the government can stop people from feeling better?

Question

A friend of mine has huntingtons disiese, her husband went to go get her a perscription called seroquel. When he got there the pharmisist said he could no longer get the amount perscribed, because the insurance company would not cover it. They already pay 50 for each perscription, my friend takes 16 differant pills, just so she can manage. And even then her life is so troubled. Everyday things such as a shower bring her to tears, and seroquel helps relaxe her. Now they want them to pay another $50 so they can take one pill and split is up.

So he called the insurance company and they told him it was NOT them but the government who has stopped this. Seroquel is a controlled substance and the government is cracking down on how much is giving out, so to control it they are making people who don't have much money pay another co-pay to hinder them from selling it on the street.

Here's a thought if someone was selling drugs on the street they would have the freaking money to pay

I suppose I should have been clearer, she takes 600mg a day, which comes out to 6 100mg tablets. They said that they can't give her that, because 180 tablets are too many for one person. So they want to split up the amount of tablets she gets so a $50 co-pay now becomes $100 for two perscriptions of the same thing. When in the past 10 years it hasn't changed. And all of a sudden this is too many pills? It is crazy

Answer 1

Seroquel is a prescription drug, but it doesn't fall under the class of controlled substances, such as benzos and pain killers. It is an antipsychotic medication, and I've never heard of it being sold on the street.

I am part of a large mental health network and this is the first time I have heard of governmental controls over Seroquel. I know many, many people that take it. I even used to take it myself.

There's something that stinks about what this insurance company is telling your friend's husband.

Answer 2

Try to appeal this with your insurance company, or have your doctor do it. It's the HMO, not the government - the government isn't regulating how much Seroquel can be prescribed overall. It is not a controlled substance.

Some HMO's do require that a prescription be written so that a higher dose tablet is split in half for the patient's dose. It's a way to save money - the patient takes the same amount, but fewer pills are involved.

Answer 3

He needs to revisit this issue with the insurance company.

Seroquel is not a controlled substance. It is extraordinarily unlikely that the insurance company denial anything whatsoever to do with governmental regulation. In addition, the "pill splitting" method, is NOT kosher, and if the insurance company told him to do so, he could probably quite successfully sue them.

Answer 4

The government has to spend its money in the most affective manner, unfortunately it cant cover everyone so presumably the moeny wil go to another drug. Really you should complain about everyone wanting less tax because if peopel paid more tax the govern,ment would have the money.