What’s with Pharmacy’s?

My wife is a diabetic. She needs 2 different kinds of insulin.  Lately all of the local pharmacies will only fill her prescription when the insurance companies say so. ( typically 30 days).  But then they don't have the required insulin.  "We're out, we'll get some next week". 
 A week without insulin will kill her.  We then start chasing all over the city.   Major companies, smaller ones, mail order,  if someone has it, we then need to get her doctor to send it to whoever has it. 
  Periodically they confuse one prescription with the other and we wind up with 1/4 of what's required to last the month.  
  I just spent 2+ hours chasing around again.  

Father-in-law had Covid, stayed with me after hospital visit and needed 6 prescriptions filled upon hospital exit.

Pharmacy fills four and says the insurance won't approve the two so he decides he doesn't need them.  Apparently it's common for him.

It's an insurance world.

It's not insurance problem.  They've got there rules. We're OK with that.     It's Pharmacies don't have insulin?  

In reply to frenchyd :

My wife is also diabetic, she's pretty used to manipulating Walgreens but we still would get only partial fills of her prescription sometimes but get charged for the full amount. We would have to call ahead and make sure they could fill the prescription in it's entirety which was often met with an empty promise. We ended up building a good rapport with a certain pharm assistant and would only pickup prescriptions when he was working.

Our healthcare provider also offers us the option of having a 3 month supply shipped right to our door. It comes in a box that has a small styrofoam cooler packed with ice packs. Since we started doing that over a year ago we haven't had a single issue with getting what she needs when she needs it.  I'd see if your healthcare provider has a similar program.

Is it possible to get insulin from Canada ?

probably not , but maybe other drugs , 

And what was the Website that some DotCom guy did where you could buy heavily discounted drugs  online and have them shipped to your house , 

Hope it works out .....

Because of unaffordableIinsurance, I used to have to get both my insulins...off of Craigslist. Seriously. Situation was beyond berkeleyed.

We run into similar BS for my fiance and her RA meds. The only option is the mail order pharmacy for them because they are so horrifically expensive, but about every 6 months she ends up spending 2 days on the phone going through the BS about yes these are covered, etc. 

frenchyd said:

It's not insurance problem.  They've got there rules. We're OK with that.     It's Pharmacies don't have insulin?  

It's not an insurance rules thing. Unfortunately, the same changes that caused my health insurance to increase 934% (fact - not exaggerated) caused the cost of medicines and a bean counter to decide they know what meds I need, and my dr. does not. 
That's not insurance rules. The pharmacy can only do what insurance allows, even if they know better, because of those changes. 
I have similar problems, but no work around that are legal up there. 

Best of thoughts to your wife, and a healthy solution. 

   Since I changed jobs recently my insurance changed too. We're currently jumping through hoops to get one of my wife's meds that is magically no longer covered.

Fortunately, we have the assets to pay cash for it if needed but, I'm done with them locking health and wellness behind a paywall.

I love America for this.  I talk to my Dr.  They think I need X.  I agree I need X.  My insurance company can say, naaaaahhhh, you don't REALLY need X.  So you can't have it.

In reply to frenchyd :

Not sure if applicable but you mention different types of insulin so likely she's on some more advanced stuff.  The core components of some of the more advanced diabetes treatments were recently proven to have weight loss benefits which caused a whole new market and a resulting shortage in product worldwide.   I don't talk shop too much but this is kinda where I hang my hat these days and all I can really say is it has caused plans to double the size of all manufacturing plants within the next 3-5 years for at least one of the major providers.   No one saw it coming and it hit hard, my wife has struggled to get her meds which fall under the same ingredient umbrella.

It's great that Banting and Best are long dead . It would be a special kind of punishment for them to see what has happened to the price of insulin. 
 

