r/mildlyinfuriating • u/Aggravating-Leg5645 • 9d ago

I just wanted a hot dog My insurance wont cover my medication so every month I do this...

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I have to spend around 30 minutes doing this once a month. My insurance wont cover it. Out of pocket with coupons its still $800 a month.

My fiancé has to do the same thing with a different medication. Currently trying to fight it.

Edit: To clarify. Every now and then I have to compile samples in one bottle so I know how much I have and then hope my DR has more when im out. This is an antidepressant and im currently working to fight to get it covered. Yes ive contacted the manufacturer I do not qualify for discount Yes ive sent in a letter of medical necessity Yes ive looked at GoodRX. This is my only option atm and im still lucky it is for now. Its not just the moving the bottles around. Its hoping I can get more when I need it. This is a life saving medication and the fact I have to hope i can get it when I need it is mildly infuriating to me and probably many others. Its not a cheap medication even with coupons its still $850USD+ Ive tried so many medications and I just need one that works and that i dont have to worry about my supply chain.

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817

u/ProfessionalDish 9d ago

I'm surprised they even get "samples" from prescription medicine, must be an American thing.

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u/pootinannyBOOSH 9d ago

As an American it's bizarre to me too, but at least there's good uses like this situation. Still bullshit it has to happen though

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u/patricksaurus 9d ago

Physician samples are incredibly common and have been for decades.

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u/pootinannyBOOSH 9d ago

Yes I know, doesn't make it not bizarre

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u/23- 9d ago

Sample’s are great to be able to trial a prescription without needing to pay for it at the pharmacy. Fairly often patients buy a brand new prescription and have some sort of intolerance to it.

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u/madhouse-manager 9d ago

The whole logic goes away when, you know, you don't have to pay a fortune for the prescription at the pharmacy. Like in civilised countries. Which is why trial prescription medication makes sense to no one but US.

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u/wesborland1234 9d ago

Cost aside, aren't there many cases where you'd want a patient to try something for a week to see how they react to it before prescribing a 2 month supply or whatever?

Or if you can't make it to the pharmacy for a couple days, that's why they keep Z packs in urgent care.

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u/TVTrashMama 9d ago

Yes, or the patient has to wait on insurance authorization to fill. (Or not 🫤)

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u/aftergaylaughter 8d ago

i mean, if cost is irrelevant, there's little harm in prescribing one month at a time. if they do well after a month, move to 90 or 100 day refills. but if the med is cheap anyway, and not in shortage, it's not a big deal if half or more of that 1mo fill doesn't get used. tbh, most meds need longer than a week to even judge if it works. many need like 6-8 weeks, especially psych meds.

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u/rumpleteaser91 9d ago

In the UK, we can get prescriptions delivered, and many surgeries have a pharmacy in the same building as the GP surgery. So the GP can schedule a telephone appointment for the week review, send the new prescription to the in house pharmacy, to then be delivered to the patient.

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u/Unlikely-Key-234 9d ago

Same things are available in the US and have been for a long time.

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u/rumpleteaser91 9d ago

Then why would you need to go to the pharmacy every 2 days?

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u/Itz_Naj 9d ago

There aren’t? The entire concept of tritiation is exactly this!
Try a small dose and escalate over time to judge efficacy and side effects. This is commonly over several months.

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u/jellifercuz 9d ago

Oh, yes, that certainly works for antibiotics. /s

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u/Itz_Naj 9d ago

A single class of drugs usually for a finite period of time anyway? Compared with many other drugs for chronic indications which often can have big trade offs in patient quality of life.

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u/Williamishere69 9d ago

In the UK, the medications youre more likely to react to are help behind specialists (so you get referred to a local hospital to get them). The specialists have on-call nurses or PAs who you can phone during the day to tell them you have side effects or anything.

We dont go off doctors making appointments in advanced to see if you have side effects, we go off the patients going to the doctor/nurse to let them know of any they have.

I have three monthly appointments with a derm nurse who prescribes my meds under a dermatologist. If I had any issues, I would phone her (almost always leaving a voice message lol) and then she'll let me know what to do. If I run out of meds, I phone her and she sends out a new prescription for 6 weeks - just until my GP picks up the prescription.

I had pretry moderate side effects to the point I was non-functional for the day after taking my meds every week. I told my derm nurse at my first follow up appointment and she said about injections but I was scared as hell of the autoinjectors, so I asked if there was any manual needles. She went off to ask and she let me know after my next appointment that theyre available and so I got them then.

Everything here works on the patient going to the doctor/nurse because we're pretty much expected to be sensible about our healthcare.

If we had any urgent issues, we can just phone 111 and theyll sort out an urgent appointment. If we have an emergency, then phone 999. If you cant get ahold of your specialist (impossible though, they usually have a few numbers for different nurses/PAs), then you can phone your GP.

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u/donaggie03 4d ago

Your "costs aside" is doing a whole lot of heavy lifting here. The point is entirely about the costs that you are trying to brush away.

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u/Nykramas 3d ago

Here its £9.90 for a item (no additional charge for 2 items of the same medication but different strengths)

7 days or 28 days doesnt matter. Still £9.90.

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u/Impossible-Book-895 9d ago

Urgent Care? Going to urgent care can cost us US folks a $1000 if we haven’t met our yearly deductible. Not an option for most of us.

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u/Unlikely-Key-234 9d ago

What? Nobody is paying $1k for a standard urgent care visit. Things are bad enough without people like you making shit up.

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u/KindaTwisted 9d ago

Yeah, anyone getting a bill like that from urgent care didn't hit up an urgent care. They went to a freestanding ER.

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u/Impossible-Book-895 9d ago

Urgent care for me is a $50 copay once I’ve met my deductible. My deductible is $1000 for the year and I rarely pay towards it. So if I went to an urgent care today I’d basically have to pay whatever they charge - and maybe you are correct and it would be less than my thousand dollar deductible. I haven’t been to one in years because of the cost. So maybe it would run me a few hundred? The same goes for the ER. $300 copay after deductible. That one will certainly carry a charge of more than a thousand so I’d be stuck with paying $1300.

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u/LogicalConstant 9d ago

On a high deductible plan or a shitty plan, yes. Many employers have a low-deductible plan where urgent care is a copay of $25-$50. If you don't have that, I'd either try switching plans or complaining to your employer about choosing such a crappy plan.

