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

  1. #1
    Distinguished Community Member Lazarus's Avatar
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    Default 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!"

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    Distinguished Community Member agate's Avatar
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    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.
    MS diagnosed 1980. Avonex 2002-2005. Copaxone 6/07 - 5/10.
    Member of this MS board since 2001.

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    Distinguished Community Member Frog42's Avatar
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    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

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    Distinguished Community Member Howie's Avatar
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    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.
    Roswell was a gift.

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    Distinguished Community Member Lazarus's Avatar
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    Quote Originally Posted by Frog42 View Post
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    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!"

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    Distinguished Community Member Cherie's Avatar
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    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.

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    Distinguished Community Member Lazarus's Avatar
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    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!"

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    Distinguished Community Member Cherie's Avatar
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    Sure is...

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    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.


    Quote Originally Posted by Lazarus View Post
    This quote is hidden because you are ignoring this member. Show Quote
    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.

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  19. #10
    Distinguished Community Member BBS1951's Avatar
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    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.

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