Wednesday, September 24, 2008

Because nothing says Fun like a black box warning and an $87 co-pay.

Where to start. I guess I should begin by bidding aduei to my ole pal Ritalin. It's been fun. Only, not since the shit never worked for more than a few days. Of course it was fun only paying $10 for my medication.

Let me back up.

I have Idiopathic Hypersomnia. It's sorta like Narcolepsy Light. 1/3 less sleep paralysis than that other sleep disorder! Cataplexy free! (Well, you can be cataplexy free with Narcolepsy too, but I digress.)

Basically my brain sucks and doesn't know when it's day and when it's night. And it tends to think it's night all the damn time. So even when i've gotten a full nine hours with no problems (i.e. sleep apnea, seizures, etc) i'm tired. Rug on valium tired. Look at my lawn from the mailbox and think how comfy it looks tired. Really, really tired.

The only real way to treat this sort of problem is with stimulants, so please don't comment that I need to exercise or eat better or get more sleep. The only way for someone with this problem to feel better and function is to use stimulants.

Now Provigil is the new hotness for these disorders, but the week I was on it I had the headache non-fucking-stop, so that's out. Ritalin has been the second choice for a long time, but after three months on it at various doses it wasn't helping. So I went to the doctor yesterday needing something new.

Now let me pause here to praise my doctor. First of all, he's hot. He reminds me of Dr. Rip Studwell on the Fairly Odd Parents. He's got the coiffed dark hair, the glasses, the manly jaw. He is, as some would say, conventionally handsome. Like the hero in every 1950's movie and TV handsome. Sigh...

He's also very smart, very nice, always explains the meds to me, and has only asked me once if my depression could be the culprit here. He also acknowledged that the Provigil could interfere with my birth control and also acknowledged that was a bad thing for me. I love it when a doctor shows me respect!


So the Ritalin was crap and I needed something new. He gave me Vyvanse since it has a lower risk of giving me migraines. Awesome. He also told me that it has a black box warning from the FDA about dependency. Not awesome. But I told him that I didn't think I have an addictive personality and that i've seen enough Intervention episodes to be very afraid of loosing control to a substance and that I would tell him right away if I felt that something like that was happening. He explained that this medication could cause tics and possibly mood changes. Again I assured him that anything strange would be reported to him right away. So after reassuring my doctor (it's nice to have a doctor who doesn't gloss over these things) I left with a prescription and instructions to take 30mg for a week and then go to 40mg after that.

Super. I wasn't a hopeless case after all. This could work.

I went to Walgreens last night to get the prescription filled. I was looking forward to getting up today and taking a new medication that might make me feel better. I was just like the actors in all those drug commericals thrilled that their herpes is better, that they can get an erection again, or in a newer one, taken a poo that morning. Better living through chemistry!

When my name was called I went to the counter to happily pay my $30 brand name co pay. Or $50 if the drug is really new and exotic or can be replaced by something else. (For example a freind of mine was charged $50 for Nexium since they felt that two Prilosec a day would do the same thing.) But, no matter. Wakefulness was in my reach! No fear of falling asleep on my drive home from work! No struggling to get through work! Hooray!

"Ok, that will be $87. 32."

Wait, what?

"Well, the prescription was written for 30mg for seven days and then 21 days at 40mg so we're required by law to fill them separately."

Ok, but why $87?

"Well the 21 caplets were $50 for your co pay and the seven days one was $37 which is less than your co pay would have been."

Oh. Ok. What can I do? I pulled out the charge card since paying the mortgage and all the bills has left us flat broke until Tuesday. I swiped the card and chose credit. Then a little message popped up:

$87.32 Is this amount ok?

Uh, no, it's not ok. It's too damn much for 28 pills. I'll give you the $50 co pay for the 40mg. But I want to know how much those seven 30mg would have been each. So we'll say a month supply is 30 pills at $50, that comes out to about $1.67 per pill. So $11.69 for seven. That's what I want to pay for those. I think that's fair. Sadly, Blue Cross disagress.

So I said yes, it's ok and left with my drugs much less excited. Of course by then it was 9:00 and I was about an hour away from turning into a pumpkin so I wouldn't have been too excited then even if my drugs were free.

So it's me and you now Vyvanse. I'm taking some fairly serious risks for you, not to mention your cost. You had better be worth it.

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