Pregnant w/#2 after 8years HG AGAIN!

[dgh1973]

Hi Everyone- I just realized there was a 1st trimester site so I'm posting this over here too... I'm a former hg survivor and pg w/ #2 and am suffering once again. Part of the reason we waited 8 years between pregnancies is because of what all I went through w/ my first. I just didn't know if I could do it again. I have to say it subsided for me at 16 weeks at least but until then I was deathly ill. I'm now 9 weeks and have been struggling. The zofran seems to help me quite a bit. My problem is w/ my insurance company not wanting to pay for it more than every 30 days between prescriptions! They say I have to have recieved IV fluids (done it) and tried 2 other forms of antiemetic... dr. gave me phenergan, I broke out in hives and had an anxiety reaction..I haven't had the energy to call and ask for something else yet... I know the zofran works for me, it seems like they would realize it is cheaper to give me the zofran than to pay for my hospitalization, etc.. They will cover 12 pills in a 30 day period.. I'm supposed to take one pill every 8 hours, if you do the math those 12 pills don't last very long at all!! I've actually been breaking the pills in half and taking 2 mg in the morning and 2 mg in the evening but it isn't enough now. If I take a whole 4mg pill in the morning I can actually eat a small breakfast like one scrambled egg and piece of toast, it's miraculous... but once again the cost of the zofran is overwhelming and I've already had to miss work. I only get paid if I work because I'm a nurse and work PRN (as needed) about 2 shifts per week, so I have no actual benefits through my work. The zofran is the only thing making it possible for me to work at all. Has anyone else battled it out w/ their insurance company and won? I'm hoping I can get reimbursed because for the 12 pills it's about 300 dollars and I'm going to have to get a refill tomorrow! I'm so tired and frustrated and stressed and it's making the hg worse I know. As many of you I'm sure agree 300 dollars for meds every week or so is insane. I guess I just needed to vent and see if anyone has dealt w/ this issue/s. TIA. Dee

[kitty_doc]

Hey, I am posting on the second trimester board, but saw your message and wanted to respond. I have lousy insurance coverage for my Zofran too (have to pay and wait to be reimbursed 70%), so I know how hard it is. I am copying a reply I received in response to my inquiry for any assistance through the drug company--I have not yet called to see what they are willing to do.

Thank you for contacting GlaxoSmithKline with your inquiry. The GlaxoSmithKline Reimbursement Resource Center was established to assist patients and healthcare professionals with coverage, reimbursement, and billing issues related to certain GlaxoSmithKline products. The center can be contacted by calling the toll-free number 1-800-699-3806 between 9:00 a.m. and 8:00 p.m. Eastern Time, Monday through Friday. Please remember that we do not guarantee or provide any explicit or implicit warranty of coverage or reimbursement for any of our products or related services.


Let me know if that helps!

[Ivydragon]

Hi Dee,

Ok, so according to the rules you have to try to antiemetics. Ok, the obvious other one most HGers go through is Reglan. Reglan is renowned for causing the same time of anxiety reaction that Phenergan caused in you. It is probably what they would accept you trying. There is a whole list of drugs that is used for HG and I'll go find the link and post it here.

http://www.hyperemesis.org/mothers/trea ... ations.php

If trying their rules doesn't turn out to be an option, have you tried talking w/ a supervisor or manager when you call and talk to the insurance company? There is often this 12 day rule, but nearly all insurance companies have an over-ride process that takes your Drs. involvement but is possible.

Some other options: 4 mg Zofran is the same price usually as 8 mg Zofran. You could get twice the amount of Zofran for the same price if your Dr. would change your Rx to 8 mg Zofran pills instead of 4 mg Zofran pills. Zofran is also available ODT, but I don't know if they are splittable, and it sounds like you're swallowing them ok, and do well if you can get an adequate dose. I'd work w/ your Dr. There ARE options and ways to make this work more smoothly for you one way or another.

Call your pharmacist and find out what the prices for Kytril and Anzemet are in comparison to Zofran. Sometimes one of these "sister" drugs to Zofran are less expensive, and although not as well known as Zofran have been used successfully by HGers.

I responded to your other message and suggested steroids as well.

Let me know if you need more info,

Andy

[dgh1973]

Thanks to all who responded. I'm working w/ my drs. office to get the situation settled w/ Aetna. He actually ordered compazine for me so I think I'll go pick it up in the am. I'm a little leary about even trying it so I think I'll just say it didn't help. That way, I will have met all their so called requirements to get approved for the zofran. At this point I'm just hoping for a partial reimbursement. A full reimbursement would be very nice but I"m not crossing my fingers! Also, the nurse at my drs. office actually talked the zofran rep into giving her 10 8mg sublingual tablets for me for free! I picked those up today. I'm an RN and work nights which is really hard for me right now. Luckily, I only have to work 2 nights a week but it is struggle and the only way I'm making it is w/ the zofran! Again, thanks for your replies!

Dee

[Ivydragon]

Wow, free Zofran! What a blessing.

Andy