Generic vs Name Oxycontin

[RosiePosie]

Hello,
I have been on Oxycontin now for nearly 8 years and was a member of this community many years ago when I was first seeking help for my chronic pain. I haven't been back in quite a while though because my pain has been getting treated effectively and I have been able to go on living my life and enjoying life again with only mild pain and discomfort. I have always been responsible with my pain meds and consider myself a success story for chronic pain management. However, I am back now with a question that I hope someone with some knowledge can help me with.

My health insurance (Health-net) has been paying for my monthly prescription for the generic Oxycontin with a $50.00 co-pay every month with no problem. However, I understand that there has been some sort of a law suit and now they can no longer make generic oxycontin. I am very worried because I have an appointment on Tuesday to get my meds and I don't know if my health insurance is going to continue with the $50 co-pay for "name brand" Oxycontin. My pharmacist told me last month that they are now out of the generic and I will have to get name-brand from now on. Has anyone else run across this problem? Did your insurance company pay for the name brand and continue with your normal co-pay? I understand that Oxycontin is a very expensive medication and I'm certainly in no position to pay full price. If anyone can offer some insight on this, I would appreciate it. Thank you...Rosie

[Kira]

I have not had this issue with oxycontin, since I'm on different meds.

I would look on your prescription insurance card for a phone number, though, and ask them if it is covered. If they say no, I would ask them what you need to do to get it covered... a lot of times it is just an issue of getting your doctor to fill out some paperwork (pre-authorization or something similar).

Another option is to see if your prescription insurance plan has a website that lists their formulary (list of covered drugs).

You could also call the pharmacy and ask them, since they have probably dealt with the same issue for other patients.

If they fight you on it and say that it's not covered, find out what steps you need to take to appeal their decision, and then do it. It is often just a matter of getting someone, somewhere, to fill out the right forms... I think that sometimes they just assume people aren't going to bother jumping through all of their hoops. If they give you a hard time, stick up for yourself and don't let them bully you. :)

[Gimpy]

I had just started taking the oxy and I only got the generic version for one month. When I went in next month they were out and I had to get name brand. My insurance charged me $50 for 60, 10 mg. This month I went in after we made an adjustment and it was $35 for 60, 20mg! Go figure!!!! I have no idea who my insurance works. It seems they change at will.

Linda

[Mark N]

Rosie, I don't know the situation with your insurance but with mine it pays for name brand if no generic is available. I hope your insurance works the same way.

[NJPain]

Not to scare you but, 120, 80mg oxycontins cost around $1500. No joke. From the pharmacy they are like $12/each which warrants their $40-$50 street value.

I found a prescription website and all I had to do is give them my name (not even my address) and my email address and I could print out a prescription card. That card saves me $200 every month on my prescription. I have a 80/20 thing with my REAL insurance which doesn't know about my print out prescription card thing. Why would they care, they are saving money too, right?

The only other narcotic out there compareable to oxy is methadone and let me tell you, a month's supply is like $40. Methadone is like a wonder drug. The reason kids die from it is because they think it will get them high and it doesn't. Hate those Nazis but damn they were some real genius people, they invented Methadone due to the fact Hitler didn't want to be dependant on opium from the East.

It's amazing.....with oxy you get relief but you are always thinking about your next dose. With methadone, it's like you never think about it. A lot of times I miss a dose it's like the whole mental thing is removed with Methadone.

The reason I never stay on it is because with my broken back, I would need A LOT of Methadone to be comfortable like I am with oxy and that scares me.

Tolerance and a worsening condition has allowed my dose to escalate into the 80mg oxys and I decided I would never go any higher. To do that, I use my dad's methadone to take small breaks and it's really quite amazing. I totally stop thinking about medications while on Methadone but it doesn't come close to the relief I need. Takes away any withdrawals but I just dont' want to escalate the Methadone. My goal is to one day just do it and get on Methadone full time as I am recommending for you to consider too.

Ask you doc that you want to control your tolerance and maybe try methadone for just one month, with the idea of getting right back on the oxy the following month. My breaks are only a week at a time.

Also, say goodbye to constipation too cause Methadone stores up in your liver and NOT in your colon. Opioids, where ever they are stored, by their nature will make you slightly constipated but not NEAR as bad as oxycontin constipates you. As stated earlier, your finances will be much enhanced when you go to pay for your Methadone prescription as opposed to your oxycontin prescription.

Good luck.