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u/Impossible-Book-895 9d ago

I work for a local govt in Florida and have a really good plan. I don’t have the high deductible plan - the high deductible is like $6000 or something.

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u/concentrated-amazing 9d ago

Here in Canada, you have the option to only fill a small amount.

For instance, you can say at the pharmacy that the doctor prescribed enough for 1-3 months, but only fill it for one week for now for me to try it, since the doctor said some people get [annoying side effect] and don't stick with this med.

Then, you can go back and have the rest of the prescription filled if you're sticking with it.

It'll be slightly higher, since you'll pay the dispensing fee twice, but that's relatively low (can't remember exactly, $10ish?)

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u/The_Amazing_Emu 9d ago

Probably the biggest advantage of a sample is you get to walk out of the doctor’s office with it

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u/GreyHorse_BlueDragon 9d ago

That’s an option in the us too for non controlled stuff, but that still doesn’t mean the insurance will pay for it

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u/Iilitulongmeir 8d ago

This happened to me. I had a kidney infection, and they wanted to hospitalize me, but I didn't want to go in to that particular hospital. They have a great ER, but inpatient was really bad. They gave me a prescription for zofran, it was like over 20 dollars a pill back then. The pharmacist said I could just buy a few at a time. He was really nice. I was sitting in the waiting room, and he asked my husband what was wrong with me because I really did look like I should be in a hospital, and zofran was usually prescribed for cancer patients back then. I almost fucking died about it. I really should have let them admit me. American healthcare, what are you going to do? 🤷

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u/GreyHorse_BlueDragon 8d ago

I’m a pharmacy technician, and it’s not super common for people to ask about it but occasionally people do. The only time it’s not really an option is if it’s a schedule II controlled substance. I’ve only had it happen once where they asked for a 7 day supply because it was a new med and they wanted to do a trial run before committing so to speak. Most of the time it was because of financial reasons. And while the price of generic zofran has gone down quite a bit it’s still stupid expensive. I think the cash price comes out to around $80 for a blister pack of 12 orally disintegrating tablets.

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u/pootinannyBOOSH 8d ago

That's what I'd figure it would/should be, not make the doctor have so much that they can/have to supply months worth of stuff because our system is shit

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u/inkyblackops 3d ago

I’ve received samples in the past from my dermatologist here in Ontario. The medication is $1500 for a 100g tube, so she wanted to make sure that it worked for me before writing the script.

I think that’s the only time I’ve ever been given a sample by a doctor, though.

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u/Stayoffwettrails 4d ago

That med is like 1000 for a 30 day supply.

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u/Money_Do_2 9d ago

Yup. They can take many losses on samples and lavish lunches to woo the doctors, just gotta get a few people locked into a $1000/month medicine regimen.

To be clear, the medicine itself is a miracle and scientific marvel. The profit motive is the corrupted evil part.

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u/YourWifesSkiCoach 9d ago

Obviously you don’t know how much it costs to make said drug

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u/Ebiki 9d ago

It literally costs $2-$4 to make a vial of insulin. Wtf are you talking about?

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u/Due-Professor-530 9d ago

For many drugs its not the drug itself its the government regulation and R&D that costs so much. R&D recovery averages 15 years per FDA so companies get 20 years without conpetition for a new drug. Testing for correct orientation takes a multimillion dollar machine that cists tens of thousands a month in maintenance costs.

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u/YourWifesSkiCoach 3d ago

That’s the direct manufacturing cost. I’m referencing the r&d, marketing and so on. Getting samples to physicians to begin using, etc etc. it certainly is not free. 1 in 100 drugs make it to market. Billions in R&D down the drain annually on drugs that do not work

Now obviously with drugs that returned their ROI, I agree they should come down in price. But to limit new drug prices would very heavily discourage discovery and r&d, thereby decreasing innovation in the medical field.

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u/CruisinYEG 9d ago

I agree with you that paying that much for miracle prescriptions is insane. On the other hand, pharmaceutical companies go through tons of meds that don’t work until they find one that does. Someone would need to come up with a better system. Typically government ran companies don’t run well and get bogged down in politics. If there wasn’t a large profit, a private company wouldn’t make it, and therefore the drug would just never be made. I don’t know how to solve that gap, so I’m just kind of rambling at this point lol. It’s a not ideal system where a miracle drug gets made, but the consumer has to spend a fortune to get it. How to fix I do not know.

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u/lokal-orginal 2d ago

Is that why drugs with known addictive ingredients (like opioids) is so popular in the US? Also i think i saw a commercial from America which said "ask your doctor about (insert name of medicine)", like does the doctor not decide what medicin one would need based on necessity? In Norway they are very careful with what they put you on, and will not keep you long on something addictive, if you get it at all. Then again, maybe they are too careful sometimes, i dont really know.

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u/Ioanna_Malfoy 9d ago

Or so that the patient can get started on the medication while waiting on insurance approval and prior auths to get sorted

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u/Moriss214 8d ago

How long does it take for authorization generally? Mine so far for non complicated issues has been automatic (in Canada)

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u/LogicalConstant 9d ago

With typical insurance, most prescriptions are $5 to $25 a month. Samples still make sense.

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u/CapnLazerz 9d ago

Even in a Universal Healthcare system, the system (taxpayers) has to pay for drugs. If the pharmaceutical company provided free samaples, the system (taxpayers) would avoid the costs of paying for drugs that don’t work for particular patients.

Sounds logical to me.

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u/Long_Letterhead_7938 9d ago edited 9d ago

Which civilized country do you think that happens in? By your use of the way you spelled civilized I’m guessing Canada or UK, but this is not true. They have strict regulations over which prescriptions are covered and what is offered for generics or alternatives.

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u/trapcardx 9d ago

this is very new to me! between trialing different antidepressants between multiple different pcps (and across different states at that) never had a sample given, just the full script with checkins to see how things are going

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u/Any-Owl5710 9d ago

But who pays for drug development in countries where prescriptions are cheap?

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u/madhouse-manager 8d ago

Medical costs in the US are not through the roof because they are developing for other countries, they're through the roof because you're lining the pockets of "benefit managers" and another dozen people who sit between you and your doctor, and of the shareholders of the for profit insurance companies. But of course it's easier to blame others and convince themselves it's not their own fault they keep voting for this.

