Caremark is one of the largest pharmacy benefit management companies in the country, so if you’re not sure who administrates your prescription drug coverage, you should check with your health insurance as soon as possible so you don’t get stuck with prescription drug claims that can’t be reimbursed. Pharmacy benefit companies like Caremark negotiate contracts with employers and handle the prescription drug benefit part of their health plans, paying pharmacies to fill prescriptions.

The announcements come as tense negotiations between the two prescription drug giants over prescription drug reimbursement broke down recently. Walgreen’s, the largest drugstore chain in the country, receives about 7 percent of its revenue from Caremark prescriptions, or about $4.5 billion in its last fiscal year. Caremark handled almost 660 million prescriptions in 2009.

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Plavix (an anticoagulant often used to prevent blood clots), Advair (a corticosteroid used for asthma), and Flomax (an alpha-adrenergic blocker often given to men with enlarged prostates) head the list of prescription drugs most often ordered online from Canada, and most of the prescription drugs ordered most often by Americans are brand-name prescription drugs that treat chronic conditions like asthma, high cholesterol, hypertension and diabetes. Considering that ordering prescription drugs online from Canada is illegal, it’s really no surprise the Americans who most often take the legal risk to order their prescription drugs from Canada use the drugs to treat chronic conditions that need treatment on a daily basis.

The rest of the CIPA most-ordered list includes: Asacol (for inflammatory bowel disease), Nexium (an antacid), Zetia, Crestor and Lipitor (for treating high cholesterol), Synthroid (for hypothryroidism), Prandin, Januvia and Actos (all diabetes medications), Premarin (estrogen hormones used to treat menopause symptoms), Celebrex (a nonsteroidal anti-inflammatory) and Dilantin (an anticonvulsant used to treat epilepsy).

As always, we do remind you that buying prescription drugs from Canada and bringing them into the U.S. is illegal, although the U.S. government generally does not enforce this against Americans who bring small amounts (90 day supplies or less) of prescription drugs into the U.S. for personal use.

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Elvis Approves This Post!

For more on finding affordable prescription drugs, visit us at MyHealthCafe.com:

Basic Tips For Saving On Your Prescription Drugs

Finding the Most Affordable Drugs Where You Are

Generic Drugs-What Are They? Are They Safe

If you have any questions or comments about how to use the website and the blog in the meantime, please feel free to contact us at myhealthcafe@gmail.com. We’re looking forward to what’s coming next for MyHealthCafe.com and we hope you are too!

The MyHealthCafe.com Team.

Patient assistance programs are programs that have been established by pharmaceutical companies to offer free or very low-cost drugs to patients who would otherwise be unable to afford them. Many of the best-known and most prescribed drugs are available through these programs. All of the major pharmaceutical companies offer some kind of patient assistance program including Abbott, and Johnson & Johnson, Novartis and Takeda, although the rules and eligibility requirements vary from company to company. Patient assistance programs are also known as pharmaceutical assistance programs, indigent drug programs, medication assistance programs, and charitable drug programs.

Instead of making patients search through dozens of pharmaceutical company websites trying to find the patient assistance program that they need, the PPA helps simplify the process by giving patients access to information on 475 public and private patient assistance programs, including nearly 200 programs offered by pharmaceutical companies. PPA member programs offer more than 2,500 brand-name medicines, including a wide range of generic prescription drugs. In addition, more than 40 of the patient assistance programs focus on the medication and healthcare needs of children.

The PPA program is free and confidential. Once you provide the PPA website with some basic information related to your prescription drugs, income, and current prescription drug health insurance coverage, PPARx.org website will be able to tell you what patient assistance programs you may be eligible for.

For more on the Partnership for Prescription Assistance (PPA), visit their website at PPARx.org.

For more on patient assistance programs, finding affordable prescription drugs, and how to save on your prescription drugs, visit MyHealthCafe.com:

Basic Tips for Saving On Your Prescription Drugs

Finding the Most Affordable Prescription Drugs Where You Are

Patient Assistance Programs and How They Can Help You

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Legally, under the Newborns’ and Mothers’ Health Protection Act (NMHPA) of 1996, if a health insurance policy covers hospital stays for childbirth, it must offer some basic minimums in coverage in connection with those hospital stays:

• For a vaginal delivery, your health insurance policy must cover a hospital stay of at least 48 hours. For a caesarean delivery, your health insurance must cover a hospital stay of at least 96 hours. These are only minimums; your health insurance may cover a longer hospital stay. Of course, if mother and child are doing well and the doctor agrees, parents may choose to leave the hospital with their newborn earlier.