Edit:

Sorry that may sound a bit harsh, but at any given time I have 3 vials of insulin in my fridge that I rotate through. Insulin pump means I only use rapid acting. The only time I have ever had my local pharmacy say anything was when COVID was on and I stayed clear of the pharmacy for an extra couple weeks. Wanted to get 3 vials instead of 2 and they asked if I needed them all now. Ended up getting the extra to get back to my regular rotation the next trip. I live in Canada I'm very very fortunate to have health insurance but the Canadian in me makes me wonder why this stuff is so expensive( even at half what it cost in the USA). 

This thread makes me appreciate my local pharmacy even more.

I was in the car with my wife when she called about my sons RX, and the pharmacist knew her name (didn't need to even tell her), knew my kids name, and was able to quickly provide a status. 

Even better than when I call the local Chinese restaurant, even after months of not ordering takeout, and the woman knows my name without me telling who's calling. 

There have been some advances in insulin over the past few decades and there's been inflation, so some of the price increases are  justified.

But, I was selling insulin in the 60s for $1.99 a vial. That was my cost from the wholeseller and we added no mark-up.

M2Pilot said:

There have been some advances in insulin over the past few decades and there's been inflation, so some of the price increases are  justified.

But, I was selling insulin in the 60s for $1.99 a vial. That was my cost from the wholeseller and we added no mark-up.

The patent was sold 100 years ago for $1, so it could be affordable for all who needed it.  Please tell me how it's justified that I spend $500 a month for medicine that keeps my wife alive. I'd love to know. 

Maybe this can help? - https://costplusdrugs.com/

I'm in Canada so I have no experience with it but their claim is they charge the cost of generic drugs plus 15% and that's it. 

In reply to RacetruckRon :

I'm not trying in any way to justify high prices for insulin or any other drug.  As I said, advances in formulations & inflation legitimately accounts for some of the price increase but I'm not implying that the current prices are anywhere nearly justified.

Another good example of ridiculous price increases is Lindane.  It's used for lice and scabies.  Not so long ago it was available as an insecticide.  I've used it to get rid of pine beetles.  It's no longer for sale for such use but when I bought it to kill beetles I think I paid around $12 per pint.  Now, if you have a prescription for lindane shampoo, it costs the pharmacy over $100 for a 2 oz. bottle.  Your insurance may or not pay for it.

adam525i said:

Maybe this can help? - https://costplusdrugs.com/

I'm in Canada so I have no experience with it but their claim is they charge the cost of generic drugs plus 15% and that's it. 

I had read a few articles about that site, I was curious if anyone here has used them. Hopefully they are all they are cracked up to be.

03Panther said:

frenchyd said:

It's not insurance problem.  They've got there rules. We're OK with that.     It's Pharmacies don't have insulin?  

It's not an insurance rules thing. Unfortunately, the same changes that caused my health insurance to increase 934% (fact - not exaggerated) caused the cost of medicines and a bean counter to decide they know what meds I need, and my dr. does not. 
That's not insurance rules. The pharmacy can only do what insurance allows, even if they know better, because of those changes. 
I have similar problems, but no work around that are legal up there. 

Best of thoughts to your wife, and a healthy solution. 

My wife's got her blood sugar down under 120 until the pharmacies are out. By the time she finally  got hers she's in the danger zone of 322.That attacks  internal organs. 
 Now she's battling try to Re stabilize her blood sugar levels.  
  My wife is hyper careful about eating.  No prepared stuff. No sugars. Low or no fat.  Low or no Carbs. Plenty of vegetables, no red meat. Nothing fried, small portions.  
    Oatmeal for breakfast. Or maybe if her blood sugar is good she might have a piece of toast.  

M2Pilot said:

There have been some advances in insulin over the past few decades and there's been inflation, so some of the price increases are  justified.

But, I was selling insulin in the 60s for $1.99 a vial. That was my cost from the wholeseller and we added no mark-up.

I don't think you're helping the pharmacists case here.

Humalog has been on the market for over 20 years (probably closer to 30). The only faster acting thing to come along here in Canada has been fiasp...

I don't begrudge a pharmacy for making money. But it's odd that my vial of humalog gets 3 times more expensive when I cross into the us. 
 

