Sometimes, as with life in general, for every step in mental health recovery, it is one step forward and a step and half backward. I know that the saying is really two steps backward but I am trying to strike a more positive mental attitude. I am in a partial hospitalization program in which the psychiatric nurse practitioner found a medicine that works extremely well to augment the antidepressant regimen that I am currently on. The medication is Latuda which is manufactured by Sunovion and is not available in a generic form just yet because it is relatively new to the market.
This afternoon I went to my neighborhood Walmart pharmacy to drop the prescription off and inquire about the retail cost and copay of Latuda. I was expecting the medication to be relatively expensive but I was surprised to learn that Walmart was charging a retail price of give or take 1800.00 USD for a 30 day supply of a medication that I would view as medically necessary, because without it, I was not getting better. My prescription drug plan through WellCare, also known as Medicare Part D, would only cover 50% of the retail cost of the medication or around 900.00. As somebody that is disabled with a mental illness, this is cost prohibitive. If I had the resources of somebody wealthier, I obviously would not bat an eyelash at this kind of outlay.
One of the great benefits of both the program and the medication is that instead of unraveling completely at this bad news, I am looking at this as a challenge in which I have to pack my patience and start building some relationships. Sunovion has a copay savings program but it is not for people on government-funded insurance plans. That much said their benefits investigation department agreed to take on my case and see what they can do to help.
In the mean time, there are other resources such as mental healthcare advocacy groups out there that can be engaged. Tomorrow I am going to call The National Alliance on Mental Illness (NAMI) and The Mental Health Alliance of Delaware (MHA) to see what advice they can offer beyond what I am already doing. I also have a case management agency, RI International, working on my behalf that I can enlist for help as well. Basically I have to be a little bit of my own social worker and I consider this as good practice for when I become a licensed clinical social worker of my own one day.
For now though, I am home and safe and I have an extra 7 day supply of Latuda samples that I asked my program’s nurse practitioner to provide for me in anticipation of problems filling this prescription. On another note, this points to the real systemic problems of healthcare in America. Unless you have the virtually limitless resources of an Elon Musk or Jeff Bezos, you are left to your own devices. It’s not just the health insurance and drug companies that are greedy, it is also the investors placing unreasonable demands on returns on their investments. The problem is that capitalism and healthcare have no business, pun fully intended, as bedfellows. Stay tuned . . . .