Finally diagnosed! – medication/copay questions

[Anonymous]

Hey guys,

I’m a 21 male college and was finally diagnosed with ADHD this morning. It comes as such a relief – I’ve struggled for too long trying to keep up with my other classmates – hw that takes them about an hour usually takes me about four. Having to reread pages and pages of books just to understand what’s going on. Luckily, through this struggle I have been able to keep an good GPA, it’s just frustrating that my parents never took my pleas to get me tested and on medication. I’m glad I finally took it upon myself, now that I’m old enough to make my own medical choices (technically I was since 18, but we’ve never had solid health insurance). Well at last, my struggle is over. What a relief!

I have a few questions – I was put on Vyvanse 30mg and so far its been nothing but incredible. However, I learned from the doctor that it is a controlled substance and that I would need to go into the office and get checked out every month in order to get a new script.

My copay is $60. And the Vyvanse are $37 after insurance and a coupon. That’s $100 a month.. and my work study job only allows me 6hrs a week during the semester. That being said, I cannot afford my copay.

I’m trying to look for other options – maybe someone else on these forums have experienced this issue?

I’ve come up with a couple options but I’m unsure of their validity:

1. Could the doctor’s office write me 3 separate scripts and then I can go in for check ups every three months? I’ve seen scripts with “Do not fill until [date]” on them before, but I’m not sure if they would go for this.

2. They just allow me to pick up the script from the office without going for a visit so I can avoid the copay, of course as long as everything is going well.

3. They allow me to fill the scripts at my school’s health center, for which students have no copay. This would be the best option in my opinion, and the nurse practitioner I was actually seen with works at my college, so she might not object to this.

I’m of course aware that it’s a good idea to see the doc in order to find what dosage works best for me, but after that I feel going in every month is unnecessary and I just cannot afford it.

They were very helpful when I briefly spoke to them about this – I didn’t mention the options listed above but they are going to see if they can offer me some sort of student pro-rated copay amount.

I know it’s going to come down to talking this over with the doctor’s office but – has anyone had any similar experiences?

Thanks!

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[kc5jck]

My son is on adderall. One of our family doctors required an office visit at about $60 a pop each month in order to get a prescription. I checked with our other doc who would sign a prescription as he walked past between patients for $10 a pop each month, or whenever we went to get refilled, about every two to three months for me and maybe every six weeks for my son.

The second doc just needed an assessment from a psychologist to document a diagnosis.

So I would say shop around. You might check with a public school nurse to find a good ADHD doctor. If she has a lot of kids in her school with ADHD, she may be a good resource for you.

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[ipsofacto]

It’s normal to see the Dr after a month (or less) so that the dose can adjusted if needed. Vyvanse is a brand name and an extended release drug = expensive. There is no generic. My thinking is that I would sooner be on a shorter acting stimulant taken twice a day. This gives great versatility to choose the period of time you are medicated, and these tablets can be halved and quartered to give you the minimum dose needed. Typically I would take 15mg of Adderall generic in the morning and 7.5mg to 15mg in the afternoon. If I am going to a party where I might be drinking, I would omit the afternoon dose. Short acting generics are much less expensive.

http://drugs.about.com/od/faqsaboutyourdrugs/f/ADHD_generics.htm

As well as Federal regulations, there may also be State restrictions on prescribing class 2 drugs. Once the Dr is sure you have the right dose, he may write three scripts to cover you for three months. It may also be that because you are young and at college, the Dr will not do that. Sadly there is a lot of abuse of these drugs on campus, which those who actually need them.

Please remember that having ADHD means you have many other problems besides those directly concerned with school work. You may have emotional regulation issues, and impulsiveness that you are not really aware of yet, but will cause you much grief over a lifetime. There is a very real chance of developing co-morbidities like anxiety and depression. Take the time to research as much as you can about ADD.

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[kc5jck]

ipsofacto reminded me of something that Barkley said in one of his videos.

In following patients, as patients became adults, the studies quit quizzing the parents and relied only on the patient for information. At this point, the patients didn’t report problems accuratelly so the studies would think the patient grew out of having ADHD. As the patient approached thirty and beyond, they became more self aware and reported symptoms more accurately. When the studies included the parents, the parents reported essentially a continuation of symptoms throughout this time period of the patients life.

I suppost the point being that I believe in my case I was probably as clueless as anyone. I would recommend that anyone in this age range have a “normal” friend or parent to go along to any ADHD assessments.

Have I made any sense? Probably not, go look at Barkley on youtube.

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[Anonymous]

If you are in the US, Shire Pharmaceuticals the manufacturer of Vyvanse has a patient assistance program.

http://www.shire.com/shireplc/en/contactus/patientassistance

You will have to provide some income information and other personal data. It is worth a try.

They may be able to offset some of your co-pay costs.

Good luck!

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[Anonymous]

Thanks, that helps a lot!

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[shutterbug55]

@Vice,

I take Adderall, and it is as if it was tailor-made for my brain. With 5mg a day taken twice a day, it wakes my brain up and allows me to focus on the right things, allows me to switch focus. I find I can even use working memory. My ability to deal with crowds is better while I am on meds as well, and I can interact with people far better.

I see a Psychiatrist once every 3 months so we can touch base on dosage, refills, and side effects. To me that is VERY important. I take my wife along, because she has the outside perspective needed to give the doc a better picture. ADD is more than how we live inside our skin, it is as much if not more so about how others deal with us.

Personally, I like the regular generic short acting pills. The XR does not work for me. I like to be able to increase or decrease the dose as I need it as well as the timing. These doctors are big help to me, and I use their advice. To me they are far more than just another rat-hole I am trying to fill with money.

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[deebee]

In all three US states I’ve lived in over the last 20 years or so, my doctors always gave me three=month prescriptions unless I was trying a new drug and we did not yet know how it would affect me. I’d get a one-month prescription, then three if it worked out. I did see one doctor – just once! – who required a $200 office visit every month, even though I was only trying to maintain a med regime that had been working for me for years. At the time, I had insurance that would have paid most of his fee, but I wasn’t willing to feed his habit.

BTW, the retail cost of Vyvanse is horrendous; 30 days of 30 mg runs $225 and up!

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[blackdog]

@deebee

You can say that again! I nearly faint every time I get my perscription filled. And it gets more expensive as you increase the dosage.

It took awhile for my doctor and pharmacy to work out the prescription problem. They weren’t happy with the way that he was writing them at first, I think because it wasn’t clear that I could only get 30 at a time. And then he told me to increase my dosage, but didn’t provide me with a new script, which I didn’t notice at the time, and I had to call the office and try to explain to them that he had to fax a new script to the pharmacy before I ran out. Then he messed it up completely when he increased it to 80 mg but only gave me a script for 20 mg, assuming that they would just fill that and the previous one for 60 mg….

So in short, it really depends on the doctor, and how much experience they have. And yeah, there are probably a few here in Canada who try to do the monthly appointment thing to make extra money too. The difference is, they can get caught here, if they have enough unnecessary appointments for it to become suspicious. My doctor usually schedules an appointment every 3 months, because I am still struggling to figure out what works for me. If I get to the point where I am more stable and the meds seem to be helping, then he’ll drop it to twice a year probably (going by past experience).

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