As stated earlier Banting and best sold the patent for a dollar to the U of T to keep insulin affordable...I can't imagine what they would have to say about people who can't afford to keep themselves alive today because of the cost of insulin. 

1SlowVW said:

It's great that Banting and Best are long dead . It would be a special kind of punishment for them to see what has happened to the price of insulin. 
 

Edit:

Sorry that may sound a bit harsh, but at any given time I have 3 vials of insulin in my fridge that I rotate through. Insulin pump means I only use rapid acting. The only time I have ever had my local pharmacy say anything was when COVID was on and I stayed clear of the pharmacy for an extra couple weeks. Wanted to get 3 vials instead of 2 and they asked if I needed them all now. Ended up getting the extra to get back to my regular rotation the next trip. I live in Canada I'm very very fortunate to have health insurance but the Canadian in me makes me wonder why this stuff is so expensive( even at half what it cost in the USA). 

You are aware that insulin was discovered by a Canadian in 1921.   
 Today they add a couple of cheap basic chemicals together  and poof. There is insulin.  
       Without insurance  my wife's insulin is $800 a month.   But with Co-pays. It's $45.  How much of that is mark up and how much of that mark up do insurance companies  get back as rebates or discounts?   
     Go by some of those drug companies.   That big fancy building is only a tip of the iceberg.  Go out to the airport and count the number of private jets.   Then look through the books for beach front real estate,  New York penthouses  to attend opera, or theater.   European mansions listed as training centers, fancy Yachts, hunting lodges, etc.  

   the reason for so much luxury is to get the gate keepers ( board members ) who approve use of such perks to major stock holders.  
     What's a few millions here or there to a billon dollar stock holder?  Oh by the way not only is use of those toys free, but carry no tax consequences because of the way the approval is written. 
    So those costs are listed as development costs. The rules for the Uber wealthy are different than the rest of us.    

gearheadmb said:

adam525i said:

Maybe this can help? - https://costplusdrugs.com/

I'm in Canada so I have no experience with it but their claim is they charge the cost of generic drugs plus 15% and that's it. 

I had read a few articles about that site, I was curious if anyone here has used them. Hopefully they are all they are cracked up to be.

Started by Mark Cuban, so I suspect it's legit. 

z31maniac said:

gearheadmb said:

adam525i said:

Maybe this can help? - https://costplusdrugs.com/

I'm in Canada so I have no experience with it but their claim is they charge the cost of generic drugs plus 15% and that's it. 

I had read a few articles about that site, I was curious if anyone here has used them. Hopefully they are all they are cracked up to be.

Started by Mark Cuban, so I suspect it's legit. 

I just wonder where some of the list price numbers come from,  I would like to see what the Walmart price is , 

But I am glad he started it , it seems a good option ....

Not to downplay the cost, but it is not as simple as combining a few chemicals, and "poof" there is insulin.

Originally it was purified from animal insulin, and now it's manufactured using cells grown in bioreactors that have had their dna altered to produce insulin. 
 

Insulin manufacturing

Neither process is simple or cheap, and are subject to manufacturing capacity limitations. Therefor companies may be reducing supply as a result of dedicating equipment to product that are protected by patents to maximize revenue to offset development cost before patents expire. 

Not that I normally like government involvement or subsidies, but in this case the solution may be government subsidies for insulin production to make increasing production more appealing to bean counters. 

It's not the pharmacy, it's the drug companies and how our laws allow them to make the bulk of their profits from the citizens and insurance companies.  Hard to argue when drug companies and insurance providers are making trillions in profit while you can't get a simple, life-saving drug for your wife.  The same insulin sold in the US costs 5 times more than the second-most-expensive country (source:  Cost of Insulin by Country 2022)  

Have you tried a mail-in company?  My dad uses ExpressScripts and/or Walgreens depending on how his insurance flip-flops every year.  He gets a 90-day subscription of strips and insulin for next to zero dollars, automatic shipments.  It comes in a box with ice packs on a FedEx express truck and they call him the day before to make sure he'll be there to accept the shipment.