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I had to pay $50 for a 30-day supply of 10mg Lexapro tablets. The price without insurance would have been $105. The insurance-agreed (Aetna) pricing is $87.02.
Apparently Lexapro is a "Non-preferred brand copay" type medication (where I pay 20% of the cost of the drug with a $50 minimum).
If it were "Preferred brand copay", it would be 20% of the cost of the drug with a $30 minimum.
If it were "Preferred generic copay", it would be 20% of the cost of the drug with a $10 minimum.
Apparently Lexapro is non-preferred, because it is considered "step therapy", and I would have to try "one or more 'pre-requisite'** medications before the step-therapy medication will be covered".
So if the doctor had prescribed one of the others first, and then Lexapro, it would have been cheaper. If the doctor had prescribed one of the others first, it probably would have been a generic one which would have been even cheaper. And it might have even been one of the ones you could get at Walmart for $4.
I wonder if the drug companies and the doctors have some kind of deal, where the doctor gets a kick-back for prescribing drugs which don't have generic equivalents.
** The pre-requisites are listed as:
Any one of: budeprion sr QL , budeprion xl QL , bupropion hcl QL , bupropion hcl sr QL , citalopram hydrobromide QL , fluoxetine hcl QL , fluvoxamine maleate QL , mirtazapine QL , mirtazapine odt QL , paroxetine hcl QL , sertraline hcl QL , venlafaxine hcl QL
Apparently Lexapro is a "Non-preferred brand copay" type medication (where I pay 20% of the cost of the drug with a $50 minimum).
If it were "Preferred brand copay", it would be 20% of the cost of the drug with a $30 minimum.
If it were "Preferred generic copay", it would be 20% of the cost of the drug with a $10 minimum.
Apparently Lexapro is non-preferred, because it is considered "step therapy", and I would have to try "one or more 'pre-requisite'** medications before the step-therapy medication will be covered".
So if the doctor had prescribed one of the others first, and then Lexapro, it would have been cheaper. If the doctor had prescribed one of the others first, it probably would have been a generic one which would have been even cheaper. And it might have even been one of the ones you could get at Walmart for $4.
I wonder if the drug companies and the doctors have some kind of deal, where the doctor gets a kick-back for prescribing drugs which don't have generic equivalents.
** The pre-requisites are listed as:
Any one of: budeprion sr QL , budeprion xl QL , bupropion hcl QL , bupropion hcl sr QL , citalopram hydrobromide QL , fluoxetine hcl QL , fluvoxamine maleate QL , mirtazapine QL , mirtazapine odt QL , paroxetine hcl QL , sertraline hcl QL , venlafaxine hcl QL