The biggest sign that it‘s working is that I can get out of bed in the morning without a feeling of soul-crushing dread. Stacks of laundry no longer look like mountains. The to-do list which perpetually grows faster than I can cross items off seems like a challenge rather than a taunt. And I don’t imagine the people I love dying horrific deaths. SCORE.
This is the sixth depression/anxiety medicine I’ve tried but the first that’s not generic. The insurance I enjoyed while married employed a pricing differential such that brand-name prescription co-pays were perhaps twice as much as their generic equivalents. The insurance I’m using now also favors generics, which is of course as it should be. However, the penalty for “choosing” a brand-name drug is steep: I needed to meet a deductible first, then insurance would pay only a fraction of the drug’s cost. Three months of Cymbalta according to their pricing plan would cost approximately $675 when purchased at my local drugstore.
Reluctantly I paid for the first two months at the Walgreens down the street. I didn’t pursue lower-priced options because it seemed pointless to order in a larger quantity (for example) if my body didn’t tolerate the drug. And I wanted to check at my next appointment to see if another drug could duplicate the altogether satisfactory results Cymbalta was providing.
My lovely medicine doctor looked doubtful. “You could try a combination of two drugs,” she said, and named off the medicines. I realized I’d tried one a few years ago only to find that after a few weeks of good results I began twitching uncontrollably all over my body. My doctor had made me stop taking it immediately and refused to let me try anything else until it cleared my system. I could hardly get out of bed.
Having no desire to repeat that experience so I somewhat reluctantly accepted an updated Cymbalta prescription and the doctor’s recommendation that I look into having it filled in Canada. The idea that I should have to get any part of my health care from another country offends me horribly — but not so horribly as paying $675 for ninety small pills.
And do you know what I found out when I went to the local company my doctor recommended? Can you guess? In approximately fifteen minutes I’d filled out a form, paid $193 (including shipping) and was told to expect the order in ten days.
The difference between paying $675 or $193 for one prescription is huge for my budget yet it’s only the most infinitesimal example of what is wrong with health care in this country. “Look at all the Canadians who come to the US because of the long waits for treatment,” some say. “Why would we want to emulate a system that rations care? No Americans go to Canada for their health care!”
I beg to differ. My care has been rationed by my prescription’s cost, leaving me with the option of foregoing an absolutely necessary treatment or else going to Canada to find a price I can afford.
- Debunking Canadian health care myths – The Denver Post
- Mythbusting Canadian Health Care — Part I
- Mythbusting Canadian Health Care , Part II
- Mothers Know Best: Myths and Facts about Healthcare Reform
- Public health care: Canadian perspective on myths and reality
- By T.R. Reid — Five Myths About Health Care in the Rest of the World
- Sara’s Sunday Rant — Orcinus
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If you don’t mind my asking, why did you switch? Weren’t you on citalopram (generic brand celexa) before? I seem to remember that you were. I ask because I am on citalopram, and…yeah, I can’t figure out what the rest of that statement should be. If you’re not comfortable answering here, you’re welcome to e-mail me.
I was. It stopped working for me. Apparently that sometimes happens. :)
I’m with you. There are many, many, many, many reasons I wish we would move to socialized healthcare. Unfortunately I just don’t see it happening any time soon because the propaganda machine has been churning too long here.
You can also try your luck at getting free drug samples from your doctor.
Medicine in Canada is not really socialized, it’s mostly a single-payer system where the provincial government is the payer.
Wow, that’s fucked up. That makes me angry.
“My care has been rationed by my prescription’s cost” That’s the kicker.
We’ve had universal Medicare in Australia for decades, and we like it so much we’re even agitating for Denticare, due to the proven correlation between tooth decay and heart disease. When people can’t afford the dentist, they place a greater burden on the health system down the track. Denticare makes financial sense for the same reason Medicare does. It’s been proven to us that productivity is maintained if everyone has access to health care, and that in the long run, it’s cheaper.
This has also been well and truly proven with mental health. Surely there would be less risk of you (and your kids) becoming a drain on the system later if it just paid for your friggin pills now.
I just checked out the link on myths the US holds about the rest of the world. Very illuminating – it’s interesting to see it from the outsider’s perspective. And funny, of course. Here’s my rebuttal:
1. It’s all socialized medicine out there.
Well, we also have private health care. There’s still the option if you can afford to take it – if you can’t afford it, you’re bloody grateful for Medicare.
2. Overseas, care is rationed through limited choices or long lines.
I’ve never heard the word ‘rationed’ used here in regards to health care. Yes, there is triage system in the hospitals which can cause long lines. And some specialist treatment, plus elective surgery, have long waiting lists. So do some private doctors and other private services. Is this not the case in the USA – can you walk into an appointment with any one at any time? If so, that’s an aspect of your system that needs to be advertised.
3. Foreign health-care systems are inefficient, bloated bureaucracies. Well, we complain a bit…. but actually it’s more efficient and less bloated when health insurance is primarily centralised.
4. Cost controls stifle innovation.
Recently, a doctor from Australia discovered and developed a vaccine for cervical cancer. Innovative, much?
5. Health insurance has to be cruel. Er, that’s what the US believes about health. We believe otherwise.
Just for a different perspective, here’s what the rest of the world believes about the health system in the USA:
1 The USA has a two tier system – either your boss pays for your health insurance, or you have to pay upfront for treatment.
2 If you don’t have a job or can’t pay upfront, you won’t get treatment (even in a hospital, even in an emergency).
3 Your employer chooses the insurance company, and your boss gets receipts for all your medical stuff. You don’t have any medical privacy.
4 If you have a disability you won’t be eligible for insurance, and will have to pay for all treatment yourself, even though you won’t be able to afford it.
5 The USA’s health system reflects the values of the US government: it’s cruel, elitist and thinks money is more important than people. Only available to the rich, and if you’re poor, disabled or not contributing to the free market by working, we don’t care if you die in a ditch.
I know your system is more complex than that, and ours sure ain’t perfect. But based on those myths, we can’t imagine why you WOULDN’T want Medicare.
Some things should NOT be for profit. People’s health and well-being should be one of them. How does any insurance company make it’s money? By not paying benefits. Does anyone see the problem here?
Health and well being should not be for profit.
Does that include food and shelter?
How do we get anyone to develop new drugs?
I think you have to first remember that there is not only black and white, but shades of gray.
In your examples, it’s a win-win. Everyone gets what they need. Health insurance is different.
With other insurance, i.e., auto and home, the insurance company is betting that you will rarely if ever need to use it. We pay into the system for years and never take out of it. Life insurance, we pay in for a many years, leaving the insurance company to invest our premiums to make their profit before we die years down the road. In health insurance, we pay in and immediately and regularly take out. My family alone consumes more than the insurance company is paid for our policy. How do they make a profit? By denying or limiting coverage. It is considered a “loss” by health insurance companies to pay a claim. There is a bigger incentive NOT to pay the claim than there is to pay it. They profit by making others suffer. That, to me, is wrong.
My sister is or at least was on Cymbalta. She seemed to think it worked for her.
The huge commercial interests that underpin US heathcare will fight like demons to retain the current system that so obviously disadvantages those on limited incomes. The most laughable objection that I’ve yet heard to Obama’s push for a more equitable system was that his plans were ‘Orwellian’.
In the UK we might moan about the NHS but in a crisis it’s unbeatable. My mother-in-law takes an enormous number of prescribed drugs every day for her range of health issues, including heart problems. She was left with severe depression in 2001 following a minor stroke nd suffered dreadfully for seven years. Last year a specialist hit upon the perfect combination of three drugs that have solved her depression – she came out of it rather like an 82 year old Sleeping Beauty awaking after many years. What is the cost to her of this vast array of drugs – at least a doxen drugs each day? Nothing. Not a penny, and quite rightly so. I take a prescribed drug to control my blood pressure – it costs £7.20 ($10) every two months.
In my view you can judge a country by the access it allows to free or inexpensive healthcare for children, the elderly and the financially disadvantaged. The US must come bottom in the developed world league table for accessible healthcare, which is something I’d call ‘Kafkaesque’.
Shame on those who are opposing Obama.
We’re not at the bottom. But we’re also not at or near the top. Shame on us indeed.
Sometimes the generic is better. I was on lithium carbonate. It was fantastic. Then the manufacturer changed. Same drug. But the new binding or filler ingredients or SOMETHING wasn’t reacting with me. It didn’t show up in my bloodstream. I was nuts. Now I get it compounded at a compounding pharmacy, straight LiCO3 powder in a capsule. Plain and generic and keeps me sane!
Also, if you go to a small, independent pharmacy, they may work with you. If I needed my pills a little early, they would fill it and charge after the insurance was happy. If my doctor wanted me to try a medication but insurance would only cover a whole 30 days, they would let me buy just a few. Get to know your pharmacist. They are good people.
Speak for yourselves, folks. I like my private health care, and would not be willing to accept “free” government-supplied health care.
In fact, I _DO_ pay for my own private health insurance, despite the fact that I ALREADY have “free” government health care. I’m retired from the U.S. Navy, and my wife and I could get “free” medical care. Thanks, but no thanks. I had enough of that when I was young and healthy; I don’t intend to suffer through 2-month waits now that I’m a geezer and not in the shape I used to be. (The best part of my military-funded health care is a PRIVATELY RUN FOR-PROFIT mail order pharmacy that charges me $22 for those same 90 little Cymbalta pills that AAG pays 8X more for.)
The frank truth is, government health care is BARELY better than nothing. The US Veteran’s Administration is overwhelmed and underfunded. Medicare and Medicaid (or here on the Left Coast, Medi-Cal) squeaks by by paying a fraction of the cost of PROVIDING that care. Many doctors are refusing to take more Medicare (or in my case, “TriCare”) patients.
Drugs? Name a drug developed in Europe or Asia in the past 20 years. When everybody is getting American drugs at Canadian prices, who will pay for the VERY EXPENSIVE process of developing new drugs? Cymbalta is one of the newest still-in-patent drugs that are priced high – high enough to recoup the R&D costs for that drug and 30 other candidates that didn’t pan out.
Health insurance for the young and healthy is cheap; $110 per month from Blue Cross for a 24 year old man in good health. (That’s what I pay for my son’s care, since he’s too old to be on either TriCare or my employer’s medical plan.) But a lot of kids in that age bracket can’t be bothered, and gamble that they won’t get hurt or sick – and stick the rest of us with the bill when they crash their motorcycles or fly hang-gliders into cliffs.
Our current system is a long way from perfect, but I’m absolutely certain that the proposed government-run plans will provide WORSE care at HIGHER costs.
“Rationing? Nobody talks about rationing.” Canadians and British NHS victims wait MONTHS for care beyond basic screening; isn’t that a form of “rationing”?
I hope I’m wrong; I hope that miracles happen, and the bluebirds sing and rainbows come without rain, and everybody is healthy forever for free, and nothing bad will happen. But while I was born at night, it wasn’t LAST night; bad things happen even when everybody wants only good things.
I fear that government healthcare will become a VERY bad thing. Sorry.
Hi:
From an insider’s perspective (I’m a pharmacist): if the Cymbalta works for you, keep getting it from Canada!
But: have you ever tried Effexor? Effexor XR is now available generically. It is in the same class of drugs as Cymbalta (they’re both different from Celexa, for example. They act on *both* the body’s serotonin receptors *and* norepinephrine receptors).
Anyway: the secret is, that there is currently not an *exact* generic replacement for Effexor XR , but there is a generic *alternative* for it, namely a tablet (Effexor XR is a capsule) that is generic venlafaxine extended release form (venlafaxine is the generic name for Effexor).
Venlafaxine XR is still kind of expensive, but it is still cheaper than the brand-name Effexor XR. It is an extended-release version of venlafaxine that should work just as well well for 99% of anyone who needs the brand-name, Effexor XR drug.
So: If you are really balking at the price of the Cymbalta, even abroad, ask your MD if the Effexor might not work just as well, since both drugs are in the same class, and there is no evidence currently that one drug works better than the other for anyone. Then you could get an RX for the *generic* XR version, which would probably *also* be much cheaper if purchased abroad.
Your MD can probably provide samples for the Effexor XR. If they work, then it would be worth trying the generic alternative, the venlafaxine XR tablets. Like I said before, both Effexor and Cymbalta are in the same class of drugs, they are currently the only two drugs in this particular class of medications, and they work on the same receptors, and there is currently no evidence that one is any better for most people than the other (though some people may get better results from one over the other–so far it’s a completely subjective thing!)
OK, hope that is helpful rather than confusing…
Kate the Pharmacist
Tried it.
Didn’t work.
Gave me horrific electric shocks when I came off it.
But thank you anyhow for the info. :)
‘Canadians and British NHS victims wait MONTHS for care beyond basic screening’
Oh, DO stop believing the Healthcare and pharmaceutical industry propaganda. In the UK we don’t get people excluded from care just because they can’t afford it. Care and treatment should be seen as a basic human right independent of ability to pay, especially for children and the elderly.
Yeah I’d have to agree with David H here.
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Maybe the US uses the word ‘rationing’ in a context that we don’t. I’m not saying we don’t have waiting lists; I’m just saying that we don’t consider our health care to be ‘rationed’. I guess I’ve always seen rationing to be the doling out of a finite resource, like food. But we never seem to come to an end to our supply of health care. Hence we don’t use that word for it. It’s difficult for me to put the concept of rationed on top of a healthcare system which I’ve never heard described that way before this us debate.
Is the US talking about scrapping private health care in favour of Medicare, or just expanding the limits on what Medicare already does?
The reason I’m asking is that people like techreader would prefer to stick with what he’s got, which makes sense to me. But I haven’t yet seen anyone say they’d say no to Medicare if it was more than they already had or could afford.
Is it an all or nothing proposal, or a system like here where the rich can choose private and the poor have a safety net?
Very interesting! Definitely highlights the RIDICULOUS state of affairs we currently have to deal with.
I liked the links – some were EXCELLENT. I do get annoyed about how some left-wing people are ALMOST as ill-informed about foreign health care as the right-wing idiots (I’m from Europe, so I know a thing or two about the NHS and when I hear people raving about it, having never experienced it, it makes me roll my eyes.)
The ‘socialized medicine’ thing infuriates me. Most people don’t seem to comprehend what that means. Fortunately some of your commenters do.
But the fact is, we have a system that has the potential to be the best in the world and if we can steamroller the industry lobbiests and the ill-informed right-wing into allowing reform, it can BECOME the best in the world.
Why? Because it’s infrastructure is quite close to the French system – which is, unequivocally, the best in the world. And I know that from more than just WHO figures. I worked in Paris for five years and my aging parents still live in France.
http://rolandhulme.blogspot.com/2009/09/guess-what-america-french-hate.html
Oh, Cymbalta. It’s working for me, too, although so far I haven’t been able to have an orgasm. I surprised myself when I realized that’s not a dealbreaker if I can finally feel normal again.
But the money… yeah. Something’s gotta give.
AAG – I can’t believe how much you pay for medicine! I’m on Cymbalta in Australia and a one month supply costs me $32.90. That’s it! The health care reform conversations that are going on in America have reached our wide brown land, and we all hope that one day soon, you will have the same level of health care available to you that we do. Yes, we have waiting periods and yes,we have our own issues with our healthcare system, but EVERYONE has access to a doctor, hospital and treatment when they need it.
FOR FREE.
Good luck