By now, you’ve probably heard that this year’s flu season is getting pretty bad (or “moderately severe”, as the CDC puts it), with widespread flu activity all across the U.S. We believe prevention is the best medicine, but certain strains, like this year’s H3N2 virus, are more resistant to the flu shot.
So if you find yourself feeling feverish and with chills, congestion, runny nose, or body aches (among other common cold and flu symptoms), you might be tempted to head to your local drugstore. But with over 300 products on the shelf in the typical cold and flu aisle (we counted), it’s easy to feel pretty overwhelmed – especially if you’re not feeling quite like yourself. Luckily, we’re here to help you sort through the confusion and pick the best over-the-counter cold and flu meds for you.
1. You’re getting duped by marketing
There are over 300 cold and flu products in the average drugstore, but what you probably don’t know is that they’re really just a handful of combinations of four basic types of ingredients: decongestants, pain and fever reducers, cough suppressants, and expectorants (mucus thinners). There are so many options because each brand (like Robitussin or Vicks) has its own version of almost every combination, plus many combinations come in more than one form (like liquid, dissolving tablets, and ‘liquicaps’). Some of this is good – for example, it’s nice to have a liquid option if you don’t like taking pills – but a lot of it is simply driven by marketing.
2. You’re spending too much on brand names
According to a 2014 study published by the National Bureau of Economic Research, drugstore shoppers spend an extra $44 billion a year on brand-name products, including over-the-counter medications and other health items. Pharmacists, on the other hand, are 90% more likely to buy generics, probably because they know how to hunt them down on store shelves and know that they’re just as effective. But it’s hard for most people to distinguish between pseudoephedrine and phenylephrine or dextromethorphan and doxylamine in order to pick a generic or store brand with the active ingredients they need.
3. You’re probably taking more medicine than necessary
People often take combination-ingredient cold and flu medicines like NyQuil or Tylenol Cold Multi-Symptom. You’ve probably seen TV commercials for these brands so they’re easy to recognize on the shelf, and you know they’ll probably cover whatever your symptoms are. But these combo products often have more ingredients than you need to treat the symptoms you actually have, which puts you at greater risk for side effects, drug interactions, and overdose. Overdose is especially risky with products that contain acetaminophen because going even just a little bit over the daily limit of acetaminophen can put your liver at risk and even cause death. Read our previous post on how to avoid taking too much acetaminophen or Tylenol.
So how do I find what’s right for me?
If you’re looking to treat the symptoms of a developing cold and flu early without having to visit the doctor’s office, our friends at Iodine have just the thing. Their cold & flu tool can help you save time, money, and extra stress on your body. Just select your symptoms, and it’ll narrow down all the options to products that treat the symptoms you actually have. You can compare them side by side and take the list with you to the pharmacy. Get in, get out, go home and rest.
Humalog (insulin lispro) is a fast-acting insulin used to treat diabetes type one and two. Doctors report low levels of adherence to insulins like Humalog because of its cost. Cash prices for Humalog average around $549 for five kwikpens, and there is no generic alternative for any insulin brand. Humalog generated billions of dollars in global sales for Eli Lilly in 2016.
Here is some information on Humalog, and how you can save.
When will Humalog see a generic?
Typically, when a manufacturer releases a brand name drug, it is protected by a patent. This means that the manufacturer holds market exclusivity for that drug, preventing other manufacturers from creating an alternative. The idea is to incentivize companies to innovate (such as spending money researching new drugs) with a period when they can reap the rewards for their work. Eventually, though, the patent expires, allowing competitors to create their own versions with the same active ingredient. These are known as generics.
In the case of Humalog, the patent expired in 2015, but no generic is on the market yet, and we may never see one. The reason has to do with the difference between drugs made of chemical formulations (think of any ordinary pill), and those treatments made from living, biologic organisms – such as insulin.
