£25 for three nights sleep

Today I got a little bit of a taste what it would be like to live without the NHS.

My surgery isn’t open, and I’ve run out of medication.   I don’t sleep at all without it, so Rob went to the chemists to ask what could be done.  They said they could give me enough for three days, but that I’d have to pay for it.  Assuming it was the price of a prescription, I traipsed to the chemists armed with seven quid.

It was actually the price of medication, and a three day supply of my dose (450mg) of Quetiapine costs over £25.  £25 for three days.  I have been swallowing gold for two years.  No wonder I still feel like shit.

Clearly, I couldn’t afford this so settled for half the dose.   I might not sleep anyway but I’ll have more change in my pockets.  I could have left with nothing but three days without any medication at all would send me loopy, it doesn’t only help me sleep.

How do you people manage?  I don’t know the ins and outs of health insurance but I am assuming that some people have to pay for their medications out of their own pockets.

Has anybody got a link or information as to how much, say, a month’s supply of the generic version of psychiatric medications cost?   There’s some information on this site but aside from that, not much.  How much do you pay?

46 Responses

  1. No link, but my medication (lamotrigine, which has just gone generic, 300mgs a day) costs $160 per week, down from $240 when it wasn’t generic. The supplementary medicine I take only prn is $45 every time I get it filled.
    $160 = ~ L 120, or L 480 per month.
    $240 = ~ L 180, or L 720 per month.
    At the moment, I am poor and student-y enough to get it for free from GlaxoSmithKline. However, I worry about what will happen when I get a job (very soon) because if I make enough money to live on with a job that doesn’t have health insurance included (very likely) then I will have to pay for it outright, which will mean that I won’t have enough money to live on. So, I need to stay quite poor or have a job that pays plenty of money or a job that pays well and also provides health insurance that covers mental health (most of them don’t.)
    Hurray for the private sector and American healthcare, the best in the world! Just ask the nearest Republican; they’ll tell you.

  2. The BNF has it in, if that’s any help x

  3. Just want you to know that I admire your courage, strength and openness. And I love your writing, it’s really interesting. I believe you are a big inspiration and also an eye-opener for many people. Thanks for a great blog!

  4. Damn it – I now realise just how many gold-mines I’ve freely handed back to the NHS. Months worth of seroquel, quietipine and more I returned to my pharmacy when I decided quite unsensibly to quit.
    I’d be wary of buying generics from internet sites. they frequently rip you off (i.e. take your cash and don’t deliver). The meds can often be suspect. You have no ‘consumer rights’ in this dodgy arena.
    As an emergency you could try your local A&E. They do often have supplies. I know that’s a hassle but I might be inclined after 3 unquiet nights.
    I won’t throw anymore prescriptions away in future and i still have a strip or two of Olanzapine going if it’s any help but obviously the postal service is closed down for the weekend so that’s no use in the immediate.
    Sorry,
    K.x

  5. like Kate said, the website of the BNF has costing for the NHS for medications. It’s not the easiest site to navigate though.

    http://www.bnf.org.uk

    I have a backlog of quetiapine ….. wish I could sell it back to them at that price!

    I found it a bit odd that they were happy to give you the medication without a prescription (although I’m guessing it’s a pharmacy that knows you?) but still charge you that stupid amount of money.

    This is one of the few occasions where I’m grateful for the existence of the NHS. And my payment exemption certificate ….

  6. http://cks.library.nhs.uk/clinical_topics

    This tells you how much (some) medications are on the NHS.

    (bear in mind that pricing isn’t strictly on quantity – sometimes having a smaller amount of tablets with half the dosage costs more).

    For a months worth of just my psychiatric meds, it’s over £100. Which is why I’m happy there are pre-payment cards, where I pay £100 for the year.

    This is one of the *many* reasons the NHS pushes lithium (and not say topiramate) for bipolar disorder. It’s as cheap as chips :) (It also works in a lot of cases, but I’d still say there’s some financial motivation even if it’s small).

  7. A packet of Aripiprazole cost £101. And that’s for 5mg tablets. Lord knows what a pack of 10mg or 15mg tablets are worth.

    Not bad earnings for a medication that has roughly the antipsychotic effect of a tube of smarties.

  8. I’m wondering about all the other ones I’ve been on. How about Depakote, Risperidone, Haloperidol, Tegretol, Olanzapine, Seroxat, Effexor (to name a few- bloody hell)?

  9. Taking into consideration the number of people who hoard their psych meds, and the expense of purchasing them, an ingenious swap-o-rama could work pretty well. Though that’s probably illegal, immoral, and possibly stoopid….

