![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 81 to 105 of 431. Go back in thread:
Posted by ravenstorm on April 13, 2006, at 13:13:47
In reply to Re: Tricare coverage!, posted by tgo on April 13, 2006, at 12:56:54
Thats GREAT news!! Hopefully as more news about the patch gets out there, more insurances will start covering it.
Also, I am assuming that most people trying (or considering trying) the patch are in the treatment resistant/treatment intolerant camp and even though many insurance plans may not put the patch on their formularies, you may still be able to get coverage if you have a doctor willing to go to bat for you and petition the insurance.
Posted by pulse on April 13, 2006, at 13:45:05
In reply to Re: Emsam Price, posted by Last Chance on April 11, 2006, at 23:54:27
> The price is appalling!!!!!! I talked with a pharmacist at Costco today - they don't have a price, but he said I could just order it, and if the price is too high they will send it back. I'll give it a try and post what the price is. I have no health insurance and low income, so unless it is a lot less expensive, I will just have to sit on the sidelines. I have been waiting so long to try it - did not think it could cost this much. Richard
Richard,
I just called my Costco in SW Ohio, and the pharmacist told me Emsam was not even listed with their supplier- McKesson. She said McKesson tells them to not give out their phone number. If you don't mind saying, where are you located? (I'm paying $540 at Walgreens, all out of pocket.)
FYI, people, I am on day #2 on Emsam. Experiencing exactly same as Robert, i.e., NO SIDE EFFECTS! + alertness, and those feelings of being easily capable of social interaction, or anything, for that matter - * EXCEPT I am having poor sleep - only 5 disruptive hours on night #1. I am also on Klonopin, and due to 2 very traumatic abuse situations, within 2 weeks, 6 months ago, (both of which I'm completely away from) I have had to titrate up from 1 or 1.5 mg. to a whopping 4 mg/day. Am not happy about that, as I well know, after the first month on ANY dosage of klonopin, it loses it's sleep 'help', and from there on foreward works against sleep.
BTW, I'm not treatment resistant, I'm side-effect/s intolerant of - now - every single oral antidepression, much less combos - all classes, and I've tried almost every one, if not every one. (Other than Remeron, which is the only one I can tolerate re my issues: upper and lower GI problems. But Remeron doesn't give me full remission, and causes a weight gain of 1 pound every 2 days. The higher dosages not only make me angry and lose their sleep help, but I actually gain MORE weight.)
Robert, please, at what pharmacy did you find that low price for Emsam? TIA.
pulse
Posted by JaclinHyde on April 13, 2006, at 14:28:54
In reply to Re: Tricare coverage!, posted by tgo on April 13, 2006, at 12:56:54
Yeah you do. Either active duty or retired.
JH
Posted by RobertDavid on April 13, 2006, at 15:45:43
In reply to Re: Emsam Price/ Ricard AND Robert, posted by pulse on April 13, 2006, at 13:45:05
> Robert, please, at what pharmacy did you find that low price for Emsam? TIA.
I bought EMSAM at a small private pharmacy in Riverside, CA. I paid $440 for 30 20mg patches. I contacted the pharmacist (Vijay) and we talked for some time about EMSAM, he's very interested in it.I mentioned this board and that others are having trouble finding it at my price. He said he would be happy to fill anyones scripts from the board (perhaps he'll include shipping - he also may ship outside the U.S.) at my $440 price.
If you're interested you can email him at vjpate@hotmail.com or call 951-686-7373 (Spencers Pharmacy, 6942 Brockton Ave., Riverside CA 92506).
Rob
Posted by RobertDavid on April 13, 2006, at 15:54:01
In reply to Re: Emsam Price/ Ricard AND Robert, posted by pulse on April 13, 2006, at 13:45:05
> FYI, people, I am on day #2 on Emsam. Experiencing exactly same as Robert, i.e., NO SIDE EFFECTS! + alertness, and those feelings of being easily capable of social interaction, or anything, for that matter - * EXCEPT I am having poor sleep - only 5 disruptive hours on night #1.
