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Insurance is limiting Cialis

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Posted 1/24/2009 1:27 PM (GMT -8)
My urologist prescribed 5mg Cialis daily at this stage of my recovery stating it will reduce chances of calcification of blood pathways owing to the induced ED from the prostatectomy. He wrote me a 90 day prescription, but advised me that owing to the cost, I could go every other day.

I filled my prescription using my employers mail order pharmacy (required) and they are limiting my prescription to 5 a month and dispensed 15 tablets at a cost of $69.43 ($4.63 per dose). I checked with a local pharmacy about the cash price for this same 15 tablet and was told that it would cost $89.50 ($5.97 per dose), so my insurance is covering very little of this medication.

I have a few questions for the experienced folks here:

1) Is the pharmacy limit of 5 per month a reasonable dosage level?

2) Should I ask my doctor for 10 mg dosage prescription and cut tablets? Usually the per tablet cost is the same under insurance regardless the dosage.

3) Are there other medication options to reduce chances of calcification? I'm not trying to achieve an erection at this stage, but want to improve my chances in the future.

4) Would a penis vacuum pump achieve the same blood flow action to keep the plumbing exercised at a much reduced cost?

5) Other ideas?

TIA! turn
Posted 1/24/2009 2:01 PM (GMT -8)
Dandapani,
A better option with your current pills may be to ask for the 20mg tabs and split them into 4. Many of the members here have struck the same problem and now source their E.D. meds overseas. Alldaychemist has a reputation for good delivery and feedback from members endorses the effectiveness of their generics with the delivered cost coming in at about $1-00 a pill. I believe though there is a problem with bringing the generic Cialis into the U.S. because of patent restrictions. These restrictions do not seem to apply to either generic Viagra or Levitra. You can check them out here.
www.alldaychemist.com/men_health.html

Cialis ...... active ingredient........Tadalafil 20mg
Viagra......active ingredient........Sildenafil Citrate 100mg
Levita.......active ingredient........Vardenafil 20mg

The vacuum pump is a great solution to keep things in working order if the pills at this stage are not helping a great deal with erection.
Bill
Posted 1/24/2009 2:17 PM (GMT -8)
Cialis or Viagra is usually used more often than 5 a month: you could ask about more regular use which sounds more logical.

Some men often cut the pills  into 2 or 4, depending on the size.

Pump could be used in addition to medication.

Edit: sorry for some repetition: slow typing here

Post Edited (aus) : 1/24/2009 3:21:22 PM (GMT-7)

Posted 1/24/2009 3:31 PM (GMT -8)
Dandapani, my health plan sound very similar to yours. They pay for 5 Levitra per month. My cost is about $65. I began to use the generic Levitra through Alldaychemist.com. Very happy with their service and product. I bought 20 pills for $40 ish shipped.
Posted 1/24/2009 6:08 PM (GMT -8)
All good info. Thanks!
Posted 1/24/2009 6:53 PM (GMT -8)
My insurance co (BCBS Federal Plan) covers no ED medication even after I submitted an appeal and a letter from my Doctor. I will use ADC as long as I can and the "big" drug companies can keep their high dollar drugs.
Good Luck,
KW
Posted 1/26/2009 8:19 AM (GMT -8)
This is the problem with all insurance for ed - it has or is going away. Until 2005, most insurance companies covered all ed treatments, with the advent of the "blue pill' that has all changed. I have anthem - but it covers nothing. And all other private insuance carriers in Indiana do not cover this as well. This is the big concern among many of us - there is no or very limited coverage. my next trip under the knife will all be 'on me'.
Art
Posted 1/26/2009 1:49 PM (GMT -8)
My doc prescribed me 5mg Cialis. I received some samples from him that lasted a while, and also went online to Cialis and received a 30 day supply as a free trial. As the doc really wants me to take the 5mg's every other day the freebies from the on-line free trial for me are good for 60 days. I know this is only temporary but with the high costs of these things every little bit helps.

I am also using a Trimix mixture - the doc was not high on pumps because he says the pump does not effect the area most needful for reconstruction which is not exercised by the pump.

