Really is flomax that expensive?

Ok so I work home health.I'm a fairly new nurse.I have a patient who loves to "experiment" on himself as I would call it and self treat himself. He has an enlarged prostate...and has a prescription for flomax.He stopped take it because the co-pay for this med is expensive according to him (he is on medicare) He recently purchased a over the counter some sort of vitamins for enlarged prostate (Prostalex plus) This med according to the label also decreases the size of prostate.This man has not told to anyone (me his nurse or his doc) that he started this new med.Now he has a diarrhea that alternates with normal stool.It has been like this for the past two weeks.I asked him why did he stopped to take the original med Flomax,he said it was to expensive yet he has medicare and he purchases another meds like Prilosec OTC,prescription meds for hypertension.cholesterol etc..Now I wonder is this man really telling the truth? Last edit by Blackheartednurse on Jul 29, '10
He could be. Easy to look up the cost of meds. I'll bet Flomax ain't cheap.

Quote from caliotter3He could be. Easy to look up the cost of meds. I'll bet Flomax ain't cheap.

Is he in the coverage gap? If so, it's about $400 for 90 capsules. If not, co-pays can still be quite high for brand name meds. If he is taking the brand name, Flomax, I would advise him to check with his doctor to see if he would be allowed to take the generic for Flomax, which is Tamsulosin HCL. If approved, his doc would write him a new script. The co-pays for generic meds can be dramatically cheaper. For example, most of the meds on the $4 list at Walmart are generics. I worked at Humana's mail order pharmacy and many, many times the MD would check the box which said "brand name only." The patient usually had no idea there was a generic version available. I can't tell you how many of them got mad at the doc too, when they found out they were paying a $90 copay for the brand instead of a $10 for the generic.

Quote from BlackheartednurseHow can I look it up?

I would bet the reason he enjoys self treating is because he is trying to find cheaper alternatives to manage his health.I spoke with many seniors who had to pick and choose which med was more important because they couldn't afford them all. Especially when they hit the gap. I HATED telling them they hit the gap. It was really heartbreaking. They would cry over the phone when I told them their 3 month supply was $364. Check out this website Prescription Assistance Program | I would give this website to many seniors or their authorized care giver to see if they were eligible for any sort of assistance. It was worth a shot.Some people spend thousands every month is prescription meds.

Walmart online doesn't list tamsulosin on the their $4 list (for 30 days) but they do have terazosin, which is sometimes prescribed for BPH.Costco.com prices tamsulosin at $26.39 for 30 capsules. Walgreen's lists Prostalex Plus at $19.99 for 30 capsules.You might point out to your client that products like Prostalex Plus are considered dietary supplements and are not evaluated by the Food and Drug Administration. But WebMD does state that saw palmetto (the main ingredient) may be as helpful as tamsulosin, but a person may need to take it 1-2 months to notice an effect. And one of the side effects is diarrhea.I think he definitely should have a conversation with his doctor if this is what he is choosing for treatment.

Is your patient a Veteran? If so he may qualify for VA Pharmacy benefits. My spouse does.

I take doxazosin for BP and I know that is also used as a prostate medication. It is on Walmart's $4 list.

Thanks guys for the suggestions.I will forward this information to his doctor tommorow and I'l let him decide.

2004 Formulary Management article on cost/benefit drug comparisons.Consumer Reports blog entry on the same subject.

Quote from P_RNIs your patient a Veteran? If so he may qualify for VA Pharmacy benefits. My spouse does.

Tamsulosin is a new generic so the price difference isn't as much as a lot of generic vs. brand name drugs. As someone has stated before it's the coverage gap (donut hole) that usually causes patients to not be able to afford their meds. Something that we advise people to do is get a $4/10 dollar list from their pharmacy. If you take that list to the doctor and get as many meds as you can changed to this list it will really save people that have medicare. The pharmacy can then run those drugs as "cash" so that it doesn't even go towards medicare. This keeps people out of the coverage gap in alot of cases. This might even involve getting a strength for a drug that is half or double what they usually take. You can then just double or half tablets to get the right dose. FYI...if you take Yaz there is a generic now available. I know quite a few people get this at our pharmacy and the generic usually cuts their copay in half.