$$$, Insurance, and the Lidoderm Patch - Pain Management Message Board

tyler7 · 01-10-2004, 01:59 PM

Hey all,

I know I've asked in the past about the retail cost of the Lidoderm (lidocaine) Patch, and sure enough it was in the hundreds. For a few months now I've had to constantly ask my PM's office for more free samples of them, as they've actually proved to be a good help for the burning pain I have all around my right shoulder area due to nerve damage. The problem has always been, while I've appreciated all they were able to get for me, it's never been enough. It says you can wear up to 3 at a time per day, and I could always use to wear at least 2, but have barely ever had enough for just 1 per day. And I have my discounts I get on RXs through my People's Prescription Plan, but I doubt they'd take that much off to make it viable.

Anyway, through a new job I've since started to have some indication that real, normal health insurance may be available for me in the near future (as opposed to the Medicaid I've meanwhile been applying for, an epic ludicrous journey in itself, and I don't know fully what that would bring me anyway). The only conventional coverage I've ever had in my working life was during my two years at Sony/Columbia Studios in LA, where I had Aetna. It always seemed great to me, and I often had more experienced people remarking on how it was a fantastic plan. So, if this indeed happens for me, I'm hoping that anyone who uses the Lidoderm Patches with any sort of regularity, and with normal coverage like Aetna (or Blue Cross, etc), how much would I be looking at to pay for an actualy script of them? Say for a month's supply, 60 I suppose? Does it end up being the same amount you pay for any other bottle of pills? (for instance, when I had Aetna, my normal copay for scripts was $10 for generic, and $15 for brand I think. Am I right in assuming the patches would still fall under that category?)

Thanks for your help

Kaylbe · 01-10-2004, 06:48 PM

Prescription copays generally cover a 30-day supply of that medication. Sometimes, however, the insurance company will have a limit on what encompasses a 30-day supply of a particular drug.

For instance, I use Duragesic patches, which are normally prescribed one patch every 72-hours or 10 patches per month. My doctor has adjusted that dose down to one patch every 48-hours or 15 patches per month, which is the maximum my insurance will pay for each month. A special insurance authorization must be obtained yearly by my doctor with justification for the increased dose.

15 Duragesic patches, by the way, retail for over $600 where I live. Quite expensive also...

--Kaylbe

feelbad · 01-10-2004, 07:14 PM

tyler,

I was rxed the Lido patches while in Rehab after my last surgery.I was sent home with quite a few ,so I didn't need to fill my Rx right away.So I was really surprised when I went to pick up the Rx when I finally needed it filled and it was twice the normal cost of my normal co-pay.We normally pay 12.00 for a regular Rx so this one was 24.00.It wouldn't be so bad but I am on multiple meds since my surgery and my son had a liver Tx three years ago so our Rxes are pretty spendy when you put them all together at the end of the month.After finding out just what the retail cost of these patches are,I guess I don't feel to bad about paying the 24.00.I was given a months supply.it comes in this big bag type thing with a wierd looking zipper deal across the top.I was rxed 30.I put these (one a day)across my L shoulder blade for extreme burning/stinging. I have since been Dxed with central pain syndrome caused by nerve damage during my surgery.it has also spread to my L forearm and up the back of that arm,and my R leg.I wanted to save some money, and the areas that now needed coverage were just not doable with the patches anymore so I had my doc Rx the gel.That was the normal price of my regular Rxes.I also was Rxed Doxipin cream by my rehab doc and this actually works much more effectively than the gel.I was rather surprised about that.If you are having the intensity of burning that I am experiencing, nothing really works to get rid of the pain,but the Doxipin really does manage to take just a little bit of the edge off.Just a thought.I don't know what the actual retail price is,but it has to be much cheaper than the Lido patches. Marcia

Wittesea · 01-10-2004, 11:20 PM

Hi, I am on Lidoderm patches and I pay a $20 copay for 30 of them because it is a name brand, if there was a generic available, it would only be $10.

I get unlimited refills, and I am allowed to use up to 3 per day, but luckily, I don't need to use them that often, because that would be $60 a month for me... although I did talk to my doc about that, and she said that if I need to use them more often that she would put a quantity of 60 or 90 on the Rx so that I could get either 60 or 90 for $20....

I just did a search, and Endo Pharmaceuticals (the makers of Lidoderm) do have a patient assistance program for Lidoderm patches...

[url]http://www.pharmhelp.info/Endo.html[/url]

I hope that helps.

~Wittesea

ps- I am assuming that it is ok to post that link, since the sticky post at the top has links to other patient assistance programs.

deerme · 01-11-2004, 05:31 AM

I have Traditional Blue Ins. Under my wifes plan I pay 30.00 for 90 patches.