Friday, April 17, 2009

Me vs. medication and insurance

I just finished taking my nightly cocktail of 5 different medications which in turn becomes seven and a half pills. My neuro upped my Requip at the beginning of the month to help with my restless leg twitches so I take a pill and a half now. It's a good thing I just took it because my legs are starting to bounce and those muscles are ready to kick it up and do a cha cha cha in my calves.

In the morning I take four-five other medications (5 when I'm working) which turns out to be 6 pills spread out over the morning.

I'm also supposed to take a multi-vitamin, Omega-3 fish oil capsules, and a heavy duty Vitamin D3 daily.

Hello my name is Weeble and I'm a pillaholic.

I take meds to go to sleep, to avoid pain, to help with depression and anxiety, to calm my legs, to lower my blood pressure, to wake up and stay alert. Name it and I probably have it covered. I also take Tysabri monthly instead of the daily Copaxone shots for two years and an almost year long attempt at Rebif three-times-a-week.

I try not to think about how much my insurance is paying for these various medications. I'm pretty sure my insurance has a cap on it of a million or two. I wonder how long I can keep up with the pill and Tysabri train before the train is no longer able to leave the station. Does anyone else out there with MS or other medical issues ever think about this stuff? What will I do if I eventually hit the top of my limit? I know it won't be this year or next but it could happen.

I'm already paying a lot out of pocket for Tysabri and I just got a bill from OT I had this past summer for $155. I know how much some of my meds cost compared to what I pay for them. Thankfully, we have good prescription benefits where I work. Knock on wood. But still...

Just some things that have been on my mind recently. I have been thinking that maybe I should consider participating in a drug trial. You might get a placebo and you might not but all the costs are covered including doctor visits and MRIs. For now, I will stick with Tysabri and my pills.

Anyone have any thoughts on any of this?


Nico Blue said...

If Tysabri and the pills are working, I'd say stick with it. You can always try trials if things change.

Oh crap, I never thought about a cap on insurance. I should check into that.

I'm enjoying your blog :) Cheers!

Cranky said...

If you're receiving drugs and ongoing care for MS but don't have lots of other health issues going on (like a big surgery or extended hospital stays), I doubt you'd hit the $1MM limit anytime soon. I'm sure your insurer could tell you how you're doing compared to that limit and what your Tysabri costs them. Don't you get an EOB (Evidence of Benefit or something like that) when you have the Tysabri filled? That should show you what your insurer paid.

Enjoying your blog, by the way.

Erin said...

I'm on Tysabri, too---I have google alerts to update me on Tysabri info. I know what you mean about paying out the ear for meds. I'm not sure if this is correct or not, but I thought to participate in a trial, you weren't supposed to have been on any other drug. Not sure if that's true. However, I do know that Tysabri hasn't gone head to head with the pills, but from the data on the pills, Tysabri is still the best. As for insurance, I know there's an out of pocket max each year and there is a lifetime max. For me I think the lifetime max is so high I'd probably have better chances at winning the lottery! I'll start following your blog. I'm a 31 year old working female, too!