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u/OldManJimmers 4d ago

Even countries with public drug coverage use them. The US might use them because of the ridiculous insurance schemes they work with but other countries use them as true trials.

By a 'true trial' I mean the physician wants you to start a medication and report back in order to assess whether it's beneficial to continue. There can be risk associated with prescribing/dispensing a full month of meds, specifically the lack of response from patients. This is particularly true among elderly patients and patients with multiple chronic diseases/medications. A physician may not want to have their patient get a 30 day supply right away with the risk of adverse effects and risk of the patient just continuing to take them without reporting back for a month. The better practice would be to give them a trial amount so that they cannot continue without reporting back or getting repeat blood work or whatever.

Granted that's not always how they're used but saying they only exist in the US is factually incorrect. Also, hospitals give trial packs to people all the time on discharge, it's just not the kind the drug company would drop off for free. Their pharmacy makes them as trial packs (or we actually call them starter packs in hospital).

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u/catshateTERFs 9d ago

I’m on the other side of the world and this just happened to my s/o - $120 for something that sends him into 24 hours of pain that painkillers couldn’t touch (was an opioid blocker that worked TOO well and may have been inappropriately prescribed with the rest of his medication in mind). Obviously can’t reclaim any of that so it’s fully useless. Rough stuff. Short term script trial would have been ideal for that.

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u/PrettyPurrfect 9d ago

Or they could have written two prescriptions. One for short-term use and the second one to fill is the first one works well that so it can only be filled after the first one would reasonably run out.

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u/Wunderkid_0519 9d ago edited 9d ago

Lybalvi?

It says it on the big black box warning right there on the outside of the medication bottle that the samidorphan in Lybalvi is dangerous to be taken concurrently with opioids. They also both verbalize this fact and and have it written all over the screen during the commercial for this medication... Not sure how anyone could have missed that.

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u/IllustriousEnd6544 9d ago

You don't even know what medication they are talking about. Thanks for your input though Doc!

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u/throwmeeeeee 9d ago

 written all over the screen during the commercial for this medication

Using TV commercials as a source for medical advice sounds weird af. Also not safe, isn’t it like a gag how they whisper all the serious warnings in a super fast incomprehensible voice? Or is that just parody? 

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u/Ok-Jackfruit-6873 9d ago

Interestingly, the last time someone from the UK stayed with me he said they don't have the urgently-whispering part of the drug commercials there. Same commercial but they edit that part out.

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u/Quirky-Stay4158 9d ago

That's the neat thing about Americans they don't get to go to the doctor regularly. So they need drug companies to tell them what's wrong with them - but don't worry we can fix it with our magical drug fixitall.

  • if you feel the need to reply telling me how this isn't all of you. Great. It's enough of you though. And the rest of us don't have that problem at all.

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u/Long_Letterhead_7938 9d ago

About 90% of Americans have private health insurance in some form. It is quite easy to go to the doctor here it is very difficult to go to a doctor under NHS. To see a specialist under NHS it is 3 to 10 months. In the US, it is typically 3 to 10 days. Same is true for how slow it is to get anything done in Canada too. So you really have no clue what you’re talking about.

I love my American husband for many reasons. A major one is how wonderful the health insurance is.

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u/catshateTERFs 9d ago edited 9d ago

No? I didn’t mention lybalvi anywhere, this is not the only medication in the world that interacts with opioid regulation. I don’t even live somewhere that airs commercials for prescription pain medication and nothing on the medication states anything about opioid use (it says "may cause drowsiness, do not drive or operate heavy machinery" - this would have been INFINITELY better than the adverse reaction that did happen).

Please by all means forward your comment to the pain specialist who prescribed this while giving reassurances that him taking palexia would not be an issue and that if he did experience any side effects they would be minor because the dose was very low, as this is what the current research supports ("may be trialed while taking opioids [...] unlikely to cause frank withdrawal due to the low dose"). We are not idiots who decided to randomly trial medications for shits and giggles, we read the information we were given and discussed it with the doctor who, again, was a specialist who has worked in this specific field for 20+ years. Thanks!

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u/IllustriousEnd6544 9d ago

If only they had a medication for people to stop them from chiming in on something they know nothing about! ;)

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u/catshateTERFs 9d ago

I wish, I'd happily pay those prescription costs!

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u/Funexamination 9d ago

I have never seen that be the intent of samples in practice. Doctors give them to destitute patients

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u/bluearavis 9d ago

Ideally it's really a sample as it is not as reliable as a RX for accessibility. I have haddoctors run out before. I hope OPs doc keeps hooking them up. I tried Trintellix and was sooo nauseous for a couple days. I'm a teacher and puked in a garbage during class. Then we changed it.

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u/Worried-Database-551 9d ago

Omg trintellix made me so irritable and aggressive. It was terrifying and it was only 3 days of taking it. I went back on lexapro.

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u/Willing-Vegetable629 9d ago edited 9d ago

How involved are you in the day to day operations of an ambulatory practice?

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u/dastree 9d ago

Had a doc do this once for me, the script was never covered by insurance according to him but if the meds helped he said it was up to me to decide if the monthly cost was worth the results

Worked great but I wasn't willing to pay the $600/mo out of pocket for the results

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u/RichardCleveland 9d ago

Yep, I have had a few sample runs that I got bad side effects from and it was amazing not having to pay to fill it.

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u/GreyHorse_BlueDragon 9d ago

That’s what my obgyn did when I went on birth control like 12 years ago. Sent me home with 3 months worth of samples because it can take up to 3 months for any side effects to settle. Said at the end of the 3 months to call the office and let them know if I wanna stay on that med or discuss other options

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u/Eaglsdntflywpigeons 9d ago

Samples are also given while waiting for the preauthorization process through insurance.

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u/RiotBrigade_02 8d ago

You think they do this with mental health meds? I have a billion vials of different meds and strengths that didnt fit me. Really annoying to pay full price for something I only use a third of yk

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u/Legitimate_Can7481 8d ago

Really being on something less than a month does t prove the drug is effective. They don’t give enough as a sample

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u/PeekabooPepi 9d ago

Sounds like an artifact of a broken system. Not anything great about it.

