Back in April, reader B. e-mailed the Consumerist tipline about a change to his health insurance plan’s prescription drug schedule. It raised a drug that he’s taken for years, the generic version of Prozac, to a different schedule—more than tripling B.’s co-pay, from $8 to $25.

He wrote, in part:

I don’t know how many people are affected by this, but I bet quite a few. I’m certainly annoyed by it. I’ve been taking Prozac for years. I remember how nice it was the day it went generic (fluoxetine hcl) and my prescription drug insurance cost went way down. It’s been generic for a long time now.

United Health Care has a three tiered prescription drug program. Tier 1 for generics (the cheapest, was $8 now $10 for 30 days supply), Tier 2 for name brand ($25) and Tier 3 for optional stuff like Viagra ($40). That was how it used to be defined anyway. Now it seems they can put any drug in any tier they want. As of last August my generic Prozac went from Tier 1 to Tier 2. I asked them why and they just said that sometimes drugs change tiers.

As many people take this, I’m surprised there hasn’t been more of a backlash. I used to have 2 generic Tier1 prescriptions and one name brand Tier 2 (Lipitor), for a total of $41 per month. (8+8+25). Now I have two Tier 2 and one Tier 1 for a total of $60 per month (10+25+25).

It just makes me mad that they are so greedy.

We don’t normally have time to answer every question on the tipline, but I had some extra time that day. So I wrote B. back, telling him about the $4 generics program at Wal-Mart, Target, and some other stores. I remembered seeing fluoxetine on the list, and behold, there it was. I advised him to fill his prescription at Wal-Mart without using his insurance card.

A few weeks later, he wrote back:

I just want to thank you for your reply. I was not aware of the deals available at Wal-Mart on fluoxetine and triamterene/HCTZ, both of which I use. Now, instead of paying $33.99/month for these two items thru my United Health Care prescription drug plan, I can pay $20 every 3 months by not using any insurance at all! It turns out that even though the fluoxetine is a $25 Tier 2 UHC drug, Walgreens “only charges $23.99 for it because that’s how much they sell it for”. So they save me $1.01 and think I should thank them.

I’ve been thinking about it since, though. It’s been a few years since I’ve filled a prescription with an insurance card. I remember Target charging me just the $4 generic cost instead of my $10 co-pay, I wasn’t sure whether Wal-Mart and other stores had this policy, and even whether it was still done that way, so I advised him not to use his insurance.

Have you switched to a store that carries $4 generics since stores started this policy?

Have you taken advantage of low-price generics?(polls)

(Photo: jm3)

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