I recently hit the donut hole in medicare. Its no wonder when the price of nadolol has skyrocketed. I was told that for 80 mg tabs, 3 a day it would cost me $300. Before I got medicare it cost me about $50. I'm fortunate in that I won't need it until the 30 of this month and next yr is soon. I won't be getting enough for a month this month. Ok question: If you're paying for it out of pocket what is it costing you?
Perhaps ask doctor to prescribe less expensive form.
Talk with your pharmacist, about other drugs which can be used to cut cost.
Call around to different pharmacies, you will be amazed at the different prices.
The donut hole sucks !!
Doesn't it (Medicare) drug stages start over in January?
Advice : never stop or omit drugs from your regime
My best to you
Dear KM; Sure wish I had some kwowledge on the" medicare donut" hole
so I could give you some payback. But, I still owe you and your little
doggies too. It will be intresting to see how long it takes for them to get back to you..That is alot of out-of pocket money to come up with... $$ dd $$
Kaismama please all pharmacys prices are different i find chain stores to be the highest prices when you have to pay for a rx there is no set prices anyway i just called two pharmacys around here i got this NADOLOL 80MG AT TID I ASKED FOR A PRICE OF 90 TABLETS THE HIGH ONE WAS 149.50 AND the small store said 110.00 call around but i used to do this all the time i would give my low income patients a week or 2 to get by then fill it in january There has been several times i have tried to send a question just to you how did you do this..i wanted your advice like someone was asking about out of diamox generic aceazolamide the FDA SAYS there was a hold on it expecting it in to pharmacy this month or next at the latest.
And i don't like spending time on junkies what do yu do??? Again if ther pharmacy your going to was not charging these high prices but the insurance company cuts it down look at one of the slips and see what the insurance is paying..but call around you are getting the bad end of the stick here i am very sorry i have been trying to answer but im one fingering it im shaking so bad again today your friend chuck
can you tell me what im doing wrong that i can't ask you a dirrect question.just for the heck well you let me know if that price was 90 tabs..chuck
I'm not on nadolol, but I've been told that once I go on medicare for primary prescription coverage (on COBRA right now), I'll go in the donut hole the first month because of my IgG treatments. I'll end up paying $15,000-$16,000 per year for out of pocket costs just for my treatments--- WITH medicare insurance. Have you checked online to see if nadolol is in WalMart's listing of meds that you can get for $4 per script, with or without insurance? It's worth a shot. I doubt it, but you can try. I empathize with you. My day is coming when I'll have to deal with the donut hole on Rx's. At least I was able to get COBRA from ex for 3 years. Medicare has always been secondary to that insurance. Yikes! I hate to think of it.
Here's my answer from Mylan:
We appreciate your concerns and very much recognize the importance of affordable medicine. In fact, as one of the world's leading generics companies providing access to high quality, affordable medicine is Mylan's mission.
Please note that the prices charged to consumers for our products are ultimately determined by the pharmacy/on-line pharmacy/retailer where you fill your prescription, or by your insurance company.
Again, we are committed to making high quality medicine affordable.
I don't know if you folks heard about the below announcement but you need to provide responses to the Federal Register announcement if you want to have any input to try and protect yourself and your doctors so that you can continue receiving legitimate pain medication. If you are 65 or older you especially need to respond to this announcement.
The Centers for Medicare & Medicaid Services (CMS) has proposed new rules to combat fraud and abuse in the federal Medicare Advantage and Part D prescription drug program.
"Prescription drug abuse is a serious and growing problem nationwide. Unfortunately, the Medicare Part D prescription drug program (Part D) is not immune from the abuses associated with this nationwide epidemic," CMS said in a statement issued January 6.
CMS takes this problem "seriously and is taking steps to protect Medicare beneficiaries and the Medicare Trust fund from the harm and damaging effects associated with prescription drug abuse," the statement reads.
CMS says a centerpiece of the antifraud strategy that focuses on protecting beneficiaries is identifying Part D enrollees who have "potential opioid or acetaminophen over utilization issues that indicate the need to implement appropriate controls on these drugs for the identified beneficiaries."
In addition, the agency will employ data analysis to identify prescribers and pharmacies that may be engaged in fraudulent or abusive activities.
"We are leveraging CMS' access to all PDE [Prescription Drug Event] data and using it to guide our anti-fraud efforts and share the results of our analysis with Part D plan sponsors, law enforcement agencies and pharmacy and physician licensing boards, as appropriate, so this information can assist our joint efforts to combat fraud and abuse," CMS says.
A key provision of the proposed rules is to require prescribers of Part D drugs to enroll in Medicare. This will ensure that Part D drugs are prescribed only by qualified individuals, CMS explains.
CMS is also seeking authority to revoke a physician's or eligible professional's Medicare enrollment if:
CMS determines that he or she has a pattern or practice of prescribing Part D drugs that is abusive and represents a threat to the health and safety of Medicare beneficiaries or otherwise fails to meet Medicare requirements; or
His or her Drug Enforcement Administration (DEA) Certificate of Registration is suspended or revoked; or
The applicable licensing or administrative body for any state in which a physician or eligible professional practices has suspended or revoked the physician or eligible professional's ability to prescribe drugs.
"Providing CMS the authority to revoke such prescribers' Medicare enrollment would help protect beneficiaries and the Medicare Trust Fund from fraud, waste and abuse," the agency says.
Another proposed rule would provide CMS, its antifraud contractors, and other oversight agencies the ability to request and collect information directly from pharmacy benefit managers, pharmacies, and other downstream entities that contract or subcontract with Part D sponsors to administer the Medicare prescription drug benefit.
