I'm just trying to get my goddamn asthma medication!

[Robyn66]

So I go to the Blue cross Blue Shield site that sends me to the pharmacy site and I look up
ADVAIR because I need it for my allergy induced asthma, and a BIG MESSAGE IN RED LETTERS comes up saying THIS IS A "STEP 2" DRUG you need to try a "FRONT LINE DRUG" which almost always works just as well as the "step 2" drugs.

They can't tell me what the "Front Line" drug is in place for ADVAIR. I have to see my doctor for that, fair enough but here is the kicker- The only place I can get a list of "Front line drugs" is from my husband's HR department. So my DOCTOR doesn't even have access to this list until I get it from his company!

Oh and by the way there IS NO GENERIC FOR ADVAIR.

But they assure me that if I can't use a "Front Line" drug, I can apply for approval for the "Step 2" drug (Advair) which they will give me for the highest co-pay which is $45.00 each inhaler, unless the co-pay has gone up.

Boy, I am SO GLAD THE INSURANCE COMPANY DOESN'T GET BETWEEN MY DOCTOR AND ME!!!!

:banghead: :banghead: :banghead:

All I can think of is in Sicko in Cuba they could get inhalers for $5.00 each! I bet mine isn't worth $45.00

[Kadie]

1. I have had the same problem with a couple of medications.

:mad:

[Jane Austin]

2. Check the side effects of Advair very carefully.

It can make you more susceptible to respiratory infections.

I only lost my voice for three weeks and had bronchitis before a second doctor suggested it could be caused by my starting use of Advair three weeks before.

Cromylin also prevents asthma attacks.

[Robyn66]

7. I have used it before but there are more hoops this year to jump through

my asthma is caused by allergies and if I don't jump on it right away it turns into bronchitis and lately, pneumonia. I should be using it year round but that $45.00 a month maybe doesn't sound like a lot but there have been a lot of times it has been too much over the past year. Going through surgery and chemo created a lot of costs besides the medical bills, there was gas and food and parking. So that $45.00 was an easy cut to make when my asthma wasn't really bothering me.

[Jane Austin]

28. Have you tried Cromylin?

It should be a lot cheaper and might work as well for you.

Ed: Just saw your response.

No, it doesn't work the same way as advair, but it is for prevention of asthma and allergies. (The allergy treatment is NasalCrom, which is applied to the nasal mucous membranes.)

NasalCrom and Cromylin both work at the cellular level to prevent the mast cells from producing inflammatory substances, including histamine.

[gkhouston]

8. But it must not work in exactly the same way, because I just check *my* fomulary

(Aetna) and they don't have any suggested alternatives. Believe me, if there were something cheaper that worked, Aetna would be all over it, like stink on a shithouse rat. To their credit, Advair's not listed as having step medications, although apparently there is a generic expected out in the near future for the Advair diskus.

[formercia]

14. I used to have problems with lung infections

until my doctor gave me a Pneumonia vaccination. Until then, I couldn't use Advair.

[orleans]

3. sorry, robyn--it's terrible they pull this crap. n/t

[gkhouston]

4. OMG, at least my insurance company tells us they're doing this shit months

in advance, sends us a letter telling us which meds they're talking about, *and* you can look it up on-line any old time.

[timeforpeace]

5. Your doctor doesn't need a list, it's a common therapeutic dictum, not an insurance co mandate.

It's good medical practice and if your doctor is a good medical practicioner he/she knows all about this. Edit to add that if anyone thinks health care reform will change stuff like this, they are wrong. It will be harder not easier.

[MNDemNY]

6. We have the finest health care system on earth.

Quit your goddamn whining and get in line. Who the hell do you think you are to second guess what BC/BS says is best? Sheesh. Commie.


Why do you hate America. so?

[Robyn66]

9. Thank you Senator Hatch ;P

:spray: You are SO right! Just as long as the GOVERNMENT doesn't get involved because things are just PERFECT NOW!!! :rofl:

[MNDemNY]

11. Really, though, best of luck with that crap.

B-)

[MineralMan]

10. Actually, I don't think Advair is the first choice...

it's an adjunct for other asthma inhalers, if I understand the prescribing information correctly. Normally, it's not the first thing prescribed, but is added if the other inhalers don't control the asthma effectively.

Call your doctor and ask him/her about this. If you're not already using an inhaler, Advair may well not be the best prescription, but your doctor will have to decide that.

[Robyn66]

12. I use albuterol for asthma attacks

but this time of year I can't sleep at night because I cough and cough when I lay down. The only thing that has helped is Advair. I will definitely ask if there is something different that can be used.

[MineralMan]

13. Well, then, you're already using the first-line meds.

Stupid insurance companies. I think your doctor will have to push it for you.

