The latest updates on prescription drugs and ways to save from the GoodRx medical team

Hurricane Harvey: How You Can Help

by Elizabeth Davis on August 30, 2017 at 3:00 pm

Find out more about what GoodRx is doing to help here.

By the time Hurricane Harvey is finished, millions of Americans will be affected. More than 30,000 people are expected to need emergency shelter, and many more will face property damage and financial challenges. Those affected will need help long after the storm is over.

What can you do to help? Whether you’re able donate money, blood, or volunteer manpower, these organizations are a good place to start.

Keep in mind:

  • Many places will be overwhelmed with donations of food, clothing, and other goods, while others may be asking for them. Check with the organization of your choice before sending physical items, to be sure they go someplace they can be used, and they don’t take up volunteer time that could be used for other efforts. In the end though, you may want to consider donating money instead of food or clothing—it lets the organization use your donation most effectively.
  • Some donation web pages may be experiencing high traffic, and may load slowly—don’t give up, keep checking back!
  • As always, before you donate, do some research! Site like Charity Navigator or Charity Watch can be a good place to start, and Consumer Reports has some good tips on how to check out a charity.
  • Are you affected by the storm and looking for help? Most of the organizations below offer resources and ways to request help. FEMA has a Hurricane Harvey resource page, with emergency phone numbers, how to apply for assistance, and more. They are also fact checking rumors about shelters, insurance, immigration, and other topics. The United Way Storm Recovery page is another good example, with an After the Storm guide and phone numbers to call for assistance with cleanup.

The national organizations (the charities you’ve heard of)

  • The American Red Cross is also accepting donations online, and via phone (1-800-HELP-NOW). If you’d also like to donate blood, you don’t need to wait for a drive to come to you—the Red Cross website has a tool that can help you find a place to donate.
  • AABB (formerly the American Association of Blood Banks) is also calling for blood donations, and lists several resources for you to find a local blood drive. The most-needed is type O-positive.
  • The Salvation Army is providing help to survivors and relief workers. They’re accepting donations online, by mail, and via phone (1-800-SAL-ARMY). You can find more info on their website, or donate from your phone.
  • The United Way of Greater Houston lets you choose to send your donation to help a particular area, or to let them use it wherever it will do the most good.

Local relief

  • The Hurricane Harvey Relief Fund was established by Houston Mayor Sylvester Turner and administered by the Greater Houston Community Foundation, the fund will coordinate donations with relief services.
  • The Houston Food Bank is asking for donations, along with the Food Bank of Corpus Christi. Remember that monetary donations are likely more useful—even though these are food banks.
  • There are also several local organizations coordinating blood donations, including the South Texas Blood and Tissue Center and Carter Blood Care. If you’re located nearby, consider donating to help get blood to those who need it quickly.
  • Try contacting local shelters or food banks directly, or checking their websites for ways you can help or donate.

Help for pets

  • The San Antonio Humane Society has a page set up with information on what you can do to help, including donations of money and supplies.
  • The Houston SPCA has a disaster response hotline for animal emergencies, questions, or reports (713-861-3010). You can find more information or donate on their website.
  • You can also donate to the Houston Humane Society, or the SPCA of Texas—they don’t have special pages set up for Harvey-related donations, but they will be able to use any help you can give. If you’ve been affected by the storm, the SPCA of Texas also has a great list of resources to help you find a safe place to stay with your pet.

Want to volunteer?

If you are in Texas or Louisiana and want to donate your time, consider these organizations:

There are so many ways you can help right now—these are just a few of the great people and organizations working to help Texas and Louisiana in the wake of Hurricane Harvey. For more resources, we highly recommend starting with these great lists from the New York Times and NPR.

Type 2 Diabetes Treatment Will Soon Be Unavailable

by The GoodRx Pharmacist on August 29, 2017 at 2:30 pm

On July 26, 2017, GlaxoSmithKline (GSK) announced that they would be discontinuing the manufacturing and sales of Tanzeum, their once-weekly injection for type 2 diabetes.

A pharmaceutical company can decide to discontinue a medication for many reason reasons. Just like any other business, if a product does not sell as expected, the company can decide to stop making it—and this just what happened with Tanzeum.

What is Tanzeum indicated for?

Tanzeum is used, in combination with a healthy diet and exercise, to improve blood sugar in adults with type 2 diabetes.

Why is Tanzeum being discontinued?

GlaxoSmithKline is discontinuing Tanzeum due to the limited prescribing of the medication. There are no known safety concerns.

Your doctor may switch you to other once-weekly injectables like Trulicity or Bydureon.

When will Tanzeum be off the market?