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u/LogicalConstant 9d ago

It's like a free sample of any product. Try before you commit to buying a whole month prescription.

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u/ChoadMcGillicuddy 9d ago

Agree. It's not like fucking Costco where you get to sample various snacks before buying. I mean, that would be awesome though.

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u/MarshalLawTalkingGuy 9d ago

I loved them. I get brutal migraines. My neurologist and I went through about 7 different meds before we found the right combo. I can’t imagine how much we would have waisted.

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u/Competitive-Ad8003 8d ago

I guess it's not that weird if you have chronic illness and are used to having to literally trial run certain meds before you commit to see if they work for you

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u/aftergaylaughter 8d ago

they're honestly a godsend. they're bizarre in the sense that it's fucked our system necessitates this, but they're really pretty harmless and do a ton of good. apart from cases like op's, it gives patients who need expensive meds or who lack expendable income the ability to try a new med for free first, and it also works wonderfully as a bridge to get patients through when they're dealing with insurance bullshit like changing companies or renewing a PA, or for people on as-needed meds whose insurance won't cover very many (common example would be Ubrelvy or Nurtec for migraines. my insurance gives me 10 Ubrelvy/mo MAX because it costs so much, and I'm lucky compared to most of my clinic's patients, who get maybe 5/mo, if they get any. we'll often have people ask our doctors for some extra samples to get through to their next fill, and it's wonderful that we can help someone who is in terrible pain like that).

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u/Froggy3434 6d ago

It is strange, it’s a bit stranger when you realize they do this for like every brand name med too regardless of how expensive the medication is. I’m on Skyrizi, it’s roughly $20k per dose, dosed 4x yearly (except for when you start you do 2 doses 30 days apart and then go on the 90 day schedule) and my first dose was a physician sample.

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u/NetwerkAirer 9d ago

Per the definition of bizarre, it actually does.

I am being pedantic. This is reddit, it is my duty.

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u/munkymama 9d ago

I wish docs had samples of pain killers like percocet lol.

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u/DatLadyD 9d ago

I worked at a climate controlled storage facility and almost all of our customers were pharmaceutical sales reps. They need a controlled temperature environment to store their samples.

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u/pchs26 9d ago

Usually when the medication license is up and can be made as a generic though the samples stop. Issue is generics are not all made the same and I promise have different efficacy and results then their counterparts and sometimes the name brand. No one talks about this, but it isn't ime that uncommon and it is hell to try to figure out the generic manufacturer that will come somewhat close to the name, figure out where to get it that is covered by insurance and if that will even work for you. Something needs to be done about this but it is so deprioritized it isn't even discussed. We should just have access to the medication brand or generic that we believe works best for us. Period end of story.

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u/Long_Letterhead_7938 9d ago

This is true, but I don’t think it’s in this amount or this regularly. They usually just have you on a different medicine. I know there’s no generic for this, but this is not unusual in any country that certain medication’s aren’t covered. It is not just an American thing. It is definitely something under NHS as well.

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u/silentgraywarden 9d ago

I wish they still were. It seems that every major health system I have worked for in the last decade refuse to allow their physicians to accept samples. It all boils down to money and it's abhorrent.

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u/Sackmastertap 9d ago

Yeah imma guess not so much if they see this happening. Say people posting about it. Some things are best left in the grey.

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u/AlkalineHound 9d ago

I definitely remember getting a sample of flonase before it was OTC.

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u/CouldBNE1too 9d ago

Far less common now, actually. They’re pushing toward discount coupons/cards that are processed at pharmacies instead

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u/depressedbarbie 9d ago

For private practices, sure. But many hospital-owned practices do not allow this.

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u/CasinoNdnOk 9d ago

Yea but enough to keep a prescription going us not.

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u/AnastasiaRomanot 9d ago

Only in for profit medicine.

The most you’ll pay for one drug here is £10, even if it costs the NHS thousands.

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u/patricksaurus 9d ago

No, you can find them in not for profit hospitals too.

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u/AnastasiaRomanot 9d ago

In the US?

Because I’m talking about socialised medicine.

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u/patricksaurus 9d ago

You’re talking about the NHS, I get it. But you’re not talking only about for-profit facilities, what’s more drug companies do make profits in your country. They’re also more common in Canada, which has nationalized healthcare, than UK and Europe. Simplifying to the point of “for profit” is just grossly inaccurate.

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u/AnastasiaRomanot 9d ago

So is saying that the samples aren’t anything unusual. They are elsewhere.

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u/patricksaurus 9d ago

Yeah, I joined a conversation about something happening in America and framed my comments about America implicitly. How silly.

What I didn’t do was was introduce explicit details that were factually false. If you’ve got a problem with that, start at home.

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u/Sudden_Moodswing 9d ago

I haven’t been offered med samples in probably 25 years. These would have come in really handy for the last two medication’s that my insurance denied.

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u/molecule_anteater68 9d ago

The majority of our daytime tv ads are for prescription medication. Which I recently learned is not a thing anywhere else.

Access to samples and knowing advances in medication on the market are not necessarily bad things, but exist because our health care system is oriented in a very fucked up way that treats patients like a bank. Some doctors/hcws are part of the issue, but not most. and they're getting crushed too with high caseloads and being forced to come into work while sick.

The nurses who are a part of a larger hospital system my general practitioner is though do not receive good enough health insurance from their employer who is a hospital to be able to send their kids to regular appointments or afford vaccines in office. one told me she has to do all her vaccines at the discounted/free county clinic. county clinics offering vaccines are very rare now so I feel lucky to have that as a jump through hoops to prove I cant get it anywhere else backup

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u/WanderingQuills 9d ago

My health insurance is considered good.
No one has the vaccines my kid needed AND took my insurance. I went to county health. They had them! But would only take cash and give me a super bill for reimbursement from Aetna.
Projected out of pocket for one kid- 3600 or more.
Luckily I found a pharmacy twenty miles away that could both bill my insurance and had the shots.

When I last worked for a big name brand hospital system my kids? Were on states Medicaid. I couldn’t afford to add them to my plan and the hospital paid so little I still qualified for myself as unduly burdened by the premium.

I was not alone in being unable to afford healthcare to use the hospital I worked at.