Humalog’s biosimilar ‘follow-on,’ Admelog, was approved last year but is not yet available in pharmacies. Stay tuned, we will keep you updated.
Why are there no generic insulins?
The cash price for insulins can range anywhere from $120 to $600 a month. At the moment, there are no generic insulins on the market, but we do have what are called biosimilars. Without getting too technical, biosimilars are close – but not identical – versions of a biologic. Since insulin medications are made out of living cells, they are slightly different and aren’t deemed therapeutically equivalent, or interchangeable, by the FDA. Where the FDA allows a generic manufacturer to move a chemical drug to market without additional research, biosimilars must go through deeper regulatory scrutiny before approval. They are also harder and more expensive to manufacture. For more information about biosimilars, see our previous blog post here.
Unfortunately, biosimilars, unlike generic drugs, they rarely provide any savings to consumers. You may remember the first insulin biosimilar that was approved in 2015 – Basaglar. Basaglar is manufactured as the ‘follow on’ to Sanofi’s Lantus, with the same active ingredient – insulin glargine. When Basaglar was first approved, many were hopeful that it would help to bring down insulin prices and reshape insulin insurance coverage. However, prices for Basaglar remain high; current prices are around $234, and few changes have been made to insulin coverage by insurers.
So how can I save on Humalog?
Bottom line: without insurance, Humalog is expensive. Cash paying patients will have to shell out as much as $549 for a carton of 5 kwikpens. Here’s how you can save.
- Try Manufacturer Eli Lilly’s savings programs. Manufacturer Eli Lilly has a manufacture card and patient assistance program to help patients save. The Humalog U-200 KwikPen Savings Card can reduce your co-pay to as little as $25, while the Lilly Tru Assist program can help you receive your medication at no cost. Be sure to contact Eli Lilly to see which program you qualify for.
- Use a GoodRx Humalog coupon. GoodRx offers discounts for Humalog online. A discount may only save you 10% to 15%, which won’t make it affordable for everyone, but every bit helps.
- Try to appeal your coverage. If you have insurance and your plan doesn’t cover Humalog, 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.
Are there any alternatives to Humalog?
There are options to Humalog. While the cash prices of these may not significantly less expensive, depending on your insurance coverage, some alternative insulins might be more affordable.
Lantus (insulin glargine), and its biosimilar Basaglar are another type of insulin that has been found to be just as safe and effective as Humalog. Lantus and Basaglar are slightly more affordable, with cash prices averaging at $274 and $234 respectively, but they may be more affordable for you if your insurance covers it. You can read more on how to save on Lantus and Basaglar here.
Novolog (insulin aspart) is another fast-acting insulin that provides all-day blood sugar control, and it can be used by children as young as two years old who have type 1 or type 2 diabetes. The downside with Novolog is that it may cause weight gain, which could require you to adjust your dose.
If you’ve ever been afraid to show up at your doctor’s office because you’ve been “bad” then this post is for YOU! You may think your doctor is “pushing medications on you” especially if you aren’t experiencing any symptoms of the condition they are treating you for. However, their reasoning is not without sound medical and professional judgment.
One of the many reasons you might receive a lecture about the importance of taking your medications is due to the progressive nature of many diseases if not properly treated. The following are common disease states that are often “silent” and can be deadly if not properly managed.
Diabetes is a disease that occurs when your blood sugar is too high. Blood sugar is your main source of energy and comes from the food you eat. There are several different types of diabetes, with the most common being type 1 and type 2 diabetes.
Signs and symptoms of uncontrolled high blood sugar can oftentimes be overlooked, as you may not be able to tell. Some signs that are associated with low blood sugar include increased thirst and urination, blurry vision, lethargy, and frequent headaches.
Some people will stop taking their medication or take them inconsistently due to not “feeling” any different whether they take them or not. This is a more common occurrence with type 2 diabetics but has happened in type 1 diabetics who forgo their insulin.
