Restless Legs Syndrome (RLS) Discussion Board

Last month when I went to pick up my 30 day supply of Tramadol ER, I was shocked when they said that my co-pay was $156 when it had been $6 the previous month. I did a bit of research and thought that the price change was due to a way that my doctor had written the prescription, which had forced a change from generic to name brand. So, I asked that the prescription be written in a different way this month, only to find out that there is some sort of restriction that limits the number (but not strength) of pills the insurance would cover, so the insurance would only pay for 15 days even though the prescription was written for 30. The good thing was that the co-pay was back to $6.

So, I called the insurance provider to find out what's up. They said that the 15 days of meds was due to some sort of new legal requirement that limits the number of opioid pills that can be dispensed. Rather stupid because they do not differentiate between 60 100-mg pills or 30 200-mg pills.

So, I asked about the previous price increase and what I could do to get 30 days of 200mg pills. The lady looked up the info on the more expensive prescription last month. She said that the difference was that all of the pills were generics, but that the expensive ones were capsules whereas the cheap ones were tablets. She continued that there are a few medications where capsules can cost $100 more than comparable tablets and that Tramadol ER is one of these. In fact, she agreed that the cost difference was much more than $100 and exceeded 15 times for the same amount of medication.

So, be forewarned both of the limit on the number of actual pills dispensed (I don't know if this was a new state or federal limit) and of the difference between pricing for capsules versus tablets.

Wasn't it just as well that you did some research.

When I hear of something like this it always concerns me that there are folks who would not be so capable of sorting out such a situation. Who would be paying more unnecessarily. Or even worse, wouldn't have their prescriptions dispensed because of the high cost.

Steve, we get our opioids filled in Wyoming, because it is closer and more convenient for us. No issues so far.
The only thing that is costing me a lot is potassium.

I received a notice from my insurance company that I would be limited to a certain mg, not number.