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American “Health”

JackD

JackD

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Sep 16, 2010
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I also forgot to say this earlier. But, insurance companies, lab draw companies along with Pharm companies are all in bed together for a nice 3 some love fest. Use testosterone for example. 10 years ago the reference range was 300 to 1200. Now the reference range is 250 - 827. When I asked the Dr last year what’s happening with the test results, he said, the insurance companies don’t want to pay for TRT so they’ve changed the testing and make the tests extremely sensitive so they don’t have to pay. Which is also insane because if you used to use say 200mgs/wk a few years ago, you’d test around 600, with that same test now you test at 1600. It’s all about money and not about health and that person.
 
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Iron1

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Jul 7, 2021
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I he said, the insurance companies don’t want to pay for TRT

I've encountered this with my own TRT. 10mL of Watson Cyp used to run me $15.

I went to refill one day and they handed me this puny 1mL vial of the same stuff for the same $15. I asked the pharmacist what my doctor called in and they confirmed that the script was for 10mL. He explained that the insurance company overruled the doc and is only authorizing 1mL at a time. I tried calling several pharmacies in the area, both chain and locally owned. All said the same thing. Insurance overrules doctors orders and they would all only script 1mL at a time. When pressed for an explanation why they won't fill the doctors script, the pharmacist explained that the insurance considers TRT to have a high potential for abuse, that if filled the doctors orders and were audited by the insurance company, the insurance co would go after the pharmacies license to operate. They stopped advocating for the patient after legal threats from insurance.

So, to get the same 10mL that I was scripted, it now cost 10x as much requiring 10x the inconvenience of actually getting to the pharmacy. They really don't like paying for proper, convenient TRT.
 
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ceo

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Oct 12, 2010
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I've encountered this with my own TRT. 10mL of Watson Cyp used to run me $15.

I went to refill one day and they handed me this puny 1mL vial of the same stuff for the same $15. I asked the pharmacist what my doctor called in and they confirmed that the script was for 10mL. He explained that the insurance company overruled the doc and is only authorizing 1mL at a time. I tried calling several pharmacies in the area, both chain and locally owned. All said the same thing. Insurance overrules doctors orders and they would all only script 1mL at a time. When pressed for an explanation why they won't fill the doctors script, the pharmacist explained that the insurance considers TRT to have a high potential for abuse, that if filled the doctors orders and were audited by the insurance company, the insurance co would go after the pharmacies license to operate. They stopped advocating for the patient after legal threats from insurance.

So, to get the same 10mL that I was scripted, it now cost 10x as much requiring 10x the inconvenience of actually getting to the pharmacy. They really don't like paying for proper, convenient TRT.
Pay cash so you can get what you want and not be at the mercy of your insurance co. Use a cash card service like goodrx and get a discount. Depending on where you are it could be from $35-55.

Sent from my SM-G781V using Tapatalk
 
Swiper

Swiper

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Jan 8, 2011
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Has anyone ever compared what the hospital charges insurance vs what insurance actually paid that hospital?

I will say pharm companies are all about making money and charge as high as they do to make up for all the money they won’t get after generics are offered. Use any drug. Before the generic, 30 would cost around 300-500 dollars. The generic comes out and 30 costs $20. Truly Highway robbery.

As evil as that whole medical field is, it’s very lucrative for those that work in it. You think your making a difference and you’re not complaining by what they pay you either.

They charge a lot of money because it costs around $3 billion to bring a drug to market which takes several years up to 20. so yeah of course they’re going to charge a lot. they have to make their money back and then a profit. that’s if they’re lucky enough that the drug even makes it to market. they can spend billions and 20 years and have nothing to show for it. it’s extremely risky and with risk comes rewards (profits). it wouldn’t take so long or costs billions if the government didn’t have all their rules and regulations, taxes and all the bullshit they have to go through to get a drug to market.
I blame the government and this anti-capitalist system we have. would be nice to have capitalism in the USA again.
 
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rawdeal

TID Board Of Directors
Nov 29, 2013
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The great thing about unrestrained capitalism is that some people can make more money more quickly. The bad thing is that some people get fucked.

Textbook Big Pharma case about insufficient government restraint in various countries last century might be found here, but there are plenty of others google can take you if you're worried this was fake news.