Diabetes is one of many diseases that is often referred to as a “silent killer” as it can lead to amputations, vision loss, heart attack, stroke, sexual dysfunction, bladder problems, and kidney disease if poorly controlled.
Patients with diabetes may control their diabetes with injectable medications like Humalog, Novolog, Humulin, Lantus, and Tresiba, or oral medications like metformin, glipizide, glimepiride, and invokana.
High blood pressure
High blood pressure occurs when the force of your blood pushing against the walls of your blood vessels is consistently too high and can damage or weaken your blood vessels. However, it can’t physically be felt, as there are no obvious symptoms indicating something is wrong. You will need to visit your doctor to determine if you have high blood pressure.
Also referred to as a ‘silent killer,’ consequences of poorly controlled high blood pressure may include heart attack, stroke, vision loss, heart or kidney failure, and sexual dysfunction.
Cholesterol is a substance your body needs to build cells. However, there is bad cholesterol (LDL, and triglycerides) and good cholesterol (HDL).
Too much of the bad kind and not enough of the good kind increases the chances that cholesterol will begin to build up in the inner walls of arteries. Over time, this buildup can narrow or completely block the arteries leading to a variety of serious, life-threatening problems.
You can’t physically feel if you have high cholesterol and usually don’t know unless something bad happens or through routine blood work called a lipid panel. If not treated properly, high cholesterol can lead to heart attack, stroke, and chest pain.
Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall, or, in serious cases, from sneezing or minor bumps. Osteoporosis affects both men and women, and as our bodies age the likelihood of developing osteoporosis increases.
Breaking a bone is often one of the first indications that you may have osteoporosis. People with osteoporosis most often break bones in the hip, spine, and wrist. You may also notice that you are getting shorter, or your upper back is beginning to curve forward. These symptoms may also indicate that you may have osteoporosis.
Consequences of untreated osteoporosis include one fracture, broken bones, pain, and limited mobility.
The first thing to understand about testosterone replacement is that oral testosterone (pills taken by mouth) doesn’t really work because it is broken down so quickly by the liver. The solution to this problem involves patches, gels, shots, and even nasal sprays. Here are your options, with some new players in the game.
Androderm patches are meant to be worn on the arm or torso. Androderm patches deliver approximately 5 mg of testosterone per 24 hours and result in normal testosterone levels in the majority of hypogonadal men. These have been around for a while.
Show me the gels!
- AndroGel is supplied in both 1% and 1.62% concentrations. The 1 percent concentration was the first to become available. This will be your cheapest option for a testosterone gel.
- Testim (1 percent testosterone gel) is supplied in tubes and applied once daily. Anecdotal reports suggest that this preparation gives off an odor.
- Axiron (2 percent testosterone solution) is a solution of testosterone that comes in a metered-dose pump with an applicator. This is a gel applied to the underarm and it is quite expensive so be prepared.
- Fortesta is a new 2 percent testosterone gel applied to the front and inner thighs. Also pricey.
The option of intramuscular injections is a good one, though it requires office visits. Injections are usually given one shot of 100 mg, once a week for 12 weeks. Regimens of 300 mg every three weeks and 400 mg every four weeks can also be used. An advantage of the shots for men is the freedom from daily administration of a gel or patch, while the disadvantages are the need for a shot of an oily solution every one to three weeks.
Natesto is the first nasal testosterone gel approved in the United States for the treatment of male hypogonadism and testosterone deficiency. Natesto is a metered-dose pump applicator that places the gel into the nostrils.
The good thing? Because this gel is applied inside of the nostril, there is little chance of transferring testosterone to women or children who come into close physical contact with the person using the intranasal gel. That can occur with the gels and patches used on the skin.
There are some disadvantages. Some men won’t like that it needs to be used three times daily. People with allergies or underlying nasal or sinus problems also may not like Natesto as a runny nose, sore throat and sinusitis are among the most common side effects.
