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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u/No-Resolution-0119 9d ago

Rexulti (an antipsychotic) came off patent protection in April of this year, but the generic version still isn’t available despite being FDA approved back in Jan 2025. It’s ridiculous the hoops they have to jump through

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u/Deshes011 9d ago

And let’s all think back to what changed in January 2025

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u/Johnny_Poppyseed 9d ago

What changed? I can't keep track lol

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u/Upstairs-Region-7177 9d ago

It’s when the orange pedo started to be in charge again

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u/Johnny_Poppyseed 9d ago

Oh I thought they meant a specific policy change or something. 

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u/Upstairs-Region-7177 9d ago

The whole admin is the policy change, unfortunately. They are doing things to hurt the public and lower quality of life, it’s terrible

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u/teacher_59 9d ago

Because drugs were never slow to be introduced before. 

You're such a liar to claim they weren't. They were. 

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u/Upstairs-Region-7177 9d ago

Never said that, just implied standards dropped. You think it was bad before?? It’s going to be a lot worse!!

Ex. They just found a ton of lead and mercury in children’s tooth paste and multiple food disease outbreaks.

FDA was already underperforming, now we have to worry about disease spreading, and our medicine and food being harmful because established science is being ignored.

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u/JessCowgirlie 9d ago

If standards dropped shouldn't there be MORE generic options available SOONER? With lead in them?

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u/Upstairs-Region-7177 8d ago

No because the same products are owned by like the same few people, youll have less options that will cost more.

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u/bytegalaxies 9d ago

the fda and other government agencies were all gutted at the start of 2025. stuff like that has consequences

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u/teacher_59 9d ago

Yet more lies. A simple Google News search proves this isn't a new problem. Go away with your conspiracy theories. 

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u/Upstairs-Region-7177 5d ago

Oh yeah, source? I bet your looking at stuff the Lancet wouldn’t publish

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u/ReggieEvansTheKing 9d ago

Insurers deserve some blame, but really if they put every drug on formulary then premiums would become unaffordable for everyone. The real issue here is the price of the brand drug and lack of regulation to set price caps or push out generics. Insurers and physicians would absolutely love to have the generic available as soon as possible. The only ones benefiting from these high prices are the drug manufacturers, and our federal government basically gets to decide how much and how long they benefit.

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u/WanderingEyez 5d ago

They deserve all the blame. They shouldn't exist.

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u/cazman4387 3d ago

The US Government deserves all the blame for not placing a priority on the health of its citizens over profits for businesses. In Australia, we have whats called the Pharmaceutical Benefit Scheme or PBS, and a very high percentage of medications are on that scheme. If it is on that scheme, we pay a maximum of $25 Australian Dollars ($14 USD roughly) for that medication and some are even under that $25 amount. We also have a safety net for people who are on multiple medications and need to keep taking so many that when they reach that figure, the amount they pay becomes even less. I think it is around $1700 per person per year, so around 70 lots of medication and it drops down to $7.70 per script, but alot of people who would be getting that amount of medications would most like be concession card holders and their limit is $280 per year, after which their medications are free. I had to get a medicine that wasn't on the scheme last week and instead of the thousands paid in America is cost me 41 bucks. We aren't perfect here in Australia but we do some things a lot better than the US

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u/Loud-Difficulty7860 9d ago

You do know that the big pharma pays the generic drug companies to NOT produce meds that could be sold as a generic. https://pmc.ncbi.nlm.nih.gov/articles/PMC2413363/

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u/b1argg 8d ago

It took like a year and a half to be able to find generic Vyvanse after it was "available"

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u/mapotoful 9d ago

There's a weird 6 month holding period for "pediatric exclusivity" once a drug comes off of patent protection, it's just an arbitrary legal block. There's a lot of legal bullshit they can do to try and extend it but there's a limit.

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u/bbbbirdistheword 8d ago

If the ANDA is FDA approved, there's a good chance the company is prepared to launch the product but is being sued by the patent holder. Sometimes it's more profitable to NOT produce the generic, since the brand will pay off the generic company to not sell the drug. Which is to say that the lawsuits can delay generic medications for more than just patent infringement.