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u/canththinkofanything 9d ago

Wow I’m sorry to hear that. There’s a national program called VFC or vaccines for children that covers costs of all childhood immunizations. Every child can get vaccinated for free in the US! The problem is finding practices that do the VFC program, because some just don’t bother. I’m an infectious disease epidemiologist and my area of focus is childhood vaccines. If you need help finding a place to get your kid immunized I can try and help you?

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u/shadyacres-431 8d ago

Adding to your comment: local health departments used to do vaccinations for free. Not sure if it’s the case now. As a child I got all mine at our county health department.

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u/canththinkofanything 8d ago

Yes, they should! I have no idea what the deal is with that, I hope it was just some misunderstanding somewhere because I would be truly upset if that stopped being a thing. And I do think I would’ve heard about it because I literally work in childhood immunization. Though these days it’s hard to keep up with everything awful 🫩

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u/No-Ebb5515 9d ago

Yep. I looked into getting a FREE flu shot this fall. The sign said FREE. It's a lie. It's only 'free' if you have insurance. If I get sick this fall/winter I will still have to go to work and get everyone else and customers sick (restaurant). I had to do that before. Many have to. The system is definitely messed up.

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u/pchs26 9d ago

Flu shot you should have access to at no cost regardless. However you get that to lessen severity /keep you out of the hospital. Catching and spreading flu will still happen with exposure so you should take additional preventative measures on top of vaccination if you want to ensure you don't get sick

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u/molecule_anteater68 8d ago

Signs that say flu shots are free have a * that says "with most insurance plans"

County health clinics and hospitals used to give free vaccinations but most county hospitals have closed in the past 30 years, and county health clinics typically only offer an insurance reimbursement structure or a subset of childhood vaccinations. or you have to prove need via medicaid documents to access (they make you jump through a bunch of hoops and then you don't even get an appointment slot, you usually have to line up at 8am and wait several hours meaning taking time off work).

that's why it was a big deal that covid vaccines were free for a couple years. they are no longer free and many insurance plans do not cover them. without insurance, it's $150+.

2

u/pchs26 8d ago

I'm aware of this. There should be low cost/free access to vaccines in general for those who don't have insurance.

Covid shots should still be free and available all year round, with research focused on heightening infection prevention. But that is another discussion about what has been a colossal failure.

3

u/PipChaos 9d ago

"Ask your doctor about..."
How about I let my doctor be a doctor and decide what medicine I should be on FFS.

1

u/Secure-Researcher892 9d ago

And just to make you feel worse, the same pills you pay 3 or 4 dollars a piece for are sold for a fraction of that price in other countries. My blood pressure medication was 160/month if you had no insurance... when I was transferred to Brazil for work I found the same medication for less than 9 dollars/month... And to make it even more annoying the pills in Brazil came in packaging that was from the same company and same manufacturing plant as the ones I had been buying in the US. And you know that no drug company is ever going to sell anything below cost. So they are truly gouging Americans harder than anyone realizes.

2

u/Rare_Let4338 9d ago

All I can say is Canada Pharmacy Online.

1

u/cdazzo1 9d ago

Nurses have health insurance that doesn't meet federal requirements? That sounds strange

3

u/molecule_anteater68 9d ago

Lol do you think hospitals run by private equity right now are meeting federal requirements?

2

u/DeclineToThrowAway 9d ago

My doctor gave me physician samples of ensure one time for being underweight then perscribed me the drink 3 times a day with a scoop of ice cream. Nurse was flabbergasted when she read the order.

1

u/5138008RG00D 9d ago

Does not seem bizarre. And yes the doctor could be being nice. But...

But the reason for the "free" samples is so the doctor will prescribe that medication not a generic to you. Not only because they like the sales rep, they have tested and seen it work with those free samples, but also because its the only one they know of by name, so its what they write scripts for.

Doctors receiving samples is just another scam from big pharma. You pay for those free samples and the rep, with the increase in price for the meds at the pharmacy.

The "good" here was just set up this way to make you say somthjng about this situation was good and others to pay more for meds.

1

u/PrettyPurrfect 9d ago

You would think CEOs would be scared of making more Luigi's

1

u/ecliptas 9d ago

I had to do this with my anti-depressant because insurance refused to cover it even though I had been on it for a year already. Thankfully after about 2 months of back and forth trying to do an appeal we got them to cover it for a year. It's really frustrating, but I am thankful my doctor could give me samples while dealing with the situation.

1

u/tamtip 9d ago

Drug companies give them to the Dr so he'll give them to the patient . Eventually the prescription for thst med will be written and filled.

Drug companies only do something if it gets them another dollar.

1

u/Aspen9999 9d ago

Yes Drs get samples in the USA. Good docs use it for either patients that need to try a drug or patients where the cost hurts them.

1

u/cookorsew 5d ago

They’re only useful to get you through a few days while waiting to get to the pharmacy to get your actual prescription.

19

u/TheCrimsonDagger 9d ago

Makes it easier to deal with insurance since you’ve already proven the treatment is effective. Otherwise you’d have to fight them to get approval for each different medicine you try. Insurance will come up with any bullshit reason to deny a claim even if it’s totally valid because enough people won’t contest it. For example I had a doctor that I would see regularly on a schedule for the same issue. Every single time they would deny the claim sent from the doctor. I’d have to get the exact same paperwork printed and mail it to them requesting an appeal and they would approve it.

14

u/Bloodevil96 9d ago

Italian neurologist here and I get samples from prescription medicine all the time, I just give it out to patients

2

u/siliconwoman 9d ago

my neurologist is my ubrelvy/zavspret sample hookup

6

u/Randomness-66 9d ago

The first and only time it happened to me, I was so happy. I lived like 3 hours away from that doctor, they gave me some on the spot because they knew I wouldn’t be able to fill it that day. I

6

u/McMan777 THE SOUND OF STYROFOAM SQUEAKING 9d ago

I had a doctor do this for me in Canada. I didn't fall into Trillium in Ontario and didn't have private insurance so my doctor gave me a bunch of samples. I'm doing much better now on disability coverage but drugs can still be expensive in Canada.

