What to Do When You're Diagnosed With ME/CFS and/or FMS and Don't Have Health Insurance
So, you've seen the doctor, had some blood work done and depending on the results, may have gotten a prescription to address your pain, fatigue or other symptoms. Many prescriptions for ME/CFS and Fibromyalgia are new and really expensive. This also means that there aren't generic alternatives. One doctor I saw prescribed Cymbalta which has a three-hundred-fifty dollar per month price tag! Incidentally, this particular doctor (a Rheumatologist) had almost no experience dealing with low income and/or uninsured patients as well as countless other faults. I filled only half of the prescription and charged it on my credit card.
The clinic my GP (who I really like) practices at, has a person on staff who helps uninsured, low-income patients obtain prescription medications at discounted rates or for free, depending on the situation. When I first started seeing this patient advocate few years ago, it all seemed like magic. My doctor wrote the prescription and had it forwarded to the advocate. I made an appointment to see her, she explained which financial papers I needed to provide, she'd fill out some forms and I'd sign them. In about two weeks, I'd go back, she'd hand me a bag of name-brand prescription bottles, I'd thank her and walk out the door without paying a dime. Later I started catching on to what she was doing. The best part is, anyone can do it!
The advocate was simply contacting the pharmaceutical companies and applying for financial assistance on my behalf. I thought, I'm pretty smart, I can do this myself. It ended up being easier than I ever imagined.
When I first learned about the high cost of Cymbalta, I started to panic, thinking I'd never be able to afford it. Then I looked back in my records at the forms my advocate had filled out. I tried to mimic what she had done.
The pharmaceutical company that manufactures Cymbalta is Lilly, the same company that makes Prozac. I went to the Lilly website, searched around a bit and finally found a financial assistance form to download. I can't remember exactly which financial documents they required, but I believe I sent a copy of my previous years tax return and a month's worth of my husband's pay stubs. I put the application and accompanying documentation in the mail and prepared myself for the usual routine, complete with countless follow-up calls and re-submissions of my application. To my overwhelming shock, the situation I'd come to expect, never materialized.
About two weeks after I submitted my application, I took out the copies of what I'd sent, took a deep breath and dialed the customer service number, poised for battle. A friendly man answered the phone and asked what he could do for me. I explained that I was calling to check on the status of a financial aid form I had submitted. After obtaining my name, he quickly pulled up my file. I had expected the usual "I'm sorry, our computers are really slow today" line, but no excuse was needed. He cheerfully reported that my application had been approved and the medication was already on its way to my doctor's office. I thanked him profusely, and hung up the phone in utter disbelief. His claims were not fiction as I picked up the four bottles of Cymbalta during my next doctor's visit. My doctor, apparently not used to dealing with uninsured patients, did not handle the whole situation well at all and I never saw her again after that. But that's beside the point.
What I'm about to write is also beside the point but has to be said. I found it interesting, to put it mildly, that the pharmaceutical company was so willing to mail me drugs with a value of approximately $350. It says volumes about how over-priced these drugs must be in the first place and how huge the profits are. You wouldn't, for example, walk into a grocery store, show them a copy of your tax return and get $350 worth of groceries. But, I suppose I shouldn't look a gift horse in the mouth (if you'll excuse the cliche) so I won't continue with this particular tirade
The point is, that it is possible to get prescription drugs at a discount. Most drug companies will give just about anyone (with a prescription from your doctor of course) a free one month trial. You can usually print the coupon out on your computer and give it to your pharmacist with your prescription.
In the next post, I'll tell you about third party drug distributors that offer huge discounts. Yes, it's legal and based in the USA.
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