My neurologist wrote me a prescription for rytary more than a week ago. But my CVS pharmacist said my insurance company wasn't covering it. Without coverage, the new drug would cost $978!
I'm covered by AARP MedicareRx Preferred, administered by UnitedHealthcare, the country's largest health insurance company.
My neurologist is on vacation, but should return by the end of next week. So I called UnitedHealthcare to learn how to secure coverage for Rytary. Here's what I discovered:
Formulary Exception For a New Drug
Rytary is now considered a "non-formulary" drug under my plan. To get that designation changed, we'd need a formulary exception. The insurance rep told me there were two ways to expedite such an exception.
- I could have a prior authorization form sent to my doctor, who would need to respond within 72 hours.
- My doctor could request the exception by phone.
Interesting Decision on the Horizon
Even if we get the formulary exception, I'm not sure I'll use rytary.
I switched from the regular carbidopa/levodopa to the ER version about a month ago. Since then, I'm no longer getting the scary "off-period" blood pressure spikes I regularly experienced on the regular carbidopa/levodopa. My incontinence is now more under control, and I'm feeling better generally.
Even so, this ER variety I'm taking isn't perfect. Two neurologists have told me their patients have found the new ER levodopa/carbidopa version occasionally erratic, reporting episodes of its not working at all. I recently experienced such an incident.
My research on patients' reactions to rytary has uncovered a decidely mixed bag. Next week, I'll share those responses from users.