 
Swiper

Swiper

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Jan 8, 2011
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The great thing about unrestrained capitalism is that some people can make more money more quickly. The bad thing is that some people get fucked.

Textbook Big Pharma case about insufficient government restraint in various countries last century might be found here, but there are plenty of others google can take you if you're worried this was fake news.


another good thing about capitalism is that companies are held responsible for their mistakes by their customers. if you don’t supply your customer with a quality product or service that they value you will go out of business.

Who are the people that get fucked because of capitalism? you mean the people who don’t have any desire to work? people who are lazy?
 
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rawdeal

TID Board Of Directors
Nov 29, 2013
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In this particular case, they would be the people with flippers, but note we were originally talking about capitalism with insufficient rules and regulations as it pertains to Big Pharma.
 
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Iron1

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Jul 7, 2021
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Pay cash so you can get what you want and not be at the mercy of your insurance co. Use a cash card service like goodrx and get a discount. Depending on where you are it could be from $35-55.

Sent from my SM-G781V using Tapatalk

Tried that. They still only carry 1mL vials and will only release 4/each at a cost of $30+tax.
It would cut my bill down to $75 but its still vastly more expensive than when insurance was covering 10mL at $15.
 
JackD

JackD

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Sep 16, 2010
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Tried that. They still only carry 1mL vials and will only release 4/each at a cost of $30+tax.
It would cut my bill down to $75 but its still vastly more expensive than when insurance was covering 10mL at $15.
That’s pretty insane, I haven’t heard of a pharmacy not ordering the medication when the customer pays cash. I will say I think it’s more of a problem with the actual pharmacist too. Same thing happened to me, they wanted to give me 4 ml bottles and I said no. Then the pharmacist tried to tell me he’s not getting me the 10 ml bottle because the medication isn’t good after 28 days and that I only have 2 weeks of usage. I asked him where the package insert says this… And he couldn’t. I said if I’ve never heard that. I said either please fill the medication for what’s prescribed or transfer my script to the Pharmacy next to yours. He filled it, but I still transferred it out.
 
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Wilson6

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Dec 17, 2019
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Tried that. They still only carry 1mL vials and will only release 4/each at a cost of $30+tax.

That’s pretty insane, I haven’t heard of a pharmacy not ordering the medication when the customer pays cash. I will say I think it’s more of a problem with the actual pharmacist too. Same thing happened to me, they wanted to give me 4 ml bottles and I said no. Then the pharmacist tried to tell me he’s not getting me the 10 ml bottle because the medication isn’t good after 28 days and that I only have 2 weeks of usage. I asked him where the package insert says this… And he couldn’t. I said if I’ve never heard that. I said either please fill the medication for what’s prescribed or transfer my script to the Pharmacy next to yours. He filled it, but I still transferred it out.
Most pharmacists like GPs/endos and the rest are anti-testosterone, they make up bullshit or just keep passing along the same bullshit they are taught in their schooling from lit decades old. When you ask for proof (lit citation or package insert, they just look at you like your dog when you give them a command they've never heard before). Good Rx pricing for 200 mg/ml 10 ml ranges from $35 - 50. Same BS about not being good for 28 days. I've used a 10 cc vial that's been outdated by a couple of years, no change in potency when stored properly. Same with a 30 mg vial of B-12. Multi use over a year, never had a problem. It's about making money, nothing more, and potentially bettering QOL for pennies vs big pharma pushing expensive drugs to solve problems.
 
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ceo

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Oct 12, 2010
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Gotta push back. Don't just accept their answers/excuses. It is about profit for them. Period. They don't care about your health and well being as much as they want you to think. They do care about you coming back more frequently to spend more money though.

Which state is this anyway?

Sent from my SM-G781V using Tapatalk
 
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rawdeal

TID Board Of Directors
Nov 29, 2013
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Not gonna go ot with another of my damn dog-owner posts, but had the same experience with individual pharmacists for some of the dog meds we need. Unmistakable appearance that some chain store pharmacists will inject their own moral judgements into their decision to fill a prescription at all, or else to adjust the original prescription to one that is pricier or less convenient.

With a large chain like CVS or Walgreens, you can (sometimes) have a lot of fun by letting corporate know what their little pissant local boy is doing, and how this may affect your future purchases ;):mad::cool:
 
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