    Lola x

  10. I remember running out of Seroquel a few times. Several table legs were chewed vigorously until my flatmates threatened to call the cops.

  11. Even when you find out how much these pills would cost in the UK, they’re still subsidized. If you want to know how much they really cost, ask someone in the USofA. Canada and the UK and other countries with socialistic health care tendencies buy the pills in bulk, then act as suppliers to the pharmacies. This massive buying power keeps costs to a minimum.

    The US has a totally different way of buying the drugs, and actually pay substantially more than we do. They basically pay full price, plus the developmental costs for the pills American companies produce. I still have no idea why more of them don’t move here… the pills are basically free and we get all of their TV channels.

    At least that’s my understanding of the process… I’ll look into it and let you know if I’m wrong.

    What I know for sure is in my province (Ontario) I receive a monthly drug card from the Ontario Disability Support Program. When I bring this card to a pharmacy all of my medications (as long as they’re on the government list) are totally covered. I do pay the pharmacy a $2 dispensing fee per script… which is less than a pound.

    Chances are pretty good, if I could find a pharmacy open today, they’d front me up to three days of pills at no cost… I did it with the Seroquel last year, and I used to get a weeks supply of Lithium without a prescription pretty much at whim back in the 90′s when I was mostly homeless.

    So, total cost for me… Metformin, Glyburide, Lithium, Seroquel and Wellbutrin: $10 in monthly dispensing fees.

  12. I also live in Canada and prescriptions are cheap or virtually free if you fall under a certain income bracket and qualify for government-funded disability programs. I’ve managed to find what is probably considered a loop-hole whereby I get my medications through the mental health hospital I am treated at for $5 per prescription, so my monthly total is $20. I’m not on a government-sponsored disability program, I just tell my psychiatrist that I’m not working and he writes a prescription on a blue pad rather than a white one. The blue one costs $5 per.

    But there is definitely an issue for people who don’t qualify for disability and don’t have private insurance from work. They pay full-price and I used to fall into this category. At that time my prescriptions (lithium, zyprexa, lamotragine, levothroxine and lorazepam) cost more than $200 per month. With Seroquel added it would be a fair amount more I’m assuming, although I hear it’s become “generic” therefore is somewhat less costly.

    I think the major issue with the cost of prescriptions in Canada is to do with advocacy. If someone is “in the system” but unable to advocate for themselves, then they’re essentially at the whim of their psychiatrist or healthcare provider to find a cheaper (or free) option than paying full price. And there seem to be a number of options available other than full price. Yet for the most part, when people are very ill with bipolar symptoms, they’re not exactly in the best state of mind to be advocating for themselves. This is where people fall through the cracks and stop taking medication out of pure financial reasons because they cannot access it easily.

    Despite this, I’m proud to be living in Canada where the healthcare system is relatively accessible. I do remember when I first moved to London for a couple of years and walking into a pharmacist to fill a prescription and being charged nothing, absolutely not one pence for the prescription. This was the early nineties, don’t know if that’s changed, but my NHS number was my ticket to free, free, free and I thought that was pretty much the coolest socialist thing I’d ever encountered in a national health care system.

    In the US people have to re-mortgage and then sell their homes just to pay for prescriptions, whether it be for mental health or cancer treatment. The rhetoric goes that the US is the only industrialized nation in the world that operates this way i.e. not a national health care system but a for-profit, privatized (and therefore tiered) health care system. This makes me sick to my stomach. And angry. The US provides opportunity while denying fundamental access to health care for its citizens. Health care should not be a for-profit business within the capitalist marketplace. You’d think the US would have determined this by now based on the experience of their colleagues in the rest of the industrialized world. But then of course, there is no other industrialized nation that supports the right to bear arms in quite the same way as the US. How ironic. The US grants any US citizen the right to shoot someone else in self-defense, but they deny the right of the person that was injured access to free health care. It makes my head spin and I wonder just how the US manages to call itself a first world nation. First world for who exactly?

    • to cravinglife:

      I completely understand and agree that the US should have a national healthcare program, but what does being able to shoot someone in self defense have anything to do with it? In other words, why should I feel bad for someone who was trying to kill me, exactly?

  13. Venlafaxine 150mg is about $180 a box in NYC. That’s c. $360 a month for me as I need 2 boxes. Now, I was in NYC for 6 months but was back in the UK during that time so managed to get my pills on th NHS.

    Olanzapine is $7 a pill there I am told.

    Lithium? $40 for a month’s supply.

    It;s also $150 to see a GP there. I do not recommend showing up at the ER at the Jersey City Medical Centre as an alternative unless you like gang members.