I can't tell you how happy I am that your getting a similar positive response!!! Hopefully your sleep issues will improve. It's still not a problem for me and I'm a guy that can't buy a good nights sleep! Good luck! Rob
Posted by Iansf on April 13, 2006, at 16:39:26
In reply to Re: Emsam Price, posted by crabwalk on April 11, 2006, at 19:38:46
$540, $440 - good grief! Many new meds are expensive, but this is truly outrageous. And what's the justification? Selegiline had already been developed, so there were none of the high development costs associated with most meds. All they did was put it on a patch, and it's not difficult to figure out how to do that, considering that compounding pharmacists were already able to put just about any med on a patch. They had to run tests, sure, but the costs are still a lot lower than developing a new drug from scratch.
The pricing isn't simply outrageous - it's IMMORAL. I shouldn't be shocked, but I am. This kind of pricing should be criminal. At the moment I get my meds for free through a city clinic, but I can't imagine the city's going to spring for a med this expensive. And even if it does, all that means is that the city will have to cut back on some other services to cover it, either by reducing the number of people eligible for coverage, firing people and loading more work on the remaining staff or limiting access to other treatment. This is just WRONG, WRONG, WRONG. At the moment I feel ashamed to call myself a US citizen.
Posted by ed_uk on April 13, 2006, at 17:00:32
In reply to Re: Emsam Price, posted by Iansf on April 13, 2006, at 16:39:26
>This is just WRONG, WRONG, WRONG
It's amazing how much prices vary. I work in a pharmacy in England. When we buy generic fluoxetine (generic Prozac) from our wholesaler, a box of thirty 20mg caps costs 39 pence (68 US cents). A box of twenty-eight Zyprexa 10mg costs £79.45 (about $139.22)
Ed
Posted by Last Chance on April 13, 2006, at 21:06:27
In reply to Re: Emsam Price/ Ricard AND Robert, posted by pulse on April 13, 2006, at 13:45:05
Pulse, hi. I am in Portland Oregon. Funny about McKesson - they are the supplier for my local Pharmacy, and I got a price of $444.00. As soon as I score from Costco, if I do, I will post the price. Richard
Posted by pulse on April 14, 2006, at 1:41:46
In reply to Re: Emsam Price/ Ricard AND Robert » pulse, posted by RobertDavid on April 13, 2006, at 15:45:43
Robert,
This info re: your pharmacist and his being willing to fill others' scripts is no less than amazing! I have made a note on all.
So VERY kind of you to post this, and thanks, also, for your encouragement in your post following.
BTW, my main lifelong diagnoisis is, and has remained - until now, hopefully! - Major Depressive Illness, recurrent. Moderate to very severe. I have HAD to be off an antidepressant for 6 months! - longest I've ever gone, and, due, wholly, to my unbearble GI problems on the pill-form antidepressants passing through the gut. The last 2 months have been VERY scary. (What I think of as abit lesser and/ or "breakthrough"/ waxing and waning diagnoses are: GAD, PTSD, and OCD.) So, I am taking the Emsam, first and foremost, for MDD.
However, it surely seems to be helping the GAD and PTSD for me also already; not so sure about the OCD (yet).
Went to my therapist today (my day #2), and she is beyond amazed. I was going to have to start EMDR again; now she feels no need to. Says she's never seen me, over this last decade/+ with her, so focused and able to stay on topic. She does not feel there is anyway all this can be a placebo effect.
Thanks again!
'
Posted by pulse on April 14, 2006, at 1:55:32
In reply to Re: Emsam Price/ Pulse, posted by Last Chance on April 13, 2006, at 21:06:27
Richard,
(BTW, sorry for leaving out the "h" in your name when I started posting. So glad you caught my post to you!)
Thanks for this info re: Costco/ McKesson/ and price in Oregon. (FYI: I was thinking of moving there, several months ago. May still, as this is further incentive.)
Let me just say that SW Ohio often runs about 5 years behind the rest of the nation. I'm going to now call my Costco back and be VERY insistent. The pharmacist almost laughed at me. Sheesh. She will be getting a REAL taste of my relentlessness now.
Posted by ravenstorm on April 14, 2006, at 8:29:40
In reply to Re: Emsam Price/ Pulse » Last Chance, posted by pulse on April 14, 2006, at 1:55:32
I really feel for you. I am in the exact same boat. I have been unable to even try any more med trials (although the only thing left to try was cymbalta and the traditional MAOI's) because of severe stomach problems. I have been off of meds for nine months.
Posted by elkat on April 14, 2006, at 10:35:32
In reply to EMSAM-Day 5, posted by RobertDavid on April 12, 2006, at 9:53:45
Thanks for your reports. It sounds very interesting. It also sounds very expensive, and my HMO still considers Wellbutrin XL a "non-formulary" and doesn't provide the usual benefits for it, so it will probably be 2025 before EMSAM is covered, but I'm still very curious.
Posted by Last Chance on April 14, 2006, at 10:45:44
In reply to Re: Emsam Price/ Pulse » Last Chance, posted by pulse on April 14, 2006, at 1:55:32
Pulse - Oregon's health plan was once considered an example for the U.S. Now it is almost non-existent. There is no $$$$$ here, and you have to be pregnant or over 63 and pennyless for them to even accept an application. That is the sad reality about the OHP. About Costco and Emsam - the Pharmacist here said he showed no price, but that if I ordered it he could get it - if it was too expensive he said he would send it back. So now I'm waiting and expect it on Monday. He did make a guess, though - since it is $444.00 at my pharmacy, he said probably about $300.00. That would be better, of course, but I would still have to beg, borrow or STEAL! So we'll just have to wait and see. Richard
Posted by Last Chance on April 14, 2006, at 10:57:31
In reply to Re: Emsam Price/ Pulse, posted by Last Chance on April 14, 2006, at 10:45:44
There is a poster, NY Marine, on The Anxiety Community - he is on day 6 of Emsam, and says that he feels "agitated, anxious, nausea". Maybe it is not the miracle that some of us are hoping for. Richard
Posted by pulse on April 14, 2006, at 12:09:41
In reply to Re: pulse/GI stuff, posted by ravenstorm on April 14, 2006, at 8:29:40
ravenstorm,
thanks for your empathy/ sympathy. it's i that should feel for you - wow - NINE months on no AD/s. must be pretty to very tough! are you the one here who can no longer take even 2 mgs. prozac? prozac was my mainstay, but over the last 3 yrs. - i did best at only 10 mg - i've gotten closer and closer, then finally, to the point that the nausea just never quit - even at only 2.5 mgs., and, how much could that help (as a stand-alone AD)?
years ago, when i still went to/ believed in psychiatrists, i had one woman who was, at least, very med savvy and returned calls immediately, most always. she said she had another client, like me - that ADs making them sick in any way, and never relenting, made any gains they had/ were making with their depression, then, disappear.
i honestly don't feel like i could have hung in one more day. i've worked so hard these last 2-3 weeks at putting ALL things in motion to get the patch as early as possible, despite my being so very cognitively impaired. it's literally been like being a doctor, 2 pharmacists, and a bms medical "helper." (my degree is in art and art history, sheesh!) somerset, however, was very kind to me, and one researcher gave me her personal ext.# there...said call back anytime. i DO believe in being highly involved in one's psych care, but i don't feel i should have had to go to such lengths as doing others jobs for them, and continually calling back, to make sure they had followed through. more often than not, they had NOT!
pulse
Posted by pulse on April 14, 2006, at 12:20:31
In reply to Re: Emsam Price/ Pulse, posted by Last Chance on April 14, 2006, at 10:45:44
Richard,
yes, i'd heard that the medical/ healthcare situation in oregon had gone WAY downhill.
sorry, i see i was confused re: your post to which i responded earlier. i didn't "get" that it was your regular pharmacy that quoted the price as $444. wow - costco may be only $300!
now, i'll REALLY get relentless with costco here. i think my best option is to actually go there in person, rather than to just call again. let's see how they deal with ms. petite yet mighty. good luck to me, regardless - they seem to be a bunch of real wankers.
thanks again.
pulse
Posted by pulse on April 14, 2006, at 12:33:13
In reply to Emsam The Anxiety Community, posted by Last Chance on April 14, 2006, at 10:57:31
egad, Richard, i so hope that doesn't come to pass. i've heard through the grapevine that the other big drug cos. have put out the "reports" re: nausea, constipation, and other gi problems. hey, as we ALL should know by now, they don't want to lose a dime of their billons that they are already taking many of us for. they do the least possible and only care about those who can somehow tolerate /get a good enough RESPONSE, but rarely FULL remission, with their toxic meds.
i am doing well and intend to stay in deep denial re: ANY gi problems cropping up.
pulse
Posted by verne on April 14, 2006, at 14:23:19
In reply to Tricare coverage!, posted by JaclinHyde on April 13, 2006, at 12:54:34
That's great. I have Tricare and thought they might be slow to insure this. I've had battles with them in the past.
Thanks for the info. I'll mention emsam to my doc next week.
verne
Posted by pulse on April 14, 2006, at 15:58:33
In reply to Re: Tricare coverage! » JaclinHyde, posted by verne on April 14, 2006, at 14:23:19
my slim sw (fairfield) ohio lead (instead of costco) turned out to be a big lead. i have already transferred my Emsam script to jungle jim's, a one-of-a-kind (sorry!) 'multiplex' gourmet food, rare produce, and now, of all things, a pharmacy.
they could not have been more accommodating and helpful. they also happen to be a compounding pharmacy, just fyi.
PRICE: $427 per 30 days - 6 mg. patch. they are planning only to carry the 6 mg., but i believe, since they do so many special orders, they would get in the 9 and 12, upon request. also, they will ship through the us mail.
pulse
Posted by strugglingsteve on April 14, 2006, at 15:59:44
In reply to Emsam The Anxiety Community, posted by Last Chance on April 14, 2006, at 10:57:31
> There is a poster, NY Marine, on The Anxiety Community - he is on day 6 of Emsam, and says that he feels "agitated, anxious, nausea". Maybe it is not the miracle that some of us are hoping for. Richard
I have terrible anxiety and agitation and am on day 4 and emsam is having no effect on that. It may be like wellbutrin is for me in that its worse but then gets better. Too soon to tell for anyone right now. Give it 6 weeks and then lets see where we are.
Posted by strugglingsteve on April 14, 2006, at 16:14:15
In reply to Re: Emsam The Anxiety Community, posted by strugglingsteve on April 14, 2006, at 15:59:44
I am going to get a medic alert bracelet if emsam pans out as a long term med. I know with nardil its 10 days off it before hospital surgery or anesthesia at a dentist. Isnt selegiline a very short half life so wouldnt the time off of it be much shorter to, anyone out there with any ideas on this??
Posted by ttee on April 14, 2006, at 17:10:13
In reply to Half life $ Anesthesia, posted by strugglingsteve on April 14, 2006, at 16:14:15
Having a medic alert bracelet sounds like a cheap good thing to do. You never know what could happen in an emergency situation and/or will the resident intern at your local hospital know what EMSAM is?
I think you are right about Selegiline having a sort half-life. However, I don't think the half-life is relevant with an MAOI. Selegiline is an irreversible MAOI, so once you have destroyed your MAO with Emsam, it will take 2 wks after you discontinue the Emsam for you body to remanufacture some normal functioning MAOI. So if Emsam is working for someone, it might be a scary proposition to have to go off of it just to have some minor surgery, or a tooth filling. Will it work again when you restart it, or is it like the other AD's that sometimes doesn’t work again like they had done before stopping them?
TTEE> I am going to get a medic alert bracelet if emsam pans out as a long term med. I know with nardil its 10 days off it before hospital surgery or anesthesia at a dentist. Isnt selegiline a very short half life so wouldnt the time off of it be much shorter to, anyone out there with any ideas on this??
Posted by tom_p on April 14, 2006, at 19:20:15
In reply to Re: Emsam Price, posted by Iansf on April 13, 2006, at 16:39:26
Hi,
I've been reading messages here for years and I thought I'd start posting.
I'm really interested in trying Emsam and I too have been checking prices for the med.
I spoke with someone at Costco and she estimated the cost for 30 days of the 6mg patch at $405.
Another local pharmacy said their price would be $480 to $500.
Tom
Posted by Phillipa on April 14, 2006, at 19:39:36
In reply to Re: Emsam The Anxiety Community, posted by strugglingsteve on April 14, 2006, at 15:59:44
It has to work there has to be something out there. Is it us? Love Phillipa
Posted by strugglingsteve on April 14, 2006, at 21:07:49
In reply to Emsam The Anxiety Community, posted by Last Chance on April 14, 2006, at 10:57:31
I couldnt find that posting of ny marine, did anyone else post there?
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.