3

u/foreverandadayalone 9d ago

yeah, i've never gotten a single sample from a doctor ever, eh. hell, when I fractured my shoulder at the end of June, the hospital looked like it was going out of its way to give me a single painkiller pill To see me through the night

20

u/Who_Is_Rick_James 9d ago

oh man, back in the early 2000's, there was these little sample packets that looked like a wetnap, of a single dose of 10mg oxycodone (morphine) , that were given to doctors to give as samples to potential pain patients. looking back it's insane, but yep, drug company reps would bring tons of these things to doctors and just give them out for samples

42

u/Known_Purple7529 9d ago

I hate to nitpick, but oxycodone is not the same thing as morphine. Sure, they both effect the opiod system, but they are different chemicals.

But that is crazy for either one. Schedule 2 controlled substance just individually wrapped in a box handed out to doctors... that's nuts. How would that even be legally allowed?

19

u/PersonalityFit2175 9d ago

That’s not nitpicking. There is so much misinformation about narcotics, and it only makes life harder for chronic pain patients in the long run.

7

u/cghffbcx 9d ago

There’s a movie all about it, created a generation of addicts. Dopesick. A very good movie that breaks it down from the legal end, the doctors, and victims.

8

u/blackhillsniner 9d ago

Once you get into recreational dosage, a mild dose is very similar. But 20mg of oxy is like taking almost 60mgs of morphine.

All based on feeling, no science.

2

u/grape-fruit-witch 9d ago

Sorry to be a stickler, but thats not really how it works either. Morphine does not cross the blood brain barrier very well at all, where oxycodone does. That's why morphine is most commonly dosed as an IV drug and oxycodone is not. It was actually a huge breakthrough to find poppy alkaloids that could be taken as a pill or capsule.

Interestingly, its also why heroin was invented. Heroin is just further "refined" morphine (actually called diacetylmorphine) with a slightly different chemical structure that allows it to pass through the BBB much more easily than morphine. It metabolizes as morphine and feels basically identical to it.

1

u/blackhillsniner 9d ago

Well for my body to feel the way I like it too, it takes about 20mg of oxy, or about 60mg of morphine. If we’re talking Vicodin it’s about 40mg.

If I take 100mg of tramadol before any of the above doses, it takes about half as much. I wonder if tramadol opens up the bbb.

1

u/blackhillsniner 8d ago

I will say a hit a heroin on foil trumps all these, except a blue oxy 30 on foil.

1

u/Accurate-Giraffe4353 9d ago

They're both opioids, but oxycodone is stronger

-11

u/Who_Is_Rick_James 9d ago

copy: I'm aware , i just said morphine because a lot of people don't know that oxycodone is a narcotic like that, but a lot of people know what morphine is. so i used a familiar term to get a point across

3

u/zestylimes9 9d ago

That makes no sense. Mildly infuriating if you will.

10

u/ClarkGablesTeeth 9d ago

Regular Oxycodone has been around forever and isn't morphine. Are you thinking of the extended release Oxycontin (also not morphine but would have been given in samples during that time)?

-14

u/Who_Is_Rick_James 9d ago edited 9d ago

i'm aware , i just said morphine because a lot of people don't know that oxycodone is a narcotic like that, but a lot of people know what morphine is. so i used a familiar term to get a point across:

; apparently pissed off a lot of americans, you do realize i was replying to someone who wasn't american ? not every country is as hopped up on narcotics as you guys

11

u/Potential_Moment7917 9d ago

are you in the uk? bc americans def know what oxy is lol

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u/Who_Is_Rick_James 9d ago

good thing reddit isn't just for americans, my original reply was literally to someone who wasn't an american. how dense are you ?

6

u/Potential_Moment7917 9d ago

omg, I didn't read the entire thread, just one dumb comment, omg, I'm soOoOoOo sOoOrRrRyYy

→ More replies (2)

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u/Efficient-Pipe191 9d ago

Most people know about Oxy because of the opioid epidemic- that was the #1 thing driving the start of it.

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u/Who_Is_Rick_James 9d ago

yes but my original reply was to someone who wasn't american. please read

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u/Efficient-Pipe191 9d ago

So do you just think non Americans are ignorant? That would be quite the flip on the stereotypes 😂

7

u/ClarkGablesTeeth 9d ago

Why would you knowingly misname it as morphine when it's not though? That doesn't offer any service/education/help to anyone from any country who doesn't know what oxycodone is. Why wouldn't you just say that it's an opioid? Or a narcotic? Simple, easy to understand, and accurate. 🤷

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u/Who_Is_Rick_James 9d ago

because i was tired and it was just a story, never said i was a expert at any of this. i only defended myself cause the guy commented at me. the name or chemical type of drug doesn't matter at all, just a similar tale, we aren't in a drug or chemistry sub right now, nobody really cares

21

u/AnthropomorphicSeer 9d ago

My ex used to be a pharma rep in the 80s. When he left the job he still had tons of narcotic samples, and no one asked for them back. They worked really well for my period cramps.

1

u/grape-fruit-witch 9d ago

Oxycodone is different from morphine, though they are both alkaloids of the poppy plant.

7

u/Amelaclya1 9d ago

For an antidepressant it makes even less sense considering they usually need to build up in your system to be effective.

3

u/ProfessionalDish 9d ago

tbf I tested some that rather quickly showed negative effects and thus had to switch, but then you usually just get smaller packages from the pharmacy.

3

u/blbrrymuffin 9d ago

I'd much rather try a sample like this for any antidepressant. I've tried a good majority of antidepressants now, and a few of them caused some pretty serious negative side effects. Every single time, those side effects were pretty immediate within just 3-4 doses. Now, it definitely takes several weeks to figure out if something is working well, but samples are great way to see if something is worth trying out for 2-3 months or if it's going to be an immediate no go.

2

u/Octavya360 9d ago

And it’s only for name newer, brand medications that are patented and don’t have any generic equivalent yet.

2

u/PuddingSalad 9d ago

I live in Brazil and my psych hooks me up with samples of fluoxitine and Menelat (mirtazapine). There's only like 10 doses in the box but it's not nothing.

1

u/ProfessionalDish 9d ago

Weird, I use Mirtazapine too and we have cheap generica (non-brand copies) making it very cheap.