GlaxoSmithKline is recommending that health care professionals switch their patients to a different treatment option as soon as possible. They are alerting patients by updating their consumer website here. Be sure to speak with your doctor if you are currently taking Tanzeum.

GSK is ensuring that Tanzeum will remain available to existing patients until at least the end of June 2018. This will allow for enough time for patients to identify and initiate a satisfactory treatment alternative.

Check out the website for Tanzeum here, or call the GSK Consumer Response Center at 1-888-825-5249.

You Thought Epipen Was Going To Get Cheaper? Think Again

by Elizabeth Davis on August 28, 2017 at 5:00 am

Remember way back in 2016 when we were outraged by the rising cost of EpiPen? How kids and schools couldn’t afford a simple, life-saving treatment? How the company’s CEO was grilled by the government and reporters and they pledged to do something about it?

Well, so much for public outrage. The cost of EpiPen has gone up yet again—by as much as 25%. No, we’re not kidding.

The EpiPen outrage of 2016

It’s been almost exactly year since news broke that EpiPen prices had increased by over 400% since 2007. At that time, Americans paying cash for their EpiPen would pay about $600 for a two-pack. While insurance often covers some of the cost, parents typically buy multiple two-packs to ensure that this life-saving treatment is available at home, school, in the car, or anywhere else they could be needed in an emergency. Those additional pens would not be covered, and the pens also have a limited shelf life, so they have to be repurchased every few years.

Thus, the typical American family would have to spend $1,000 or more to ensure that they had quick access to this life-saving medicine.

The outrage was swift and loud. It seemed like the American public had had enough with high drug prices, and finally something was going to be done. Or was it?

2017: Epipen prices increase by up to 25%

By August 2017, the price Americans are paying for brand-name EpiPen has increased yet again—this time by up to $150. That’s an increase of up to 25% since 2016. Yes, really.

Not all bad news

While all of the epinephrine pens out there are still expensive, there is some good news—you have more ways to save than ever.

  • EpiPen and EpiPen Jr now have a less-expensive generic alternative, and a better manufacturer offer.
  • CVS has introduced a lower cash price for the Adrenaclick generic.
  • Auvi-Q, another epinephrine auto-injector, has been re-approved and is in pharmacies now.
  • Another alternative, Symjepi, has also been approved and is expected to be available by the end of 2017.

Read on to find out how to save on each type of pen.

What are my options now?

First, know that all of the currently available epinephrine injectors come in two doses, 0.3 mg for adults and 0.15 mg for children, and come in a package containing two syringes or auto-injectors.

EpiPen and EpiPen Jr are still the most commonly used and prescribed epinephrine auto-injector pens. Mylan made an authorized generic available following the concerns over pricing, and made changes to the discounts they offer. However, we’re still seeing generic cash prices over $300 per two-pack, and brand-name EpiPen prices over $650 per two-pack—up to $750 at some pharmacies. Both generic and brand-name EpiPen have manufacturer discounts available, but they aren’t really going to cut it if you don’t have prescription insurance. The generic offer is for insured patients only. It’ll shave $25 off your insurance co-pay, but you’re still left with a $300+ cash price if you don’t have coverage (a GoodRx discount can drop this to around $150). The situation is about the same for brand-name EpiPen. Again, there’s a manufacturer offer that can drop your cost to $0—but only if you have prescription coverage. Bottom line: if you’re uninsured, or have high deductible prescription coverage, EpiPen (brand and generic) remains just about as costly as in 2016.

Adrenaclick and its generic have been the primary lower-cost alternative to EpiPen through the pricing concerns over the past year. The generic is available for just over $100 from CVS pharmacies, and has a manufacturer offer available that could reduce your co-pay to $0 if you have insurance. Like EpiPen, Adrenaclick is a pen-shaped auto-injector that’s designed to be easy to use.

Auvi-Q was pulled from the market in 2016, and re-released earlier this year. It’s very expensive, over $4500 even with a GoodRx discount, but the manufacturer has a mail order program that should reduce co-pays or out of pocket costs for many people to $0. Auvi-Q has a few unique features as well, like voice instructions to guide you through giving the injection, an auto-retractable needle, and a square shape that’s intended to be easy to carry.

Symjepi has been approved by the FDA, but isn’t in pharmacies yet. Expect to see it in pharmacies by the end of 2017. It’s intended to be a less-expensive alternative to EpiPen, and comes as a two-pack of regular pre-filled syringes, rather than auto-injectors. It won’t be quite as simple to use, and is the only option that will not have a lower 0.15 mg dose available—so this one may not be not a good alternative if your child carries an epinephrine pen. However, it could mean greater savings for some adults and medical professionals.

What can I do to save?

