- This topic has 3 replies, 4 voices, and was last updated 6 months ago by Ferret. This post has been viewed 406 times
- August 18, 2019 at 7:30 pm #11126attackingbutterfly@attackingbutterflyParticipant
Right now I’m on a rather generous insurance plan. They don’t seem to be checking too closely. As I do have something which gets me fully back on my feet though I do spend time considering future plans.
I’ve read there is some sort of coupon program for Xyrem. The ESSDS Pharmacy has been unwilling to tell me about this program. Could anyone advise me of anything about this?
Do they check your diagnosis (will they refuse idiopathic hypersomnia)? Roughly how much do you end up paying per month|year?August 19, 2019 at 7:24 am #11132mobilealguy@mobilealguyParticipant
The coupon has to do with the patient out of pocket. The coupon will be whatever makes your total out of pocket = $35. For instance, if your out of pocket for your insurance company is $125, Jazz would give you a coupon for $90 and you would owe Jazz just $35. If your out of pocket was $50, then the coupon would just be $15. So on the coupon program the patient would pay $420 a year. I’m not sure about anything Jazz might require from the physician other than the prescription, but Xyrem is used to treat cataplexy and excessive daytime sleepiness EDS related to narcolepsy. I do not know how idiopathic hypersomnia would be handled.February 4, 2020 at 2:02 pm #12222kgmelich87@kgmelich87Participant
I’ve only been on Xyrem for 2 weeks but they offered me the coupon so my medicine is $35/month. From what I’ve gathered (this is my own deduction, not anything I’ve been told by the Central pharmacy, my insurance, or anyone else), it appears that if your insurance will approve it and cover some, Jazz will kick in for the rest, or rather, waive the cost of the rest if what insurance is willing to pay is sufficient. So, I am on a high-deductible plan with a $2000 deductible and $5000 out-of-pocket max. The drug is roughly $5500/month, so my co-pay was supposed to be something like $4200, which means my insurance paid the other $1300 or so. Jazz covered the rest because they don’t expect most anyone to pay $4200 for this drug. They never asked about my household income, they just offered it. Again, this is what I’m deducing from my very limited knowledge. It’s the best answer I can come up with for why they would offer it to me for $35/month.February 4, 2020 at 2:05 pm #12224Ferret@ferretModerator
Each to his/her own. I wouldn’t take it if they paid me to take it.
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