Only passing this on as information. I am still fighting the same battle most of us are fighting with the hope of future improvements.
Posted 1/26/2009 2:21 PM (GMT -8)
Dandapani, Blue Cross(State Plan) limits me to 6 100mg Viagra a month. I'm just 17 days post-op at this point so I have not started them yet, even with the total ED. Still a bit sore down there and the doctor has not given the OK yet.
Posted 1/26/2009 6:01 PM (GMT -8)
Thanks all. I ordered the 20mg Cialis from ADC. I haven't heard anything from them yet on the order so fingers are crossed. Thanks for the pump info. I guess that's not the answer either.
Posted 1/26/2009 10:02 PM (GMT -8)
My BCBS plan covers 8 Cialis per month.  For the remainder - from a total prescribed of about 16 per month - I think my co-pay is about $80/month.  I pay an additional approx, $80 for the MUSE, per month.
Posted 1/27/2009 3:07 AM (GMT -8)
I wonder how you guys getting Cialis (tadalafil) from ADC here in the US are managing it. I just got this mail from them:

===

Dear Dan

Thank you for placing an order with us.

Please note we cannot ship tadalafil (to USA) if it is meant for consumption in USA.

(OPTION ONE) If you can send us a mail stating that the product is not for consumption in the US and then we can ship the product to you.

(OPTION TWO) Alternatively, we can ship it to any other country (besides USA) OR

(OPTION THREE) we can ship you 10 pills + 10 pills free and 10 pills extra Vardenafil Hcl 20 mg instead of Tadalafil.

Other internet sites offering Tadalafil for sale in USA are putting you at risk.

PLEASE INFORM US WHICH OF THE OPTIONS (ONE, TWO OR THREE) YOU WISH TO UTILIZE.

This is for your kind information please and we look forward to your confirmation about the above.


With warm regards

ANUJ
Tel (US): (213) 814 1441
Posted 1/27/2009 3:31 AM (GMT -8)
Dandapani
If you go back to my earlier reply to your original opening post you will see that I mentioned there was a problem with bringing Cialis (Tadalafil) into the U.S. The manufacturer Eli Liley, still has a stranglehold on the patent. Many U.S. members have spoken of their problems trying to import it and ADC has a warning on their site that they are not permitted to sent Cialis generics to the U.S. Strange because we have no problem here in bringing it into Australia. Levitra and Viagra generics do not have the same restriction and their effect is the same although some members report differing side effects to Cialis (or the generic). Now if your were to declare to them that you were not going to consume them in the U.S (perhaps a little white fib) they will obviously send them to you, but I do not know how you will get on with U.S. customs. Other members may be able to chime in and help with that.
Bill
Posted 1/27/2009 3:31 PM (GMT -8)
Sorry, BillyMac, I missed your first post. Yup. Looks like I'm SOL with the Cialis formula.

Anyway take the Levitra at the lower dose on a daily/every other day basis... ?
Posted 1/27/2009 5:03 PM (GMT -8)
All those drugs work by the same methods.........i.e. they all relaxes muscles and increase blood flow to particular areas of the body. They are known as phosphodiesterase inhibitors. So I should think the Levitra generic would be taken at the same dose rate as Cialis (5g/day or 10g every second day) or if using Viagra generic then 25g each day or 50g every second day would be the equivalent. Some members have reported better response from the different drugs with some preferring Cialis while others prefer either Viagra or Levitra. This is a quote from an article I remember reading:

"What Are the Differences Between Cialis, Levitra, and Viagra?
Cialis, Levitra, and Viagra work by a similar mechanism to cause erections. There are subtle differences in how long the drug works and how quickly it works. Levitra works a little longer than Viagra. They both take effect in about 30 minutes. With Levitra, the effects last for about 5 hours. With Viagra, the effects last approximately 4 hours.
Cialis works a bit faster (within about 15 minutes), and the effects last much longer -- up to 36 hours in some cases."

It would probably be a wise move to ask your doc if he feels there is any difference between the drugs for surgery recovery purposes.
Bill
Posted 2/1/2009 8:42 AM (GMT -8)
I just went to pick up my prescribed 15 pills of cialis (20 mg) to be able to take 20mg every other day. Pharmacy said BCBS would only approve 4 per month? So even if I cut in half and take 10mg twice a week it is still less than the every other day I am supposed to be taking. I have a call in to my doctor to get his advice on whether to go ahead and take the 10 twice a week.

After reading some posts here I think I will order from ADC and give them a try. It would cost me $250 per month to get what doctor prescribed!

Also, the pump cost me $475 out of pocket - not real crazy about and not real good results from it but I will continue to use every day.

Just wanted to share my experience.
Posted 2/1/2009 9:44 AM (GMT -8)
Tom, alldaychemist is not allowed to import Cialis generic into the USA. You can get Viagra generic and Levitra generic though. The Levitra generic should be a good substitute for the Cialis. The reason BCBS won't pay for more than 4 a month-according to my BCBS Rep.- is they still consider it a sexual aid, not a rehabilitive drug. Still living in the past as far as understanding the need for rehab use of the drug, but that's their stand. I guess they figure a man can live with sex once a week, but there's no need to regain what he has lost, it will just cost them money.... turn
Posted 3/24/2009 1:50 PM (GMT -8)

Dandapani said...
I wonder how you guys getting Cialis (tadalafil) from ADC here in the US are managing it. I just got this mail from them:

Send a reply email that elects: (OPTION ONE) If you can send us a mail stating that the product is not for consumption in the US and then we can ship the product to you.

"Please send the tadalafil, as ordered. I will not be consuming this medication in the United States."

ADC is just covering its rear with regard to patents. I doubt if it will strap a polygraph to your email to see if you're using tadalafil inside or outside the U.S.


 

Posted 3/25/2009 6:18 AM (GMT -8)
I had to jump through hoops to get my ED meds approved by my insurance company.  Once approved I was REALLY supprised that they limited the amount covered.  The coverage did not even come close to my one a day prescription.  They claimed the limit was in place to stop the recreational use of the drug.  Next time I go to an old age home I going  to look for their supply of blue pills tongue

ADC was the answer I got from this forum, and it works well.

Posted 3/25/2009 6:18 AM (GMT -8)

Congratulations! You are now in the harriest part of this ball game.  (Pardone the pun about "ball" because that's what you are doing very little of.)

I'm retired military and my insurance only pays for 6 x 100 mg Viagra monthly.  My uro says it stupid because 10 cost the same price.  Go fig.

As for the vacume device, it probably saved my marriage...not to mention my Johnson.  Yes to the VED. Minimum of 2 to 4 times a week.  Trust me, over the past six months I failed to do it regular and have noticed about a quarter inch loss in length.  I can't emphasize this enough.  Check with your uro first.

Even with the Viagra script, I use the dickins out of that pump and stock piled my pills.  Now I'm on the needle, sometimes in conjunction with Viagra.  Don't worry about the needle.  If you want an erection, that little prick in your prick isn't all that bad.  But, it looks like that's down the road for you still....if you insurance will pay for it.  Its like a couple hundred bucks for 10 ml bottle.

Here again though, ALWAYS CHECK WITH YOU DOCTOR FIRST!

Good luck.

Posted 12/9/2015 6:07 AM (GMT -8)
I use a different off-shore pharmacy than others have mentioned. I got my last shipment in late October, and it arrived after the 10/15 "crackdown" date that the FDA had imposed. I don't know how future orders are going to go though.

My local BCBS does not provide any coverage at all for the PDE5 inhibitors, although their employees have nearly unlimited access to them through their self-insured company plan. Do as I say, not as I do, I suppose.
Posted 12/9/2015 7:30 AM (GMT -8)
My experience is similar to Sandstorm's. My doc prescribed Viagra, and my BC/BS plan will cover 6 tablets per month no matter the strength (nor the reason prescribed) with a $10 co-pay, so naturally we go with 100 mg and quarter them up. I take one 25 mg 'quarter' each day. Of course this doesn't quite make it an entire month but I got a pre-surgery scrip filled to give me a head start. I wish I would've thought to get the stockpile started a little sooner, LOL!
Posted 12/9/2015 8:01 AM (GMT -8)

RSteve said...

Dandapani said...

I wonder how you guys getting Cialis (tadalafil) from ADC here in the US are managing it. I just got this mail from them:


Send a reply email that elects: (OPTION ONE) If you can send us a mail stating that the product is not for consumption in the US and then we can ship the product to you.
"Please]
ADC is just covering its rear with regard to patents. I doubt if it will strap a polygraph to your email to see if you're using tadalafil inside or outside the U.S.

I just clicked on the order, not for consumption in the US.

ADC order came in fine, umm less than two weeks ago.

If you are unable to obtain thru ADC, I was using inhousepharmacy.vu for several years although they cost more - almost twice as much. ETA $98 for 40 tablets

Post Edited (Ken) : 12/9/2015 9:06:21 AM (GMT-7)

Posted 12/9/2015 8:12 AM (GMT -8)
NO Discussion of off-shore pharmacies! They are illegal in most cases for US patients, and we do not promote illegal activity.

And a Zombie thread at that!
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