.
                      Only two insurance choices- Would you like the day old roadkill skunk or the roadkill woodchuck for dinner?

                      It hasn't been fun.
                      The effectiveness of self advocacy has lost ground and now I search for
                      an ombudsman or mediary to do what I used to do when people talked
                      routinely with civility to patients and customers.

                      Comment


                        #12
                        Renee, I sure would like to go back to a simpler, happier,
                        healthier, Younger, less expensive lifestyle. Maybe the
                        bottom needs to drop out, so we can start over?
                        Love, Sally


                        "The best way out is always through". Robert Frost






                        Comment


                          #13
                          Bottom drop out? like Mad Max????

                          Yeah, I liked cheap and simple- man that was a great way to live- thrift shops in the
                          70's and 80's were F UN. I am sooo sorry I didn't buy that cement flamingo from the
                          40's or all the beautiful hood ornaments from the 50's and before- decorative ART and design.
                          My town used to be very egalitarian. Almost everyone knew the name and story of
                          every eccentric and homeless person.
                          We all watched out for them.

                          Sally, I liked walking, hitch hiking and public transport.
                          No insurance, maintenance costs, gasoline.
                          Insurance companies are so imbedded in the economy of this country and
                          the election contribution machine I don't see them as going away real soon.

                          It's kind of like trying to clean up the bank and loan operations.
                          It will take a lot of driven, squeaky clean, intelligent, articulate people with
                          power and endurance to push.

                          Simple, honest and healthy.
                          What do you think our next incarnations shall be, little Sal?

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