• The 48-hour and 96-hour hospital stay minimums begin at the time of your child’s delivery, not at the time of hospital admission or the beginning of labor. If delivery occurs outside of the hospital (for example, in an ambulance), the clock starts ticking upon admission to the hospital.

• Health insurance companies are not allowed to offer you incentives or pressure you to cut short your hospital stay. They also may not deny you or your newborn child eligibility or continued eligibility to enroll or renew coverage under your health insurance plan or individual health insurance policy.

• Health insurance companies also cannot require you or your attending physician to show that the 48-hour (or 96-hour) stay is medically necessary. However, your health insurance may require you to get permission for any portion of a stay after the 48 hours (or 96 hours). In addition, your health insurance may require you to notify it of the pregnancy in advance of the hospital admission if you wish to use certain doctors or hospitals, or to reduce your out-of-pocket costs.

• Your health insurance is allowed to charge co-payments during your hospital stay, but any health insurance co-payments that are charged after delivery cannot be higher than co-payments charged before delivery. So, if your co-payment for your hospital stay is $50/day prior to delivery, it cannot be more than $50/day after delivery.

Please note that these rules do not apply if your health insurance does not cover hospital stays for childbirth, but most health insurance is already required to cover maternity care. Federal law requires companies with 15 or more employees to provide coverage for maternity care if they also cover other temporary disabilities, and 18 states extend the requirement to small group and/or individual policies.

By 2014, all health insurance will be required to provide maternity coverage. All health insurance offered on a health insurance exchange will be required to cover maternity as part of the required “essential health benefits package,” and maternity coverage will be required for all small group and individual health insurance policies as well.

For more on pregnancy, maternity coverage and related topics, visit MyHealthCafe.com:

What You Need to Know About Pregnancy and Your Health Insurance

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Elvis at Rest

In actuality, he is the Deepest of Nappers, Messiest of Eaters, and Fiercest of Jumpers on Furniture. (He used to also entertain himself by beating up the other neighborhood animals, but we’ve had a few talks about that, and now he mostly restricts himself to a few kitty war cries from time to time.)

Elvis the Cat is also a huge flea magnet, which brings us to why he’s the star of today’s blog on prescription drugs. A couple of years ago, Elvis the Cat’s fleas were so bad that fleas infested my entire apartment. Friends and family refused to come over until the fleas were eradicated, and since holistic pet meds didn’t seem to do much (diatomaceous earth, anyone?), in desperation I turned to prescription flea drops.

The prescription flea drops solved Elvis’ flea problem. Unfortunately, the total tab for a six month supply of Frontline Plus prescription flea drops can run as much as $105, not a very affordable option when you’re trying to save on your own prescription drugs let alone your pet’s. But even on sale at PetCo online, the Frontline Plus prescription flea drops are $68 (plus shipping and handling) for a six month supply. Other online pet suppliers carry the same six month supply of Frontline Plus for between $65 (USPets.com) to $75 (Amazon.com), all before shipping and handling.

Faced with a prospect of a miserable summer of flea-dom (for both Elvis and me!), I took to the Internet again, determined to find a more affordable option for Elvis’ flea drops, and confirmed what I had suspected:

Not only are my prescription drugs cheaper in Canada, but Elvis the Cat’s prescription drugs are, too! A quick scan through Canadian online pet stores show a six month supply of Frontline Plus routinely selling for $55 (plus S&H). ThiftyVet.com offered the lowest price I could find for a six month supply, a bargain-basement $45.99 plus $5 for shipping and handling.

For comparison, the most expensive prescription drug I use is Losartan Potassium, brand name Cozaar. Losartan Potassium routinely runs between $65 to $75 for a 30 day supply here in the United States. A 90 day supply of Losartan Potassium isn’t much cheaper, usually running around $200. However, Canadian online pharmacy ABCOnlinePharmacy.com offers 112 tablets of Losartan Potassium for $125, a more than 30% savings. A Losartan generic is even cheaper, less than $55 for a 90 day supply.

So Why Are Prescription Drugs (Both Pet and Human) Cheaper in Canada and Other Countries?