This provision would streamline CMS's and its antifraud contractors' investigative processes, the agency says.
"Currently, it can take a long time for CMS' contractors who are often assisting law enforcement to obtain important documents like invoices and prescriptions directly from pharmacies, because they must work through the Part D plan sponsor to obtain this information," they explain in a statement. "This proposal is designed to provide more timely access to records, including for investigations of Part D fraud and abuse, and responds to recommendations from the Department of Health and Human Services (HHS) Office of Inspector General."
Overutilization Monitoring System Working
The CMS is also targeting payment accuracy by proposing that Medicare Advantage plans and Part D sponsors report and return identified Medicare over payments.
The proposed CMS regulations to combat fraud and abuse in Medicare Advantage and Part D prescription drug plan are scheduled for official publication in the Federal Register on January 10, 2014. CMS will accept comments on them until March 7, 2014, and then issue a final version of the regulations.
Last summer, CMS implemented the Overutilization Monitoring System (OMS) to combat Part D fraud and abuse, and it's paying off, the agency reports. "An initial comparison with 2011 PDE data pre-dating the implementation of OMS shows there has already been a substantial reduction in the number of acetaminophen and opioid overutilizers in Medicare Part D," CMS reports.
FYI, here is a small study report from Japan on green tea and how it interacts with Nadolol.
A preliminary study reports that drinking green tea reduced the plasma concentration and the systolic-BP–lowering effect of the beta-blocker nadolol in 10 healthy young volunteers.
"We'd like to raise the possibility that green-tea consumption may change the plasma concentrations and pharmacological effect of nadolol," lead author Dr Shingen Misaka (Fukushima Medical University, Japan) commented in an email to heartwire . However, the "clinical study was just a small study in healthy adults," he cautioned. "Therefore, we consider that it's still insufficient to expand our findings to other beta-blockers, all green-tea products, and of course hypertension patients. . . . Further studies in a large population and different age groups will be needed."
The researchers showed that the blood-pressure–lowering effect of a single dose of nadolol was weaker after the volunteers had been drinking about 2 cups a day of green tea for 2 weeks than after they had been drinking this amount of water for 2 weeks.
Further, they showed that in cell-culture experiments, green tea appears to inhibit an organic anion-transporting polypeptide (OATP)—specifically OATP1A2—which is present in the intestinal epithelium and at least partly responsible for transporting nadolol into cells.
Green Tea–Nadolol Interaction
The catechins in green tea have been reported to prevent cancer or cardiovascular disease, but they might interfere with how certain drugs are absorbed by the body. Previous in vitro studies showed that catechins inhibit drug transporters such as P-glycoprotein (P-GP), OAP1A1, and OATP1A2, and nadolol is a substrate of OATP1A2.
These results suggested that drinking green tea might inhibit P-GP or OAT-mediated transport of nadolol into cells, which might alter the pharmacokinetics and pharmacodynamics of nadolol. The current study aimed to shed light on this potential interaction.
"Nadolol is prescribed for hypertension and angina pectoris and approved in many countries," Misaka noted. "However, nadolol is a relatively minor beta-blocker compared with other beta-blockers such as metoprolol and atenolol."
The researchers enrolled eight men and two women aged 20 to 30 years who had a body-mass index of 18.3 to 23.9 kg/m2, were nonsmokers, and were not taking any medications. Subjects were instructed to refrain from drinking green tea or apple, cranberry, grapefruit, or orange juice, since previous studies suggested that these juices inhibit OATP1A2 activity.
This was a randomized crossover study separated by a two-week washout period. For 14 days, the subjects were randomized to drink either 700 mL/day of green tea or water. Then they received a single oral dose of 30 mg of nadolol. Blood and urine was collected for testing, and blood-pressure and heart-rate measurements were done at specified times during two days of follow-up.
Greatly Reduced Plasma Nadolol Levels
When the subjects had drunk green tea as opposed to water during the 14 days prior to receiving the dose of nadolol, their plasma concentrations of nadolol were markedly reduced by 76%.
Green tea suppressed effect of nadolol on blood pressure, although there was great inter-individual variability. At baseline, on average, the study subjects had a pulse rate of 67 beats/min, a systolic BP of 114 mm Hg, and a diastolic BP of 71 mm Hg. After a single dose of nadolol, the maximum decreases from baseline in these measures were 20%, 12%, and 11%, respectively, when the individuals drank water. These effects, especially the effect on systolic BP, were weakened after the subjects had been randomized to drinking green tea.
The in vitro experiments in this study showed that OAP1A2 was involved in transporting nadolol into cells, and green tea inhibited this action. "Inhibition of intestinal OATP1A2 may contribute to this interaction [between green tea and nadolol], although the involvement of other mechanisms such as upregulation of intestinal apical efflux transporters, eg, P-GP, cannot be excluded," Misaka explained.
"The clinical impact of the green tea–nadolol interaction may also depend on other factors including the dose of nadolol, the amount of green tea (catechins) consumed, and other coprescribed drugs," he observed.
The study was published January 13, 2014 in Clinical Pharmacology & Therapeutics.
I just filled 90 day supply of 40mg yesterday - last filled 90 days ago, price went from $20.42 to $544.51 WITH employer insurance and on "preferred drug list". I am getting the run around from HR here about the price - they don't seem to know. Does anyone know what is going on? This drug has been around for over 30 years.
- Nadolol Information for Consumers
- Nadolol Information for Healthcare Professionals (includes dosage details)
- Side Effects of Nadolol (detailed)
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