Your savings will depend on your insurance coverage, the pharmacy where you choose to fill, and which option you’ve been prescribed.

First—especially if you have prescription insurance—check for manufacturer discounts:

  • The manufacturer offer for generic Adrenaclick can reduce your co-pay to as little as $0, and also offers up to a $300 discount per two-pack for cash-paying patients. Cash prices range from $110 to well over $500, but if you shop around, this can be a huge help whether you have insurance or not.
  • EpiPen and EpiPen Jr have similar offers—if you have insurance, your co-pay can be reduced to $0, and cash-paying patients can save up to $300 per two-pack. Keep in mind though, this offer is for brand-name EpiPen, which still costs upwards of $650 if you’re paying out of pocket.
  • The EpiPen generic also has a discount available . . . but it only offers $25 savings per fill, and is only available for insured patients. You can still use it if you have insurance that doesn’t cover the EpiPen generic—but without coverage, your cost per fill will likely still be over $300.
  • Auvi-Q also offers a mail order program that can reduce your cost to $0. It’s available for all insured patients, and for uninsured patients with a household income below $100,000. If your annual income is higher, you can still receive it at $360 per fill. For comparison, Auvi-Q costs over $4500 per fill.

If you don’t have insurance, a low cash price or a GoodRx discount are the way to go.

CVS pharmacies (including locations inside Target stores) now offer the generic version of Adrenaclick at $109.99 for a two-pack. Walgreens also has a relatively low cash price, at $147.59. CVS and Walgreens are also your lowest-cost pharmacies for the EpiPen generic—discounts for a two-pack at both stores come in under $150.

Is there anything else I should know?

With generic alternatives now available for EpiPen and Adrenaclick, some insurance plans may not cover the brands, or may only cover one or the other. For example, starting in 2018, Express Scripts (which provides prescription benefits for millions of insured Americans) will only offer coverage for EpiPen and its generic. Adrenaclick, generic Adrenaclick, and Auvi-Q are being added to the exclusion list on their national preferred formulary.

If you’re having trouble with the cost of your epinephrine pen, talk to your doctor to see if any of the other options will work for you. Trying a generic alternative or switching to a different brand may save you hundreds per fill.

Which Antibiotics Are Less Likely to Cause Diarrhea?

by Dr. Sharon Orrange on August 25, 2017 at 5:27 pm

Antibiotic-associated diarrhea and colitis is affecting more of you, given the widespread use of antibiotics. Clostridium difficile (C. diff) is the organism that causes antibiotic-associated colitis; this happens because the bacteria is allowed to overgrow in the intestine when the normal intestinal flora is changed due to antibiotics. C. diff can release toxins that bind to receptors on intestinal epithelial cells causing inflammation (colitis) and diarrhea. This makes folks very sick.

Some antibiotics lead to C. diff much more often than others. When there are options for choice of antibiotic for your infection, err on the side of safety with less C. diff risk. Here’s what you need to know:

The Losers. These antibiotics are most frequently associated with C. diff diarrhea.

  • Levofloxacin (Levaquin) is prescribed for bacterial sinusitis, urinary tract infection (UTI), prostatitis, and community-acquired pneumonia among other things. A convenient once-daily broad spectrum antibiotic is appealing, but it is more likely to cause C. diff than other antibiotics.
  • Ciprofloxacin (Cipro) is very similar to levofloxacin, though it’s taken twice daily and is most often used for UTI and diabetic foot or bone infections.
  • Moxifloxacin (Avelox) is another from the same class of antibiotics as Cipro and Levaquin. It’s prescribed for sinusitis and community-acquired pneumonia.
  • Clindamycin (Cleocin) is prescribed for skin and soft tissue infections due to Methicillin-resistant Staph Aureus (MRSA), bite wounds, impetigo, and dental prophylaxis in those allergic to penicillin. It’s cheap and has been around forever, but it’s a known culprit in C. diff diarrhea.
  • Cephalosporins like Omnicef (cefdinir), Ceftin (cefuroxime), and Suprax (cefixime) are broad spectrum antibiotics used for pharyngitis (sore throat), sinusitis, and ear infections. They also make the list for the antibiotics most frequently implicated in C. diff infections.

The Winners. These antibiotics are rarely associated with C. diff diarrhea.

