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Posted by SilverLining
 - February 11, 2013, 06:39:24 PM
The only reason I learned anything about the formulary is because my insurance policy is based on it.  If something is covered under the provincial formulary, our policy covers it at 90%.  If the formulary does not cover it, our policy covers it at a much lower percentage.

This has lead me to have to look things up sometimes because if something is not covered, I first have to check the formulary, then sometimes try to find something comparable that is covered.

I'll pm you about the pharmacy.
Posted by Ciel
 - February 11, 2013, 04:43:48 PM
The difference is likely the dispensing fee. May I ask which pharmacy you use? I've thought about trying Costco but I am at the pharmacy several times per month and the convenience of my neighbourhood Shoppers won out. Even the slightly lower rate at Loblaws wasn't enough to make me switch because I don't find their service or staff to be comparable to Shoppers, which is something I need right now.  It hurts to see the difference in black and white though, especially when I multiply it per prescription. Ouch.


I understand what you are saying about knowing/not knowing what to do, I just meant that sometimes I read things and feel like a dim bulb... To be honest, I didn't know anything about the/a formulary until reading this post. My heart is willing to help though, if or when there is something we can do.
Posted by SilverLining
 - February 11, 2013, 01:51:42 PM
Ciel, I just picked up an epi-pen over the weekend.  mine was only &106.87, of which I pay 10%

~~

My previous post doesn't mean I know what to do....only that I may have figured out why it isn't covered under the formulary.  And it's not likely I can do anything about it. <sigh>

If you decide to switch to the Allerject, I recommend you make sure your policy covers it first (unless you are willing to pay for it yourself.)
Posted by Ciel
 - February 11, 2013, 12:56:06 PM
Quote from: SilverLining on February 01, 2013, 01:55:23 PM
When I spoke with the pharmacist (in Canada) he said they are comparable in cost to epi-pens.

I just got a new EpiPen last week and the total cost was $115.00 and I had to pay 20% of that cost out of pocket with the other 80% covered by my drug plan. I wish I had seen this tread before ordering my refill so I could have asked about Intelliject.

I'm wiling to help if I can, but to be useful I need a crash course re: formulary. And if the quote in your last post is the crash course, then I might not be smart enough to help  :-[ .
Posted by SilverLining
 - February 11, 2013, 12:01:11 PM
sooooooooo!  I may have found an answer.

http://drugs.about.com/od/faqsaboutyourdrugs/f/Canada_cheap.htm

QuoteEach of the Canadian provinces, like Quebec and Ontario, has a drug formulary that puts restrictions on the use of new and expensive medications. Since the provinces provide the bulk of drugs to higher users of medication, (seniors), they have the power to negotiate directly with pharmaceutical companies to lower prices for a medication to get on the formulary. In Ontario, for example, the formulary includes less than 35 percent of new medications.
Posted by SilverLining
 - February 10, 2013, 10:56:43 AM
Quote from: twinturbo on February 10, 2013, 09:37:46 AM
When you say EpiPen would be taken off the market it seems to veer from the main topic of insurance covering Auvi-q prescriptions. I don't think Mylan's EpiPen is either facing failure or that any of us who need autoinjectors are desirous of their market failure. Unless there's a body of this expressed desire somewhere?

No.  sorry if I wasn't clear.

It took discontinuing the Anakit for my insurance to cover an epi-pen.  I do not want that to be the requirement for my insurance to cover the Allerject (Auvi-Q).   I want both available and both covered.

<greedy greedy me>
Posted by twinturbo
 - February 10, 2013, 09:37:46 AM
When you say EpiPen would be taken off the market it seems to veer from the main topic of insurance covering Auvi-q prescriptions. I don't think Mylan's EpiPen is either facing failure or that any of us who need autoinjectors are desirous of their market failure. Unless there's a body of this expressed desire somewhere?

This post is edited so I get to the point. Twitter is training housebreaking me.

Twitter tells me that the Intelliject CEO is doing TED talks and I almost tweeted the guy prepping him for it but after talking to DH we're going to go through LinkedIn. First we have to apply to Eric or Evan Edwards' circle (or any Intelliject guy). If he is not rejected he will have the option of contacting them to address "broadening their product adopters" in light of insurance barriers. DH has also agreed to cybercreep on Gonzalez and the Food Allergy Foundation.
Posted by SilverLining
 - February 10, 2013, 07:52:41 AM
When it was announced it was approved in the US, I did send an e-mail to Intelliject.  I never got a response.

To be successful in Canada they need to do this.

When I first got a prescription for epinephrine, there was something called an Anakit.  It had two adult doses in a syringe.  You had to take a rubber cover off the needle, hold it aiming up, flick to get air bubbles to the top, push in the plunger enough to get the air out, inject the needle, push the plunger half way in, then if a second dose was required do the entire thing again.  for a child, you used the plunger 1/4 of the way per dose.

That was covered by insurance, but the epi-pen was not, because that was what was covered by the provincial plan.  I argued with my insurance company, but got nowhere.  Eventually, a group of doctors got involved (not through me in any way).  I think these doctors (paediatricians and allergists) actually got the Anakit taken off the market.  Then the epi-pen was covered.

I don't want to see the epi-pen taken off the market.  I think there are people that will prefer it.
Posted by twinturbo
 - February 10, 2013, 07:31:25 AM
I'd go to the Intelliject product marketing manager because he'll have internal channels with Sanofi who in turn will have internal channels with insurance. As far as cost my 3 twin packs cost about $740 but with insurance and coupons out of pocket was about 10% of that. I plan to submit it further to my flexible spending account later.

My experience with Sanofi customer service was ludicrous.
Posted by SilverLining
 - February 06, 2013, 01:34:46 PM
The CSR that I spoke with had no information about provincial coverage.

I have now sent an e-mail and hopefully will get a response.
Posted by SilverLining
 - February 01, 2013, 01:55:23 PM
When I spoke with the pharmacist (in Canada) he said they are comparable in cost to epi-pens.
Posted by MandCmama
 - February 01, 2013, 01:50:42 PM
Re reading my post, I didn't say what I meant to say  :insane: How much would it be without insurance?  I belive the epi jrs are $260 or something like that. 

Thanks again for the coupon  :heart:
Posted by CMdeux
 - February 01, 2013, 01:20:16 PM
Pretty sure she meant "less" unpleasant.  LOL.
Posted by Macabre
 - February 01, 2013, 01:11:19 PM
Out of pocket depends on your insurance.  The pricing is supposed to be competitive with the EpiPen.  That coupon for hte first two prescriptions should make it an unpleasant cost initally.
Posted by MandCmama
 - February 01, 2013, 12:53:15 PM
I forgot to ask...does anyone know what the out of pocket price is? Is it similar to epipen?