Most options for testosterone replacement are considered Tier 2 drugs by many insurance plans, though they may fall under higher copays or may not be covered with some plans. Androderm patches and all gel options run about $550-$600 per month or per prescription (for 30 patches or one container of gel). Testosterone shots are significantly less expensive, with generic versions sometimes available for as little as $20 per dose.
For a large portion of Americans, a simple bee sting or a peanut can cause a fatal allergic reaction called anaphylaxis. Fortunately, in most cases, these symptoms can be treated by a shot to the leg with an epinephrine auto-injector. Unfortunately, one of the most popular autoinjectors EpiPen costs around $630 and it’s generic version epinephrine costs around $320 for a pack of two autoinjectors, making them unaffordable for many people in need. But there are other alternatives. GoodRx is here to help explain them.
First off, why EpiPen is so expensive?
You may remember the EpiPen pricing controversy from about a year back, but here’s a refresher.
In August 2016 many patients ordering an EpiPen or EpiPen Jr, the autoinjector for children weighing 33 to 66 pounds, experienced sticker shock at the pharmacy. Those paying cash for EpiPen were hit with a bill for a whopping $600 or more for a pack of two auto-injectors. It soon came out that Mylan had increased prices for EpiPen and EpiPen Jr by 400% from 2011 to 2016.
Why was Mylan able to do this? Because they had the market all to themselves. The main competing autoinjector was discontinued in 2012, leaving EpiPen the only autoinjector available to treat anaphylaxis. With competitors out of the game, Mylan was free to gradually raise the cost of EpiPen more than four-fold without decreasing the demand.
When news broke of the large price hike, the outcry was loud. Top news outlets picked up the story, and Mylan was eventually hit with some lawsuits—sparking a nationwide discussion about drug prices. Mylan attempted to ease the public outcry by releasing an authorized generic version of EpiPen—epinephrine. The outrage, it appeared, had worked, and manufacturers were starting to listen and respond. Or so it seemed.
How much does generic Epipen cost?
Unfortunately, prices are still sky high. Cash prices for a pack of two epinephrine auto-injectors currently average around $377. While this is about 50% off brand name EpiPen, it is still not affordable for many Americans. So how can you save?
Are there any cheaper medications I can try?
We have good news! You have three other choices for epinephrine pens in addition to EpiPen and its generic.
- Adrenaclick (epinephrine). There are a lot of benefits to using Adrenaclick and its generic version. Like EpiPen, Adrenaclick is a pen-shaped autoinjector designed to be easy to use. The main difference? Adrenaclick is affordable. The generic is available for around $100 at CVS and has a manufacturer savings program that can reduce your co-pay to as little as $0 per fill. You can read more about this program here.
- Auvi-Q. During the EpiPen pricing controversy, manufacturer Kaleo made it their mission to develop an affordable autoinjector and released Auvi-Q. The average cash price for Auvi-Q is expensive, but the manufacturer has made it easy for many patients to access it for free through the Auvi-Q Affordability program. You can read more about this program here.
- Symjepi. This one was approved by the FDA in June 2017 and isn’t on the market yet. We also aren’t sure how much it is going to cost, although it is intended to be less expensive than EpiPen. For more information about this approval, read our previous post here.
Is there a reason I should use the brand version of EpiPen?
Not really. All of the autoinjectors work equally well. While it’s might be best to find the most affordable one for you, you should always defer to your doctor.
Generic Epipen still works best for me—can I still save?
- Save with a manufacturer coupon or patient assistance program. Manufacturer Mylan offers a manufacturer program, though it only offers $25 each fill for insured patients. That isn’t much for a $300 medication. You can read more about this program here.
- Use a GoodRx coupon for Epinephrine. GoodRx offers discounts for epinephrine online, which can usually save at least $15 off the full retail price.
- Try to appeal your coverage. If you have insurance and your plan doesn’t cover epinephrine, EpiPen or EpiPen Jr, ask your doctor about submitting an appeal. Some plans require 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.