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A Less Bitter Pill

I NEVER SAW THE NEED to buy prescriptions from anywhere other than the local pharmacy until—for reasons that still aren’t clear—a medication I’ve been taking for years jumped in price.

Until January, I’d been paying $8.86 a month for the medication through my Humana Medicare Advantage plan. Suddenly, it jumped 200% to $26.85. In a series of calls, Humana agents gave me the following varied reasons:

  • The manufacturer increased the price.
  • I’d reached my donut limit for co-pays, which wasn’t true.
  • My health care provider didn’t respond to a request for additional information—a request I never heard about.
  • The manufacturer changed the drug from Tier 5 to Tier 4, which meant the drug went from a 33% co-insurance payment to a $30 maximum co-pay. This might be the correct reason, but it took multiple calls to find this out. The situation is absurd and has me reconsidering Humana when open enrollment comes around again at the end of the year.

I decided to see how much the generic alternative would cost through Mark Cuban’s Cost Plus Drug Company. I had to register online and provide a form to my doctor’s office. I’m now getting three months for just $40.26 plus shipping. I chose the faster shipping because I was worried my medication wouldn’t get here before I ran out of pills, which must be taken daily. Conventional shipping is just $5. Faster shipping is $15.

But even at $55.26, I’m saving money. Three months through Humana would have cost $80.55. I expect future refills will require only regular shipping for a total of $45.26 or $15.09 monthly—a savings of $35.29 a quarter or $141.16 a year. I received a $6 discount for ordering three months’ worth at a time, which also saves on shipping charges compared to buying every month.

Cuban’s start-up eliminates “pharmacy benefit managers” and negotiates directly with the manufacturers. While Cost Plus works with some insurance plans, mine isn’t one of them. Consumer advocate Clark Howard said this about Cost Plus: “There’s a lot of dirty dealing that goes on from those pharmacy benefits managers that handle those prescription plans…. Mark Cuban is trying to make drugs clearer, simpler and cheaper to buy.”

The company has grown to two million customers since its 2021 launch and now offers more than 1,000 prescriptions. All have been generic drugs until this past March, when the firm offered its first brand-name medication, a drug for hypothyroidism.

This was my first time ordering drugs from somewhere other than CVS or a similar pharmacy. I was a bit wary—but I took comfort from Cuban’s name credibility.

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Severly Independent
3 years ago

I have Part D with Wellcare which has a reasonable premium of about $11/month. I get two of my prescriptions through their preferred pharmacy CVS for zero co-pay. I have been getting my other prescriptions (non-insurance) from Cost Plus which has a lower cost than CVS’ co-pay even with handling and shipping added.
The service and responsiveness from Cost Plus has been excellent. The only disappointment is that I just received notice from Cost Plus that the handling fee is going up by $2 which will narrow their price advantage.
I find GoodRx cumbersome to use. They have a premium and regular level pricing. Premium level pricing is not accessible without monthly membership. The only time I check them is if it is a one time prescription.

L. Williams
3 years ago

My local news had story about Scriptco pharmacy in Waco that sells medications at wholesale prices. The two drugs I take: Amlodipine for .30 for 30 day supply and Rosuvastatin .70 for 30 day supply. Sounds great. But they have a membership fee, so this website would only be good for people that have very costly drugs.

Mark Hirsch
3 years ago

Humana. This is my first (and last) year with Humana. They have barraged me with sales pitches for their Mail-to-home drug plan. I was completely surprised that you didn’t get a pitch for their plan when you called about pricing. Or you decided not to mention it.
I have to wonder about big price jumps through a company that offers a competing service.

5Flavors
3 years ago