  • Doxycycline (brand names Oracea, Vibramycin) is an antibiotic prescribed for a wide variety of medical conditions including Lyme disease, bacterial sinusitis, chlamydia infection, rosacea, acne, or skin and soft tissue infections. It’s shown to cause nausea and upset stomach in only 8% of folks taking it. Pro tip: doxycycline monohydrate is easier on the stomach than doxycycline hyclate, and it’s essentially the same antibiotic. The difference is just the “salt” attached to it (monohydrate vs hyclate).
  • Metronidazole (Flagyl) is an antibiotic that is actually used to TREAT C. diff infections. Pro tip: Think of metronidazole as an antibiotic primarily for infections from the waist down: sexually transmitted infections like trichomoniasis, pelvic inflammatory disease, C. diff diarrhea, diverticulitis, and bacterial vaginosis.
  • Minocycline (brand names Solodyn, Minocin) is a tetracycline antibiotic similar to doxycycline that has limited use. It’s prescribed primarily for acne and treatment of STD infections.

Second Place. These are better than the worst, but not as good as the winners.

  • Azithromycin (Zithromax, the “Z-Pack”) has many uses including sinusitis, strep throat, chlamydia and other STD infections, community-acquired pneumonia, and H. pylori, among others. It’s the jack-of-all-trades antibiotic, and there is very little bacterial resistance to azithromycin, making it a popular choice.
  • Clarithromycin (Biaxin), like Zithromax, is also used for a number of illnesses including bacterial bronchitis, sinusitis, and skin infections. Pro tip: Almost 10% of you taking it may notice alteration in taste (dysgeusia), especially a metallic taste.
  • Sulfamethoxazole/trimethoprim (Bactrim) is most often prescribed for urinary tract infections (UTI or cystitis), skin and soft tissue infections from MRSA, and travelers diarrhea. Pro tip: Don’t count on Bactrim for UTI treatment in areas of the country where there is greater than 20% resistance of E. coli (Los Angeles, for example), and if you’ve used it in the previous 3 months for UTI make another choice.

Honorable Mention. These antibiotics are not frequently associated with C. diff, but are primarily IV (not oral) medications.

  • Vancomycin. While Vancomycin does come in a pill form, it is poorly absorbed from the gut so is ONLY indicated as a pill for the treatment of C. diff infection. So yes, oral vancomycin is prescribed for C. diff when metronidazole hasn’t worked. Vancomycin IV is used for treatment of many serious infections though, including sepsis, meningitis, bone infections (osteomyelitis), joint infections, and pneumonias.
  • Gentamicin. If you are hospitalized with pneumonia, endocarditis, or a severe kidney infection you may be given Gentamicin IV, but its use is limited due to risk of kidney and ear (ototoxicity) damage.
  • Tobramycin is prescribed as an inhaled solution or in IV form for patients with cystic fibrosis, as it is also poorly absorbed by the GI tract. Not all that helpful as on option if you are sick, unless you are hospitalized.
  • Amikacin is used for hospital-acquired pneumonias, meningitis, and infections in cystic fibrosis patients so you will not see infections in the community treated with this antibiotic.

Hope this helps.

Dr O.

FDA Approves Mavyret for Hepatitis C

by The GoodRx Pharmacist on August 23, 2017 at 4:25 pm

Since the FDA created the Priority Review Program, aimed at fast tracking the development of drugs used to treat serious conditions, new hepatitis C medications are being approved at a faster rate.

Recently, the FDA approved Mavyret, a new combination medication for hepatitis C.

What is Mavyret prescribed for?

Mavyret is a combination medication indicated for the treatment of all major genotypes for chronic hepatitis C.

Mavyret will be available as a combination tablet in the strength of 100mg/40mg, supplied in a 4-week (monthly) dose wallet. The recommended dose is 3 tablets once daily, for 8 weeks, with food. You may need to take Mavyret for longer than 8 weeks if you have been previously treated with other medications, or have mild liver disease.

What are the most common side effects associated with Mavyret?

The most common side effects include headache and fatigue. Be sure to speak with your doctor if you experience any of these side effects for a prolonged period of time.

Is there anything unique about Mavyret?

Yes. Mavyret is the only 8-week treatment for patients with hepatitis C, without liver disease, who have not been treated before.

Mavyret will more than likely be considered a specialty medication. You can read more about specialty medications here.

How much will Mavyret cost?

Abbvie has priced Mavyret at $13,200 per month, or $26,400 per treatment course, before discounts. Although this is still expensive, Macyret is priced significantly lower than other hepatitis C treatments. For instance, popular medications Epclusa, Sovaldi and Harvoni are priced at $74,760, $84,000, and $94,500 respectively.

There is good news, though! Abbie offers a co-pay assistance program for commercially insured patients. If you are eligible, you may pay as little as $5 per co-pay using their Abbvie HCV Co-Pay Card. Visit the website here, and call 1-877-628-9738 to learn more and find out if you are eligible.

For more information on Mavyret, see the press announcement here, and visit the Mavyret website here.

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