It’s no fluke that prescription drugs are cheaper in Canada and most other countries. The Canadian government strictly regulates prescription drug prices, and puts a ceiling on what prescription drug manufacturers can charge for their drugs in Canada. In addition, other countries, including Canada, allow drug manufacturers to start selling generic equivalents for brand name prescription drugs before they can here in the United States, like the Losartan generic I found on ABCOnlinePharmacy.com. It all adds up to much more affordable prescription drug prices.

But Is Buying Prescription Drugs from Canada Safe? Is It Even Legal?

Before you go running off to buy prescription drugs from Canada, here are some important things to keep in mind:

Under federal law, it is illegal for anyone to except a drug manufacturer to bring in prescription drugs from a foreign country, so technically it is illegal for you to buy your prescription drugs from a foreign country and bring them into the United States or have them shipped to you here. This includes prescription drugs which are originally manufactured in the U.S. and exported to a foreign country which you may want to bring back to the U.S.

That being said, the FDA generally does not take action against individuals bringing in small amounts of prescription drugs (usually a 90-day supply) for their own personal use. Of course, enforcement is up to FDA discretion, but their guidelines prioritize going after drug rings rather than your average senior citizen ordering their monthly prescription drugs from Canada.

However, there are basic safety risks in buying prescription drugs from a foreign country, especially if you are buying drugs through an online pharmacy. Anyone can set up a “pharmacy” online, and it can be extremely difficult to verify that you are actually receiving your prescription drugs from a legitimate source. Some online pharmacies have been known to ship substandard drugs, drugs that are past their expiration date, drugs that are too strong/weak, counterfeit drugs or drugs that have been sourced through countries without adequate safety standards.

In addition, prescription drug trade names are not standard across countries so there is a risk that by ordering Flomax (which in the U.S. is a medication for an enlarged prostate) you will receive the drug known as Flomax in Italy (which is an anti-inflammatory drug).

So, if you’re going to buy prescription drugs from Canada or elsewhere, be cautious and careful. The potential savings on prescription drugs can be significant, but you don’t want to do anything that would jeopardize your health or well-being.

For more on savings on prescription drugs, visit MyHealthCafe.com:

Basic Tips for Saving On Your Prescription Drugs

Generic Prescription Drugs-What Are They? Are They Safe?

O, Canada? Buying Prescription Drugs From Online Foreign Pharmacies

Where do you get your prescription drugs? Have a favorite online pharmacy? Tell us about it at the MyHealthCafe.com Forums.

However, it is expected that President Obama will be trumpeting features of the healthcare reform like the Medicare Part D “Doughnut Hole” checks, the first of which will be mailed on Thursday. The $250 checks are the first step in the Obama administration’s plan to close the infamous “doughnut hole” in Medicare Part D’s prescription drug coverage.

President Obama will be addressing seniors in a “tele-townhall” format from a senior center in Wheaton, Maryland starting at 11:40 a.m. Eastern Time. The broadcast will be available on both C-SPAN and via the Internet at WhiteHouse.gov.

For more on Medicare Part D, prescription drugs and related topics, visit MyHealthCafe.com:

Medicare Part D-the Basics

Medicare Part D-the Doughnut Hole and Me

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Hundreds of common generic prescription drugs are available for $4 for a 30-day supply at numerous large retailers around the country, including Wal-Mart, Sam’s Club, Costco, Target, Kroger’s, and Safeway, just to name a few.

With many prescription drugs having co-payments of $10 or more apiece and retail prices of much more, being able to fill a prescription for $4 for a month’s supply can mean a significant savings to many. It can represent a huge savings to someone with a chronic condition who needs several prescriptions a month as many senior citizens do.

For example, if you usually take 4 separate prescription drugs with a co-pay of $10 apiece, the cost of your prescription drugs would usually be $480 annually. Switch to generic prescription drugs at a cost of $4 apiece, and your annual prescription drug costs drop to $192 annually, a savings of $288.

Getting started can be as easy as taking a list of the prescription drugs that you currently use to your doctor along with a list of the generic prescription drugs available on the $4 generic prescription drug problem at your local Wal-Mart, Sam’s Club, Costco, Target, etc.

If any of the available $4 generic prescription drugs is an acceptable substitute for the drugs on your list, you can switch your prescription to the new pharmacy which is usually as easy as a telephone call. If your doctor is willing to write a prescription for a 90 day supply, your costs can be even lower, usually $10 for each 90 day supply.

For more on saving on your prescription drugs, generic drugs, and other related topics, visit MyHealthCafe.com:

Basic Tips for Saving On Your Prescription Drugs

Generic Drugs-What Are They? Are They Safe?

