[blueash]

Originally Posted by heims01

If there is any issue we should pay attention to regarding who votes which way this is one. You can follow those things and let your congressional representatives know you are and how you feel about it. Our form of government does require an educated public. I just don't know if in fact this would reduce availability of drugs like Eliquis. I have used a Canadian pharmacy for the first time in my life for this drug and another called Jublia, both of which are ridiculously expensive if you're on Medicare and in the donut whole.

You may be making a potentially costly mistake. While you are in what used to be called the donut hole you do NOT pay the retail cost of the medication. Rather:

"Once you reach the coverage gap, you'll pay no more than 25% of the cost for your plan's covered brand-name prescription drugs. You'll pay this discounted rate if you buy your prescriptions at a pharmacy or order them through the mail. Some plans may offer you even lower costs in the coverage gap. The discount will come off of the price that your plan has set with the pharmacy for that specific drug.

Although you'll pay no more than 25% of the price for the brand-name drug, almost the full price of the drug will count as out-of-pocket costs to help you get out of the coverage gap."

For Eliquis, the retail cost of 3 months is about 1500. But you will only pay 25% or 375. That is likely not much different than your Canadian cost. Purchases via a Canadian pharmacy, thus outside your Medicare plan, also do not count toward getting out of the coverage gap. For that 1500 Eliquis, 1425 would be applied to your getting out (95%)

You need to look at not just the cost of the medication but the overall result of paying your 25% on the big picture. I might also add that Jublia is a not covered medication in some Medicare plans as it has a very low complete cure rate, only about 10 to 15% better than placebo when using it every day for an entire year on nails where only a maximum of 50% of the nail was involved, the easier cases to cure. [see also table 2 in the link from the package insert] It did slightly better [additional 5%] if you define cure as mostly better. So if you are self paying, you may want to balance the cost against the likelihood of benefit. Photo from the manufacturer's website: