[nradov]

Physicians (and other prescribers such as dentists) don't even necessarily know what all medications a patient is taking. In theory they can check through the regional Health Information Exchange or Surescripts but in practice things fall through the cracks. This is a leading cause of preventable medical errors.

[cc439]

The unfortunate part of modern American medicine is that the pharmacy isn't likely to know all the medications the patient is on either. I'm currently going through a minor situation but have discovered that health insurance has, in some cases, switched to a model of partnering with specialized pharmacies for certain treatments. You're forced to use a specialized pharmacy for one specific condition while your day to day corner chain is completely excluded.

[tzs]

You can even get that without having some prescription that your insurance has made a special deal with. I currently have 3 prescriptions at Walmart and 1 at Safeway, all of them generics that I'm not using insurance for. I'm paying the cash price for the Walmart ones, and using GoodRx for the Safeway one.

It used to be all 4 at Walmart, and then something utterly ridiculous happened. For the non-US readers who won't believe this idiocy, I swear it is true. We really do put up with this nonsense.

One of them was for irbesartan. I'm supposed to take it twice a day, 150 mg each time. The prescription was written for 30 x 300 mg tablets, which I split in two (irbesartan comes in a rod shaped tablet that you can easily split it two by hand).

This is $9 cash at Walmart.

But then there were some irbesartan recalls (although not affecting the manufacturer of any tablets I had). There was a shortage of 300 mg tablets, and Walmart was having trouble refilling my prescription.

So we had my doctor change it to from 30 x 300 mg tablets to 60 x 150 mg tablets. The cash price for 30 x 150 mg is $9 at Walmart, same as 30 x 300 mg. (I'd guess that for this drug, most of the cost is in filler and binder, so that is probably not unreasonable). So I'd expect 60 x 150 mg to be $18.

Walmart filled that, and when I went to pick it up...it was something like $300. WTF!? So they double checked, and found out that it had actually been written as 180 x 150 mg. They redid it as 60 x 150 mg, which dropped the price to about $100. So, still a big WTF.

According to GoodRx it should be $24 cash (still a WTF...why not $18?). Since this is one that GoodRx thinks has a good cash price at Walmart, GoodRx does not offer a coupon for it there. I showed the pharmacist the listing in the GoodRx app, and he agreed to honor that price, so I got my prescription for $24.

GoodRx did have a coupon for Safeway, for 60 x 150 mg for around $13, so when it was time to re-fill that, I move it there. (That changed to about $18 next month).

I ran out of re-fills about 3 months later and so needed a new prescription, and by then 300 mg was readily available again so asked for 90 x 300 mg, which was $21 with a GoodRx coupon at Safeway.