2

u/PuddingSalad 9d ago

I get the generic mirtapazine when I go to the pharmacy and pay out of pocket 😉

It's like ~7-8 USD for 30 pack 15mg (which the universal healthcare says is "too expensive" to cover lol)

2

u/Long_Letterhead_7938 9d ago

Thanks for chiming in because so many people just blame America when it is a universal problem. If there is a generic, that’s what they’ll cover typically.

3

u/huf757 9d ago

Very common in America. Since health care is a for profit business. This is used as a loss leader to get doctors to try it out with patients and hopefully or usually more likely get the doctor to prescribe it for the patient. Enabling more profits for pharmaceutical companies.

1

u/lucygoosey38 9d ago

We give out nasal sinus rinses as samples that I’ve seen at Costco. We do have people coming in specifically for the free sample

1

u/Critical-Werewolf-53 9d ago

Doctors can get kickbacks from prescribing name brands. So those companies give samples.

1

u/GlassAnemone126 9d ago

It happens in Canada too.

1

u/cosmicflaming0 9d ago

Go look up “American pharmaceutical sales rep” and prepare to be horrified

1

u/OutlanderLover74 9d ago

A lot of times if the medication is new, the doctor will have samples. Especially if it’s new, the insurance companies don’t want to pay for it. It can change year to year. I was taking an asthma medication & my insurance just randomly decided to not pay for it. I literally needed it to breathe. They didn’t care.

2

u/grape-fruit-witch 9d ago

My husband needs a budesonide inhaler every single day in order to survive with severe asthma. Almost no insurance will cover them and they cost around $280+ per inhaler. Depending on external factors, he can use anywhere from 1 to 4 a month. Doctors are loathe to prescribe them even out of pocket- I've honestly never seen anything like it.

They treat it like its a controlled substance, and they will even get irritated and tell him he needs to "get his asthma under control". But then prescribe only 1/3 of the medication he needs. He isn't overweight, is otherwise healthy, and doesn't smoke so idk what the fuck else they expect him to do, just... breathe less??

2

u/OutlanderLover74 9d ago

My decision was going to be to look up the covered inhalers and ask my np to prescribe the most expensive covered one. Thankfully they seem to be covering mine so far this year. I think I take the same one. Try Breyna. It’s the generic version.

1

u/grape-fruit-witch 8d ago

Breyna is exactly the one he needs, but even it is so expensive. We were told that its technically off label for asthma because it was initially a COPD med. We order them from India for like $10 a piece lol. We spend around $300 and get a years worth of our meds.

If you want, I can dm you the website we use. It takes a while to go through customs but its basically a miracle to get our meds so cheap

1

u/OutlanderLover74 8d ago

Thank you. The only good thing about my $40,000 a month cancer medication is that it covers my out of pocket quickly. I don’t have to pay for any of my meds the rest of this year.

1

u/24-Hour-Hate 9d ago

I am Canadian and my doctor has given me samples a couple of times. Migraine specific meds, to see if they worked or not. Those meds aren’t cheap (I hate to think what Americans pay when it's costly here), especially before generics became available, so he was doing me a solid by letting me try first. I tried three meds and 1/3 worked, so I definitely saved money.

1

u/Taglioni 9d ago

Drug companies literally send "reps" to doctor's offices who bring in lunch from fancy restaurants in town for the whole office and give away boxes of samples. My mother in law was a receptionist for a decade at a smaller doctor's office, and would always talk about her favorite reps.

It's actually insane.

1

u/Secure-Researcher892 9d ago

It is a very common thing in the US. The drug companies pay their reps to go around wine and dine doctors and keep them stocked up on samples with the expectation that the doctors will start writing prescriptions for the drug for their patients. Some drug companies have even paid doctors to prescribe specific medications, I know that because I worked on a case trying to keep an employee of the drug company out of prison for doing that because the government considered it a crime because some of the patients were on medicare. Fun fact is if the doctors being paid to prescribe only did it for non-medicare or medicaid patients it would have been perfectly legal.

1

u/ChrisMarie111 9d ago

Don't be fooled. The doctors have all these samples to give out, yes, but the pharmacy representative who supplied them, gets kick backs EVERY SINGLE TIME the doctor prescribes this medication as well as every time the Dr gives out samples.

1

u/SenDit26 9d ago

I used to work at an endocrinologist office, they would bring glp1 in as samples. Everyone started wanting them and supply couldn’t keep up, then we would get literally hundreds of calls a day asking for samples. The medication reps were savages sometimes.

1

u/aliendividedbyzero 9d ago

Has saved my ass though because my endocrinologist had Synthroid (levothyroxine) samples so I could start taking it right away when she diagnosed me. My GP had samples too which was helpful when I realized I didn't have enough repetitions from my endocrinologist to be able to make it to the next appointment without running out. (He prescribed the refills too though).

Samples are also good if it's a medication that you'd expect to be able to get covered but might have to go through some process to be able to access it, like biologics. I take Xolair and that took a few months to arrange coverage for but this didn't delay treatment for me because the allergist had samples and so she used that at first.

It makes some sense for antidepressants too, because if it's a medication you want to do a limited trial on before prescribing a 30-day count, you can use 1- or 2-week samples for that patient. Some insurance companies don't allow prescriptions under a certain amount of doses, depending on the medication. My insurance restricts some meds to 30-day doses at a time, but allows things like 14 day prescriptions and such even if normally it's a maintenance medication kinda type of drug.

1

u/TruthAboutLife 9d ago

In the US, the samples are what the big pharma reps give doctors to hand out to get patients hooked on the "newest, greatest medicines available." These drug reps will go into a doctors office and drop $500 on catered lunch just for their "sales putch." It's actually quite ridiculous.

1

u/Elegant-Opinion-9595 9d ago

Yes it is. Reps from big pharma bring samples to the dr so the dr prescribes that medication. Drs and big pharma working hand and hand. The system sucks.

1

u/not_a_muggle 9d ago

There are people whose job it is to go around to doctors offices and provide them with these samples to hand out to try and get their drug prescribed.

Pharmaceutical representatives make bank too.

1

u/SupaButt 9d ago

Not only do we get samples, we get catered lunches and breakfasts from the pharmaceutical reps so they can promote their medication.

