The cost of mental health meds

I don’t want to get political here, but I think this blog might be. How does anyone without insurance do this?

I’m temporarily without prescription insurance, and my psych doc phoned in some orders for meds that I don’t need to refill immediately. But I didn’t tell that to CVS, and the pharmacy filled them and sent me a text that the meds are ready for pickup. I looked up the prices on their app. Two that I take are name-brand, not yet available as generics. A 30-day supply of one of them is over $2900, and the other is over $800. That doesn’t include the ~$150 for each generic drug!

I’ll be able to afford my meds once my new insurance kicks in, so I’m not concerned for me. But I truly wonder about this for others – for those with less or on fixed incomes.

I have a couple of friends who don’t have the insurance to help offset the costs of their antidepressants. I’ve seen their tears of frustration as they struggle for mental health and feel defeated, which just adds to depression misery.

What about folks on a fixed income with reduced medical benefits? How are they supposed to pay for their mental health medications if insurance companies remove effective medications from their approved lists?

What about newer medications that are improvements over what’s currently available, but they aren’t the reduced price of a generic drug? Many people are denied access to those improved meds, simply because the cost is out of reach.

What’s the pharmaceutical companies’ responsibility in this? Their research takes years and costs gazillions of dollars to find formulas and get meds approved, but do they recoup those costs on the back of the ill? How should this really work, and be fair? How can we get mental health medicines to the people who need it, in an affordable and timely manner? I don’t have answers, am not pointing fingers to blame. I’m truly asking – how can this be affordable? Is it the PollyAnna in me that wants this to be equal and easy?

Not another new medicine!

As I’ve written earlier, I had a long-time medication stop working for me a couple of months ago.

I’ve now been on a new medicine, a mood stabilizer, for two months, and am still adjusting to the side effects. I’ve gained 10 lbs due to the way the med changed my metabolism, but overall, I’d say the combinations of medicines is working. My main antidepressant is a different type of SSRI, and it’s been working for a couple of years. I still take an atypical antidepressant which I’ve been on for many years and it helps me with sleep, a tremendous deterrent against depression.

The goal of the psychiatrist together with the patient is to find the right medications that will affect the particular brain chemicals (basically serotonin, dopamine, norepinephrine) to the right degree – not too much, not too little, but just right, like Goldilocks would need. (Depression is definitely more complicated than brain chemistry, but that’s for a different blog post!)

Because of the serotonin toxicity that I had in 2010, my psych doc and I have been very cautious with the antidepressants I take and they way they are supposed to work with the serotonin in my brain. I am not sure how they work with the serotonin, only that I have to be careful. For example, Mayo Clinic lists 4 atypical antidepressants on the website on this topic, and I have taken 3 of them. Most atypicals have worked for me, but one (not on this list) sent me racing to the emergency room in fear I might harm myself. The thought was not my own, the medication caused it!

Yesterday I got a letter in the mail telling me that as of January 1, 2016, the main antidepressant that I take will no longer be a preferred med in my prescription insurance plan, which means I will have to pay more for it if I want to continue on it. It currently costs a little over $1/day with insurance, but will be at least $8/day without insurance. $240/month for just one medication, $350/month for all of them. That’s a big hit to the family budget!

But I can’t afford to be depressed, so I will have to go to my psychiatrist and see if we can try one of the others on the preferred list. Another med change. I’m nervous – if it isn’t the right one, it could make me suicidal, or maybe just not work at all, or it could have unbearable side effects. No matter how it goes, it’s a several-month process again.

Didn’t we just do this?

“And my God will meet all your needs according to the riches of his glory in Christ Jesus.”
‭‭Philippians‬ ‭4:19‬ ‭NIV‬‬

Ok, then. God knows about my need here. It will be ok.