Computing the Cost of a Prescription Part II

I already complained about how difficult it is to compute the cost of a prescription under our health plan. Here I go complaining about prescriptions again! As you probably don't recall, the gastroenterologist gave me a prescription for Rifaximin and warned that it is expensive. He said if it is unaffordable I could take Flagyl instead. I decided to try the Flagyl, although I remembered from last year that it makes everything taste bad. By day three, my food had a sour taste and it was getting worse. Also, I read that Flagyl (metronidazole) may increase the risk of cancer. I decided to make another attempt at getting the expensive medicine.

I already had Wal-mart's price but knew they didn't keep it in stock. We called three other stores. No one had even heard of Rifaximin, but after I gave them the brand name Xifaxan they looked it up in the computer. (I only knew of the brand name because I had researched it on the internet and made some notes.) However, none of the stores would gave me the price that I would pay as an Anthem insurance member, saying that I would have to come into the store before they could submit the info to insurance electronically, and then they could tell me the price. (This makes comparison-shopping pretty much impossible.)

Neither CVS or the Mt. Jackson Pharmacy had the drug in stock, but Rite-Aid had a partial supply (half the amount prescribed). I decided to go there and get the partial bottle since at least then I would only pay half price for now, and could get more later assuming that I didn't have an unpleasant reaction to it. (More than once I've bought a prescription, had an allergic reaction, and had to throw out the rest.) We drove to their store in Woodstock and got the half-bottle for $130, the amount allowed by our insurance. It was only a 5-day supply.

I didn't have notice any side-effects except for a slight dizziness which could be due to something else anyway. On Monday morning I only had one day's supply of pills left, so I called the drug store for a refill. I had to go to Woodstock for physical therapy that day, and after that tried to pick up the prescription. The clerk informed me that insurance would not pay for their share of the prescription until the next day. I protested that I only had one day's supply left and I was not planning to come back to town the next day, but it was no use, even though if the store had stocked the full amount in the first place I wouldn't have this problem.

I've had problems before with Anthem refusing to pay for medication if I refilled it early, and I didn't want to pay full price (almost a hundred dollars more), so I left without the medicine. On Tuesday we made a second trip to Woodstock and got the prescription. That's about an extra 34 miles of driving, and over an hour out of the only day this week on which we had no appointments, no reason to leave our neighborhood except for this extra trip to Rite-Aid.

I sure hope this stuff works!