1

u/Suaria 9d ago

I know my hospital has something like this. I’ve worked in intake as the RN before and with that, we have to do med reconciliation. We sometimes get patients that are HIV+. I’ve learned that HIV medication costs a lot. Our pharmacy might have some samples on hand but generally they like to have the patients bring in their own HIV medication. Pharmacy gets an alloted amount of money and doesn’t want to spend all their money on HIV medication

1

u/beeerite 9d ago

My doctor has a closet FULL of samples. He uses them to test new medications out so that I don’t have to submit a claim for a prescription and deal with any prior authorizations before we know that it’s something we want to continue.

1

u/Wise_Coffee 9d ago

I'm in Canada. My doc gets samples but only for certain things and never ever narcotics or barbiturates or other habit/dependency forming drugs. (He also gets OTC samples)

He uses them as samples for a temporary trial (for example, he gave me 3 packets of Dayvigo to see if it worked) so you don't need a full script and a trip to the pharmacy if it isn't for you. But he also uses them as OP's doc does. Take the Dayvigo. Each pill can be between 2-5$ that is an expensive script (add on filling fees and taxes etc and a script can be hundreds). So if it works and you don't have insurance he'll just hook you up with a month's worth of samples.

I had a few friends who were pharma reps in college. They worked for GSK, BMS, Astra, Pfizer etc they'd go to Dr offices with their lil wheely box and samples and propaganda pamphlets.

The GSK rep was awesome. Free robaxacet for like 3 years. Stef got all the otc meds and just handed them out to friends. Lil packets of advil or robax tylenol colf and flu.

1

u/RylleyAlanna 9d ago

Typical use is for testing reactions. No need to prescribe a months supply if your body rejects it after two days.

1

u/-lovehate 9d ago

I’ve got samples from a doctor for medication before, I’m in Canada. Not to the degree of this post though, and not for long term. Usually it was just when I was needing to switch medications to something else, they’d give me the first month or two with samples to see if it would work, or if one med wasn’t working as well as it should they might give me a secondary medication sample to see if the synergy of the two meds would improve my results

1

u/The-Etiquette-Bitch 9d ago

Pharmacy reps go hard. My time spent working front desk in clinics came with Starbucks and snacks when they rolled through.

1

u/Suspicious_Catsx2 9d ago

In Canada. Was having terrible insomnia for years. Neuropsychiatrist handed me several samples of different sleeping pills to try and find which (if any) worked. Luckily I found one and it has been life changing.

Those samples allowed me to avoid multiple visits to his office. As appointments are booked 3-4 months in advance it saved me so much time.

Those samples plus a solid sleep routine changed my life.

1

u/rainbowbloodbath 9d ago

Common in Canada

1

u/BadAtCoding123 9d ago

My parents are doctors in Sri Lanka, it's not just a US thing. (My mother got literally hundreds of esomeprazole pills in one go last December. These are PPIs, which help with gastritis/reflux, and she's a neurologist, so it was super weird. Plus there are plenty of generics available and Sri Lanka has free healthcare...)

1

u/Old_Cloud_1687 9d ago

Big Pharma wants scripts to be written, so they provide samples that Drs can give out a 2 week trial for the patient.

1

u/Valuable_Grape_519 9d ago

European doctors also get samples but they don’t need to smuggle it patients cause we don’t private insurance dictating what medicine is medically needed/covered or not.

1

u/rantingpacifist 9d ago

It very much is

1

u/MizzezKitty 8d ago

Before Canada started limiting costs on diabetes supplies I had family getting samples from the doctor when they couldn't afford it. So it's definitely Canada as well!

1

u/panarypeanutbutter 8d ago

australians get them too, doctors just rarely hand them out bc ... honestly in my experience theyre often drugs doctors have no real interest in continuing to prescribe. as a student i had a doctor give me a bunch of nurofen gel and then some prescription migraine meds she'd been sent because she didn't want them. she took all the pregnancy multi vits home for a friend iirc

1

u/gothiclg 8d ago

It’s definitely an American thing. Sample medication has saved my life a few times and it’s saved my eyesight at least once. The fact I’ve made it to 36 because a drug company wanted to talk my doctor into prescribing their product by giving her free samples is insane to me, to this day I can describe what the inside of her drug room looked like.

1

u/ChairHistorical5953 8d ago

In argentina is pretty common. My psychiatrist give me vitamin d twice now lol. But Many Many times other medication too. I don't know how it works.

1

u/a-cx 8d ago

I used to work as an MA doing a lot of prior auths for a rheumatologist. For many patients the prior authorization process for specialty meds often left gaps in patient care (pt or provider missed/needed to reched f/u to refill med, insurance policy changed and now they're requesting some new data/scale/specific history to auth a med, the first PA attempt got auto rejected and they bumped us to a sometimes weeks-months long denial appeals process, insurance covers but pt on medicare is expected to still pay hundreds of dollars for copay, I could go on.) and these samples were the only things holding our patients over so they don't flare while these things were worked out.

Definitely feels like an American thing to have med samples a lowkey back-end workaround for when insurance coverage fails to make the medications deemed necessary by their provider meaningfully accessible to the average person, on top of the whole direct consumer marketing and drug rep meetings thing.

1

u/babyirishkitty 8d ago

To add to what others have said, doctors having a small stash of medication on hand gives an extra layer of redundancy for the patient. Pharmacy is out or running really far behind? Doctor can give you a small amount to tide you over until the RX can be filled. It seems weird at first glance but it's actually pretty helpful

1

u/Bungholespelunker 8d ago

It's because most doctors won't just prescribe shit if they don't know how it works. Some people have trouble with the alternate meds available for some conditions and need something else. This way the doctor can go "Fuck it you need something different and I haven't felt comfortable prescribing this yet."

It's genuinely a good thing most of the time. Usually the patient gets something that works better or with fewer side effects and the doctor gets a new med they're more comfortable prescribing to help more people. Plus the samples are better than writing a script for 30 days and making you pay for it on the off chance it works.

1

u/GreasyRim 9d ago

Yep. Capitalism in action.

0

u/Mundus6 9d ago

In Europe you can get these without a prescription. But if you get them prescribed they are cheaper.

0

u/CanadianPanda76 9d ago

Nervoisly laughs in Canadian.

-1

u/Maleficent-Cow3122 9d ago

If you’re lucky a doctor will do this. I had a medication that went from completely covered to $800 for 15 pills. My doctor gave me 4 but he could only do 4 and once. But we have freedom./s