Want to talk about it? Visit the MyHealthCafe.com Forums.

The COBRA health insurance subsidy was a godsend to the thousands of unemployed who received it as part of the economic stimulus package. First passed in February of 2009, the COBRA health insurance subsidy gave the thousands unemployed during the economic downturn an affordable way to maintain their health insurance for an extended period of time and hopefully, until they could find another job.

Generally, COBRA allows people who leave their job to keep their health insurance through their former employer for 18 months, as long as they pay the full health insurance premium plus an administration fee or 2-3%. However, with the full cost of a family health insurance plan averaging over $13,000 annually, health insurance even through COBRA isn’t affordable to most on an unemployment check.

By subsidizing up to 65% of the COBRA health insurance premiums of those who were laid off, the federal COBRA health insurance subsidy gave many unemployed Americans a realistic chance to maintain their health insurance until they could find another job with health insurance. However, the COBRA health insurance subsidy only lasts 15 months, and the first recipients of the COBRA health insurance subsidy are seeing their benefits expire.

What To Do for Health Insurance if Your COBRA Health Insurance Subsidy is Expiring

If your COBRA health insurance subsidy is expiring, don’t panic! You still have some options for health insurance even without the COBRA health insurance subsidy. Here are some of your most likely health insurance options:

• Health Insurance through COBRA without the Subsidy. Even though the COBRA health insurance subsidy is expiring, you are still eligible for health insurance through COBRA for another three months. Depending on your health status and if you have a pre-existing condition, this may be your best and most affordable option if you need medical care during those three months.

• Private Health Insurance. If you are young and healthy, your may be able to find an individual health insurance policy that covers your healthcare needs and is more affordable than health insurance through COBRA.

• State “Mini-COBRA.” 40 states offer so-called “Mini-COBRA” programs which supplement the main federal COBRA benefits. Mini-COBRA can provide additional health insurance benefits for up to 36 months but can also be an expensive option.

• Medicaid. If you are a low-income American, you may qualify for health insurance coverage through Medicaid.

• State High-Risk Health Insurance Pools. If you have a pre-existing condition and are turned down for private health insurance, you may be eligible for your state high-risk health insurance pool. (Although the new federal high-risk health insurance pools under healthcare reform will be both more affordable and more comprehensive in coverage than the state pools, in order to qualify for a federal pool, you must have been uninsured for at least six months).

• The Children’s Health Insurance Program (CHIP). Even if you are unable to afford health insurance for yourself, your children may qualify for the Children’s Health Insurance Program (usually called “CHIP”).

For more on health insurance options, visit MyHealthCafe.com:

COBRA-What You Need to Know

Pre-existing Conditions-What You Need to Know

Medicaid-What Is It?

State High-Risk Health Insurance Pools

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Moreover, the public health costs can be staggering of non-vaccination can be staggering. A single unvaccinated child exposed to the measles virus while abroad resulted in the San Diego measles outbreak of 2008 which included exposures of nearly 850 people to the measles virus, 11 actual cases (all unvaccinated children) and the hospitalization of one infant too young to be vaccinated. Total cost to the public: more than $175,000, enough to cover vaccinations for nearly 180,000 children.

So we thought the Los Angeles Times article by pediatric resident Pamela Nguyen this week was particularly interesting. In the article, Dr. Nguyen describes the an encounter with a mother who despite understanding the dangers of measles and other vaccine-preventable diseases still knowingly chooses not to vaccinate her child:

And yet, many parents continue not to vaccinate their children. I see such children frequently. Last fall, when I entered an examination room, a 5-year-old patient loudly yelled “Get out!” Her mother apologized, then explained. “Sorry, she’s never gotten S-H-O-T-S before.”

Confused, I looked down at the chart to confirm that the patient was in for H1N1 and seasonal flu vaccines. Seeing that she was, I seized the opportunity to offer her catch-up vaccines as well, but her mother declined. She explained matter-of-factly that it was because the flu was “going around” whereas the other vaccine-preventable diseases, she said, were no longer a threat.

She went on to tell me that she was a lawyer who had grown up in a country where measles is still endemic. Since moving to the U.S., she had never known anyone to suffer from measles, but she did know several children who had autism. So, while she understood that vaccinations had not been definitively shown to cause autism, she felt that, here in America, the risk of autism was a bigger threat than that of vaccine-preventable diseases.

So we thought today we would ask you all if you vaccinate your children, and if not, why not?

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