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

Here’s How to Save on Premarin For Menopause

by Tori Marsh on March 16, 2018 at 1:50 pm

If you’re over the age of 50, you may have started to experience some of those difficult menopause symptoms. Hot flashes, fatigue, night sweats, osteoporosis…not fun.

Luckily there are medications that can help you through menopause. But are they affordable?

One of the more commonly prescribed estrogens to treat menopausal symptoms and prevent osteoporosis is Premarin, but it’s expensive. Premarin is a brand-only medication, and a 30-day supply can cost well over $200. Currently, there is no generic for Premarin, and there may never be. So how can you save on Premarin?

When will generic Premarin be available?

Premarin’s patent protection expired in 2012, so other manufacturers are allowed to create a generic with the same active ingredients, but none have been approved. Why? The answer lies in how Premarin is made.

The estrogens in Premarin are made from – wait for it – the urine of pregnant mares. Yes, horse pee. Because of this, the active ingredients in Premarin have not been defined, and the FDA will not approve a synthetic version. Moral of the story, we may never see a Premarin generic.

So, how can I save on Premarin?

While Premarin is expensive, there are ways to save.

  • Use a manufacturer coupon. Pfizer offers a manufacturer coupon for both the vaginal cream and the tablets. With the Premarin Co-Pay Card, you can pay as little as $15 for a 30-day supply of tablets, and with the Premarin Her Source program, you can pay as little as $15 for the vaginal cream. Restrictions do apply, so be sure to contact the program to see if you qualify.
  • Try a patient assistance program. Pfizer also offers a patient assistance program to help eligible patients receive their prescription of Premarin at no cost. This applies to both the tablets and the vaginal cream. Patient assistance programs are typically for low-income, uninsured patients, so call Pfizer Pathways at 1-877-744-5675 to see if you qualify.
  • Fill a 90-day supply. While this only applies to the Premarin tablets, a longer prescription can help shave off more on your out-of-pocket costs. You will need to talk to your doctor, as you will need a new prescription to fill for a higher quantity.
  • Appeal your coverage. Premarin is covered by most Medicare and insurance plans, but if your plan won’t cover the drug’s cost, keep in mind that you can always ask your doctor about submitting an appeal. Some plans require prior authorizations—meaning you need permission from your insurance plan and a special request from your doctor before you can fill your prescription. If you have insurance, call your provider and ask how to get this process started. In fact, on average 50% of people who appeal to their insurance get coverage, so it’s worth a try.

In addition to these savings tips, there are also other affordable alternatives to Premarin. More on that below.

Are there any cheaper alternatives to Premarin?

There are many forms of estrogens available to treat symptoms of menopause or prevent osteoporosis. While none of them are made from conjugated estrogens, in some cases they can be substituted for Premarin.

Estradiol, the generic for Climara and Estrace, is the most popular estrogen used for symptoms of menopause, and it’s more affordable than Premarin – a 30 day supply of estradiol is around $37 with a GoodRx coupon. There is one big difference between estradiol and Premarin, though. While Premarin is a natural hormone, derived from mare urine, Estradiol is synthetic, meaning it is made in a lab.

Another alternative, Activella, also has a generic option – estradiol/norethindrone. This combination estrogen and progesterone pill is used to relieve symptoms of menopause and lower your risk of osteoporosis, just like Premarin. Both estradiol/norethindrone and Premarin have potential side effects caused by the hormone, so the only big difference is the price. While Premarin can cost over $200 for a 30-day supply, the cash price for generic estradiol/norethindrone is around $50.

Estropipate (Ogen) is another alternative also used to treat symptoms of menopause and prevent osteoporosis. While it is affordable, estropipate only comes in tablet form, so it wouldn’t be a proper substitution for those using the tube of cream.

Premarin is expensive, so it is always worth talking to your doctor about switching to a more affordable medication, but keep in mind you will need a new prescription to fill for any of these alternatives.

Does Premarin have any side effects?

Since Premarin is a hormone, there can be a lot of side effects. Women taking Premarin may experience headache, abdominal pain, breast pain, nausea, back pain, insomnia, or depression.

Premarin can also increase the risk for more serious side effects, like uterine and breast cancer, blood clots, and stroke.