[Rhiannon12866]

31. I use both Advair and an albuterol inhaler, too.

I used to use the albuterol inhaler all of the time until my (new) doctor prescribed Advair. Now, I rarely use the albuterol unless I'm having trouble breathing which doesn't happen very often anymore. It's for emergencies, like when I'm coughing or wheezing. But Advair is expensive, even with insurance, and now that I don't have it, it's exorbitant, so I don't use it so much... I was using it twice a day, as prescribed. :-(

But it is true that some pharmacies have a greater mark-up than others (my doctor told me that, too), so I switched pharmacies, since he told me which ones were the cheapest. And, no, there is no generic for Advair. Guess we're paying for the delivery system. :shrug:

I absolutely sympathize. Since I've used the Advair, I tend to forget that I have asthma at all. :-)

Rhiannon :hug:

[snacker]

15. Same thing happened to my son.

He got a prescription for his usual allergy medication and got the runaround with this step system. He never did get the medication that he has been prescribed for several years and his worked for him. He never had this problem getting his meds before. Luckily for him, we've had several hard frosts which have ended his seasonal allergies.

[lady lib]

16. Your doctor's office should be able to call BC/BS and find out

what generics BC/BS wants prescribed first. I'm guessing they want you to try the basic ingredients of Advair - a long acting beta2 agonist (you said you're already using albuterol which is a short-acting beta2 agonist) and a separate inhaled steroid. Actually, you might find that you like this better anyway because you can separately dose each inhaler. You might also try asking your pharmacist if he or she knows what BC/BS will allow.

[Robyn66]

19. I will do that

it may end up working out better in the long run. You know, I just want to be able to sleep and breathe at the same time! It shouldn't be such a huge thing to ask of the world!!! Thank you for the info!!! :hug:

[backscatter712]

17. One inaccuracy about your description of SiCKO...

In Cuba, they weren't selling inhalers for $5.00 each.

They were selling them for $0.05 each. Yep. Five cents. One nickel per inhaler.

For the same inhaler that costs hundreds of bucks here.

[Robyn66]

18. Thanks for correcting me. I thought the 5.00 was high!

I haven't watched Sicko in a long time. I don't even want to think of how cheap mine would be down there. It just sucks!:-(

[Sgent]

21. Part of that is environmental regs

Generic inhalers that used to sell very cheaply even here have been banned do to EPA regulations on greenhouse gases (they contained CFC's). The replacement inhalers are all under patent therefore the drug companies can rape us....

[Robyn66]

24. I didn't know that

inhalers used to have CFC's in them. It just doesn't sound like that would be good for someone who already has breathing problems to begin with!!

[HiFructosePronSyrup]

20. Seretide.

Generic brand name for Advair.

[Robyn66]

26. Is that available in the US do you know?

[nadinbrzezinski]

22. They weren't Advair, to be fair

but the one I get, Albuterol... and it was for one buck.

[Robyn66]

23. True-not advair

But I bet the cost is no where near the $45.00 co-pay I have to pay for one of them. :)

[nadinbrzezinski]

25. No it is not

the difference in cost per pill in the US and anywhere else is criminal.

[Robyn66]

27. But the insurance companies need tax cuts

because they make no money!

[Rhiannon12866]

36. My co-pay was $60 for the Advair, compared to $10 for most others...

But it obviously makes a world of difference (see my post #31), so it's worth it to me. :-(

[ecstatic]

29. BCBS is complete utter crap.

Just wish I had known that 3,000 dollars ago.

[LiberalEsto]

35. We just got Bull Crap, Bull Shit

after many years with Aetna.

I can't hardly wait for the rejections and refusals to start rolling in. :(

[dysfunctional press]

30. despite their claims- advair is NOT the only med that combines bronchial dilator/anti-inflammatory-

marijuana does the same thing. :hippie:

and it used to be prescribed to asthmatics.

[Monk06]

32. I'm taking Advair and Spiriva for Emphysema and Bronchiectasis

The Spiriva is the best bronchial dilator I've
used and I get another dilator with Advair

[annabanana]

33. The insurance companies are killing us, wholesale. . . . n/t

[FlaGranny]

34. I have a similar problem with

Allegra. It's the only allergy med I can take without being "knocked out." I've tried all of them The worst ones make me groggy for 3 days. If I take the other "non-sleepy" ones it take about 1-1/2 days for them to wear off. Allegra is the only one I can take and remain alert and my insurance company classes it third line so therefore I have to pay the highest price - $65.00. Next time I'm going to order it from Canada.

Formularies are more about costs than effectiveness.

[XemaSab]

37. The asthma tax sucks

I am on pulmicort, proair, and singulair, and it's ridiculously expensive, especially without insurance. x(

[GreenPartyVoter]

38. :^( I am so sorry to hear this. I hope you get your meds soon.

[Rhiannon12866]

39. When I was in the hospital last year, they gave me Symbicort instead of Advair

But they would let me still use the albuterol if I needed it. They gave it to me to take home, but no prescription, so I went back to using the Advair. :shrug:

[naaman fletcher]

40. step therapy makes sense in theory..

There are lots and lots of times where people jump to the expensive solution first, when it would save money if they first tried the simply solutions..

But, it has been a failure in practice for reasons like your story above. It just pissed everyone off.