Friday, December 19, 2008

$424 For A Sinus Infection...WTF!?

I just don’t understand it, $424 for a sinus infection? WTF!

As most of you know, I’ve been feeling under the weather as of late, for weeks I’ve been fighting it, but last Sunday, I caved so to speak and got really sick. A horrible cough, a really bad case of laryngitis, clogged ears, a pounding headache and a low-grade fever. Ironically, my throat didn’t hurt and my blood sugars were fine. Actually, more then fine – they were textbook perfect. I’m still not sure why they didn’t go all haywire on me. Maybe it’s because I raised my basal rate before the onslaught of sickness and I barely had an appetite so my carb intake was minimal to say the least.

On Tuesday I finally went to the Dr. and was given the full battery of tests. A Strep culture, chest & sinus x-rays, and a white blood cell test.
And according to the films, yours truly was diagnosed with quite the nasty sinus infection. To quote the Physician:,

"It’s really bad
Kel, one of the worst I’ve seen in quite some time. Your sinuses are A MESS"

"GREAT – thanks.' But then I said to myself:

"OK, it could be worse, it’s treatable, and according to the Doc, I should be feeling back to my old chipper self in a few days"

So off to the pharmacy I went, armed with 2 prescriptions, 1 for Allerx and 1 for Augmentin. Twenty minutes later, my order was ready and the Pharmacist rang me up.

she said cowering – AND YOU HAVE INSURANCE!"

YES, you read correctly $424.38. Out of pocket, to be reimbursed a lousy 40% (or $169.74) by my insurance as these drugs did not come in a generic form.

I did a double take and thought WTF?!

"UMmmm, I don’t think so. THERE'S NO WAY A SINUS INFECTION COSTS $424.
This is not a chronic condition, there has to be an alternative. I mean, it’s a SINUS INFECTION," said I all ticked-off and yet truly amazed at the same time.

The pharmacist looked at my and said, “Ah, yeah – that’s crazy.”

I wanted to know what the cost was without the insurance.

The Augmentin (which they were charging me a whopping $196.38) would go for a price of $225 sans insurance. And the Allerx (which they were charging me $228) would be $260 without insurance.

Needless to say, I told them to keep the drugs and I would have my Doc call in another RX in the morning.

After suffering through another night of major coughing, which no amount of Nyquil or humidifying could help, I called the Doc and who called in an RX for Clarithromcin ($16.70) and was told to buy some Claritin ($18.99 for a 20 count pack) and a Neti pot ($14.99 and by far the most helpful)

SO, $424.38 verses $51.68. You don’t have to be a rocket scientist to realize what a rip-off the first price was.

I don’t care how much research goes into those drugs, $424.38 is highway robbery for a freaking sinus infection! And I have insurance! My diabetes drugs/supplies don’t cost that much!

Do the insurance companies want us to stay sick Or, do they just not care if we ever get well? 

I just don’t get it, in the season of giving and good will towards our fellow man, I feel as if I was about to be “taken” for a ride in order to get better and I want to Kick someones ass majorly! WTF?


Scott K. Johnson said...

Holy shyte! That is incredible!

Hope that you are feeling better soon Kel.

Colleen said...

Good for you for getting the doctor to prescribe something else. Hope the drugs work and you're feeling much better soon.

k2 said...

I know - INSANE. Yes, today is the first day I didn't crawl in bed right after work, so, I got that going for me!

Colleen -
Drugs are kicking in as of today - I am back in dblogville, like it or not!

Lee Ann Thill said...

Wow... I'm pissed just reading about it! I can only imagine how unhappy you were. I'm glad you were able to find a less expensive alternative. That was a WTF moment, for sure!

Glad you're starting to feel better. Hopefully when you're healthy and the holidays are behind us, we can finally get together :)

k2 said...

Lee Ann -
Yes, it was a total WTF moment, if there ever was one!
Slowly starting to feel better and looking forward to you and I having lunch VERY SOON!

Anonymous said...

hope you're feeling better soon Kell. Glad to hear you're using the neti pot ;)

landileigh said...

i think it is absolutely ridiculous how pharmaceutical companies gouge us all out.

hoping that you are getting some relief from the new items your doctor ordered you.

oh and don't forget to relieve the pressure in your ears, it helps sinus infections too!

k2 said...

Em -
Starting to see the light - the Netti Pot really heped!

Landleigh -
YES - insurance or not, they seem to try and squeeze every last dollar out of us in the name of "good health."
Forget the fact that the sticker shock of the drug prices were enough to give me a coronary!
The Netti Pot REALLY helps w/ the ear pressure!

Karen said...

I agree, WTF?????? I'm glad you are feeling better already. Hurray for that Netti Pot!

Brensdad said...

One time I decided to calculate how much insulin would cost by the gallon. I don't remember exactly, but it was in the neighborhood of $30,000 per gallon.

Jill said...

Geesh Kel!! That's terrible :( How are ya feelin now after a few days on the other meds?

It makes ya wonder if the insurnace companies and docs are in on it together...prescribe the 3rd tier drugs first and then if they cant pay bump down to the cheaper ones! Grrrrr!

I know for us...with insurance Kaceys diabetes supplies (insulin, pen needles, test strips and lancets) are $160 a month! I asked what the insulin was without insurance and its $220 for 5 pens vs. $50 with insurance. Its crazy!!

I sure hope you're feeling better before Santa comes :)

k2 said...

Karen -
The Netti Pot is amazing!

Brensdad -
WOW! But the more I think about it, $30,000 unfortunately, sounds about right~

Starting to feel much better Still have a nasty cough, but nothing like last week. The cheaper meds are doing the job!
I'm all about conspiracy theories as for as drug & insurance companies are concerned - the numbers speak for themselves.