From Student To Teacher: How GoodRx Helped A Mother Of 3

by Katie Mui on March 15, 2018 at 5:54 pm

GoodRx started with a simple idea: Help people find affordable medications. Help people understand their options. Help people get what they need for their health. Basically, we like to think that GoodRx helps. We’d love to hear and share more of your stories, so tell us on Facebook or Twitter with the tag #GoodRxHelps!

Amanda, 32, is a mother of three and a kindergarten teacher at a public school in Missouri. When flu season hit this year, like most parents, she was concerned about keeping her kids healthy. So when two of them came down with the flu, she was surprised to see how expensive medication would be.

Even though her children have insurance, oseltamivir (the generic version of Tamiflu) was still remarkably expensive. That’s when she remembered to look on GoodRx, and sure enough, the price was better than what she would’ve had to pay with insurance.

“The GoodRx price for Tamiflu was cheaper than Aetna’s price so we used that discount instead of insurance.”

When it comes to anything health related, Amanda is eager to try and save where she can. Her oldest son was born with a congenital heart defect and his cardiologist check-ups are expensive even after insurance, so every bit counts. But her story with GoodRx starts even further back.

Amanda had her sons, now between 1 and 14 years old, while studying and working towards her degree in Early Childhood Education. Being a student and mom, all while also putting in 40 hours/week as a manager at McDonald’s, meant that she did not have access to affordable health insurance.

Amanda had been diagnosed with adult ADHD years before, but she was trying to cope without medication. When she was really struggling to concentrate on her studies, she finally decided to give treatment a try. The first medication her doctor prescribed was affordable but had unwelcome side effects, so she was switched to Adderall XR – only it was much more expensive at $220 a month without insurance.

With three kids to take care of, this wasn’t something Amanda could afford every month, so she began looking online for coupons for medicine. And that’s how she came across GoodRx. Now she would only have to pay $67 at her local Walgreens.

“I wasn’t sure if GoodRx would work, but I figured all the pharmacist could do was tell me no. I gave the code to the cashier and to my delight, it worked.”

Since graduating and becoming a teacher, Amanda now has health insurance through her work. She says she still uses GoodRx, though, when she hasn’t met her prescription deductible yet and the prices are better than what her insurance would charge. And she keeps an eye out for savings on her children’s medications as well.

“I am grateful that I found GoodRx when I did because it helped me through my final semester.”

It’s always surprising, and humbling, to hear how long some GoodRx users have been with us, and we’re so glad to be able to help Amanda and her family throughout their journey.

New Injectable Medication Now Available for Opioid Use Disorder

by Roni Shye on March 14, 2018 at 2:59 pm

Opioid use disorder, also known as opioid addiction, is a chronic disease that changes the brain. This disease is characterized by a problematic pattern of opioid use leading to significant impairment or distress. More than 2.5 million patients in the United States are diagnosed with opioid use disorder, making it important for health care providers to have a variety of different medication and treatment options – and we have a new one to add to the list.

Recently, Sublocade, a medication-assisted treatment (MAT) option for moderate-to-severe opioid use disorder, became available.  

What is Sublocade indicated for?

Sublocade is indicated for the treatment of moderate to severe opioid use disorder and should be used as part of a complete treatment program that includes counseling and psychosocial support.

Sublocade is available as a single dose prefilled syringe and should be injected by a healthcare professional. The recommended dose of Sublocade is 300 mg monthly for the 1st two months followed by a maintenance dose of 100 mg monthlyThe maintenance dose may be increased to 300 mg monthly for patients who tolerate the 100 mg dose, but do not demonstrate a satisfactory clinical response, as evidenced by selfreported opioid use or urine drug screens positive for opioid use.

Sublocade is dispensed by pharmacies to healthcare professionals only and should never be directly dispensed to patients.

Is there an advantage to using medication-assisted treatment (MAT) for opioid use disorder?

According to the FDA, using MAT reduces opioid withdrawal symptoms and the desire to use opioids, without causing the cycle of highs of and lows with opioid misuse or abuse. At proper doses, buprenorphine-containing medications such as Sublocade also decreases the pleasurable effects of other opioids, making continued opioid abuse less attractive.

What side-effects are associated with Sublocade?

Side effects include constipation, nausea, vomiting, headache, drowsiness, injection site pain, itching, and abnormal liver function.

