What is the cheapest way to get a prescription written for Lamotrigine?
November 5, 2014 6:40 AM   Subscribe

I need to get a prescription for Lamotrigine. I have been on this drug for years, but my refills are about to run out. I need to find the cheapest way to go about this. I'm in the US and I have not met the deductible on my insurance. I can't go back to the last prescriber because I owe them money I don't have.

The last person to prescribe this was a psychiatric nurse, about six months ago. I'd seen her last year with no problems, and then her office failed to inform me that she was no longer covered under my insurance in 2014, so I got a large bill that I couldn't pay, and that went to collections. Incredibly, this is the second psychiatric office this has happened with, so I can't go back to the previous prescriber either. (The one before that is in a different state.)

I haven't seen a PCP in about a year and I don't know if he would prescribe it. It's not a "fun" psychiatric drug like Adderall or Klonopin and I've been on it for a long time with no side effects, so it shouldn't be a problem, right? I have no idea what an office visit would cost.

I can either put this on a credit card or stop eating, so that's why I'm looking to keep costs down. Since there is zero chance I'll meet my deductible this year anyway, is it cheaper to pay a doctor's office in cash than go through my insurance? What options do I have?
posted by desjardins to Health & Fitness (12 answers total) 2 users marked this as a favorite
 
The online pharmacy I use for my blood pressure meds and inhalers for the past 4-5 years has the generic. I just sent you a DM with info on Twitter.
posted by mrbill at 6:54 AM on November 5, 2014


You might be able to work through your pharmacist. A lot of them will call the doctor's office on your behalf and request a refill prescription. This worked great for me in the past.

and this is only tangibly related to your request, but you can use GoodRx to keep the costs as low as possible.
posted by royalsong at 7:02 AM on November 5, 2014 [4 favorites]


I would definitely try the pharmacy first, and ask them to request a refill from the prescriber.

If that doesn't work, I'd look up low-cost medical clinics in your area. (If you tell us the area, I'd be happy to try to find them.) You basically want the clinic for people who are uninsured or on Medicaid, the local "community health center," or a non-profit charity clinic for low-income people. The wait time for an appointment is likely to be long, so I'd work on getting on the list as soon as possible. In most cases, telling a doctor that you've been stable on the medication for years (assuming that's true) but don't currently have a prescribing doctor will get you a prescription without much problem. (And I would let the receptionist know that you're coming in for a med refill when you make the appointment.)
posted by jaguar at 7:09 AM on November 5, 2014


If you are still in the location listed in your profile, then it looks like this is the Federally Qualified Health Center (government lingo for "primarily serving people with Medicaid or no insurance") for your city. The website seems to be scanned PDFs, but the links on the bottom of that page work. FQHCs usually provide sliding-scale fees for non-Medicaid clients, based on income. I'd give them a call and see what their procedure is.

And in my area, CostCo is almost always the cheapest place for purchasing medications, and their pharmacy is open to people who do not have CostCo memberships. Here's their pricing on Lamotrigine. It looks like it may be worth looking into the generic, if that would work for you (I know some people don't tolerate various generics).
posted by jaguar at 7:17 AM on November 5, 2014 [3 favorites]


You have good answers here already but I just want to emphasize that a primary doctor can write for this. It doesn't need to be a psychiatrist. Some might be uncomfortable writing for a psych med but as you have taken this for a long time and it has non-psych uses, I'm thinking this is unlikely to be a problem especially if you have been stable in terms of symptoms.
posted by latkes at 7:36 AM on November 5, 2014


Also, you can request your medical records from your previous prescriber, and bring them with you to the next place. Your previous doctor cannot withhold them based on non payment, but can charge and administrative fee. In my experience, this can help expedite things with a new doctor, as they are able to read the notes from previous care.

Seconding GoodRx. It can tell you if a membership warehouse (whatever those are called again) makes sense. Its worked for me in the past.
posted by troytroy at 7:37 AM on November 5, 2014 [1 favorite]


I wrote an fpp on this several years ago.

Depending on your dose you can save a lot by splitting pills. For example, if your dose is 25 mg/day, you can split a 200 mg/pill in eight parts.

For example, from this price list, 30 200 mg pills go for $29.75 while 30 25 mg pills go for $15.40. So, divide the 200 mg pills by eight and you have 240 doses, or $3.72 a month. Its hard to be much cheaper than that. Of course, this will vary if you have 50 mg per day, etc.

For an operation like this, you might want to invest in a means of accurately weighing small amounts and maybe a pill cutter. (The latter is cheap)
posted by dances_with_sneetches at 8:18 AM on November 5, 2014


Response by poster: Okay, apparently my question is not as clear as I thought it was.

I can afford the actual drug, and it's available as a generic. Last time, it cost me $15 for 30 200 mg pills at CVS; I found out later that it's $9 at Walmart.

What I am asking is this: what is the cheapest way to get it prescribed?

Based on other answers here/on Twitter, I'm going to see if the pharmacy can get my last prescriber to refill the current prescription; if she won't do that (based on me owing her money/not having seen her recently), I'll call my PCP's office and ask if he'll prescribe w/o seeing me. If he won't do that, I'll make an appointment with him and pay cash.

Thanks everyone, I'll update later with what worked.
posted by desjardins at 8:41 AM on November 5, 2014 [1 favorite]


You also might be able to get away with counting this as your "preventative" visit for the year. I think most (all?) health plans are now supposed to cover one free preventative visit each year. When I went in for mine this year, it was basically blood pressure/checking my weight, doc listening to my heart, refilling all my prescriptions, and just chatting about general health issues. I think it would also cover a pelvic exam/pap smear, although I did not need one this year (apparently they do it less often as long as your recent paps are negative) -- obviously not relevant if you are a guy! Anyway, when you call your primary care doc, you might ask if it is possible to bill under this code.
posted by rainbowbrite at 8:49 AM on November 5, 2014 [1 favorite]


You might have success with the CVS minute clinic (or similar in-drug-store clinics). They do a one-time medication renewal (up to 90 days) for $59. I'd try to call them first to see if this is a type of medication they can renew.

I also recommend trying to use your preventative coverage for this. You should be able to get a physical and (if female) a well-woman visit with 100% coverage and no copay.
posted by melissasaurus at 9:24 AM on November 5, 2014 [1 favorite]


My primary care takes care of this. I'd try going through the pharmacy first.
posted by BlueHorse at 10:30 AM on November 5, 2014


Given that it can be fatal to suddenly stop taking this medication (even if rarely) I don't think your PCP would have a problem prescribing it to you.
posted by blackzinfandel at 4:05 PM on November 5, 2014 [1 favorite]


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