Sublocade also has a boxed warning, the strictest warning the FDA can give a medication in order to warn patients and health care providers of the possible serious risks associated with a medication. According to this boxed warning, Sublocade can cause occlusion, local tissue damage, thromboembolic events, including life-threatening pulmonary emboli, if administered intravenously.

For more information on Sublocade, check out the manufacturer website here, or check out the press release here.

FDA Approves Two New Cost-Saving HIV Medications

by Roni Shye on March 13, 2018 at 2:24 pm

Having a chronic disease such as diabetes, asthma, COPD or HIV can cost a pretty penny. Since these diseases are not easy on the pocketbook, it’s not surprising that many Americans often times choose between eating and the paying the bills or being able to afford their medications.

In an effort to reduce the cost burden associated with HIV medications, Mylan Pharmaceuticals is introducing two new combination medications at a significant discount compared to competing products – Symfi Lo and Cimduo.

What is Symfi Lo indicated for?

Symfi Lo is a once-daily combination medication containing three drugs – efavirenz, lamivudine, and tenofovir. It is a single-tablet and is indicated as a complete regimen for the treatment of HIV-1 infection in adult and pediatric patients weighing at least 77 lbs.

Symfi lo will be available as a tablet in the strength of 400 mg/300 mg/300 mg. It is the first combination regimen in the U.S. with a reduced dose of efavirenz.  

Common side effects include rash and dizziness.

What is Cimduo indicated for?

Cimduo is a once-daily combination containing two drugs – lamivudine and tenofovir. It is indicated in combination with other medications for the treatment of HIV-1 infection in adults and pediatric patients weighing at least 77 lbs.

Cimduo will be available as a tablet in the strength of 300 mg/300 mg.

When will these medications be available?

Both medications were approved by the FDA this February. Symfi Lo is expected to be available in the coming weeks, and Cimduo is expected to launch in the 2nd quarter of 2018.

Have there been any reports of serious side effects associated with Symfi Lo or Cimduo?

Yes. Lactic acidosis and non-alcoholic fatty liver disease, including fatal cases, have been reported with the use of lamivudine and tenofovir disoproxil fumarate.

Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus and HIV who have discontinued lamivudine and tenofovir disoproxil fumarate.

How much will these medications cost? 

Mylan has not mentioned specifics, but they did mention that there would be a significant discount in a recent press release. You can read more about this press release here.

Why Are My Eye Drops so Expensive?

by Dr. Sharon Orrange on March 13, 2018 at 11:59 am

The most frequently performed outpatient surgery in the United States is cataract surgery. After your cataract procedure, your doctor will prescribe several eye drops with the goal of suppressing inflammation and improving pain. Whether after a cataract or Lasik procedure, or if prescribed for another reason, these drops may cost you an arm and a leg. Here is what you need to know.

Antibiotic eye drops

There are some good affordable generic options now for antibiotic eye drops. While Besivance is an expensive brand name antibiotic eye drop still prescribed, there are cheaper antibiotic eye drops available:

While some eye doctors like the newer brand antibiotic eye drops because they believe there is less antibiotic resistance to the newer drops, many have shifted over to generic options with better cost and higher compliance.

Steroid eye drops

These are given to reduce inflammation after cataract surgery, and this is where the brand name eye drops are going to cost you. Lotemax, Alrex, and Durezol are expensive drops often prescribed. More reasonable priced brand name steroid eye drops are Vexol and Maxidex, but there is a good cheaper option:

  • Prednisolone acetate 1% (Pred-Forte/OmniPred). Remember that steroid eye drops vary in their potency, so prednisolone drops are used 4-5 times a day, while some other drops are more potent and are used twice a day.

NSAID eye drops

Non-steroidal anti-inflammatory (NSAID) eye drops can help to reduce swelling, pain, and light sensitivity after cataract surgery. So, adding it to a regimen with steroid eye drops may be better, but it may cost you. Prolensa, Nevanac, and Ilevro are newer expensive options. Good generic options include:

If cost is an issue, ask about the generic NSAID options, but keep in mind that they reportedly sting more and need to be used several times a day as opposed to once daily.

Bottom line? Shop around for generic options and check out prices on GoodRx. Otherwise, these drops are going to cost you.

Dr O.

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