  14. heh. It is good to live in a country that bulk buys then subsidies medication. Invega costs me $5.50 Australian. The cost price in Australia is $250, and in the states I’ve seen it cost over a grand a box.

  15. when I was on my full cocktail my drugs cost a couple of thousand dollars a month…

    towards the end of the time I was on them I didn’t have insurance to cover them all year round…about six months out of the year I had to pay for them….my mom helped me…I wouldn’t have been able to pay for them.

    I’m off them now…so that’s good. no more drug expenses…

    I’m still withdrawing off a bit of Klonopin but that only costs about 10 dollars a month and soon enough that too will be over and done with…

  16. let me give you an example, I took abilify to test it out when it was approved for bi-polar. Lucky for me I had insurance and I pay a $50 co-payment. The price of the prescription for 30 pills was nearly $600. My seroquel is given to me by my psychiatrist in sample boxes. That way I can avoid paying as long as possible. When my daughter was taking Zoloft it was well over $200 a month and that was like 10 years ago

  17. I apologise in advance if you’re easily grossed out. When you cut to the chase mental illness isn’t glamourous and neither is what I’m about to say.

    When I was a student I took Quetiapine as treatment for psychotic depression. I decided to stop (not reduce which would have been slightly more sensible) taking it for a day or two so I wouldn’t be quite to doped up for my end of year exams. Big mistake! What followed was the worst diarrhoea I’ve had the displeasure to experience. Ever seen a rocket launch? I was the rocket and the toilet needed a seatbelt to prevent lift off.

    Lesson learnt. I never tried going cold turkey with Quetiapine again.

    I’m keeping my fingers, arms, legs, toes etc crossed that you won’t experience the same withdrawal effects this weekend.

  18. Hello,

    I use Canada Drugs website to gauge cost. Not sure how often they update there website, so I don’t take it as an end all be all for prices (e.g. Generic Divalproex 125mg costs more than its 250mg, weird eh?). Its got most of the drugs you’ve mentioned in there, if not all.

    http://www.canadadrugs.com/

    I wonder if you’ll find Olanzapine’s cost a hilariously shocking as I did.

  19. i’m on depakote and lexapro at the mo, about $60 australian dollars a month which is pretty reasonable as they are subsidised here, but no where near as much as the nhs! very lucky over there, took me a while to get used to paying for it all here, hubby on drugs too so another $30 month! u poor people having to pay all those mega prices!

  20. Hmmm, Due to start Lamotrigine next week at our UK prescription charge of £7.20 for a month’s supply, ditto for 28 tablets of Lorazepam (although I’ve doubled that dose so really that’s £14.40 a month.) All in all then my mentalist meds only cost £21.50 per month out of my own pocket as I receive no benefits. Which I really don’t think is so bad – for me. Had a hairy time this week as well and had to do much the same as I ran out of Lorazepam just before the Easter weekend, fortunately found a late-night chemist and an old prescription that saved the day.

    I’d be buggered to hell and back by Bernard Manning without the NHS.

    • Hey,
      Not sure if you’re already aware of the Prepaid Prescription Certificate you can get, if you get more than 4 items in 3 months, or 14 in 12 then it works out cheaper. You pay for the prepaid prescription then you can get as many prescriptions as you need.
      Here explains better: http://www.nhsbsa.nhs.uk/1127.aspx

      Sorry, if you’re already aware of it!

  21. Hello, I work in a pharmacy (and read your blog regularly, incidentally). The three-day supply thing is totally legal, the way it works is that if someone comes in and needs some medicine they’ve run out of urgently and the doctors are closed, the pharmacist is legally allowed to provide an emergency supply of up to three (or possibly 5, I can’t remember?) days of their medicine (or a whole course, if it’s birth control or similar), providing it is not a controlled drug (the ones they keep in the safe, with certain exceptions), and provided they have reason to believe the patient has been prescribed it – ie the patient has had a script filled for it with that chemist recently, or the patient has an empty packet on them, with a recent date. The NHS will not pay for the supply, which is why the patient gets charged for it. They are charged the trade price + VAT, as I recall.

    (Incidentally, temazepam is a controlled drug, so if that had been your sleepy-drug of choice, you’d have been screwed.)

    The prices we charge are the prices we get the drugs for, but, as has been pointed out, we get them from our suppliers in bulk, so we get special deals (although as I understand it, the big chain pharmacies negotiate these deals with the pharmaceutical companies, rather than the government negotiating it, as seemed to be implied. There is a sort of NHS-approved price for generics that is what the pharmacies get paid for what they give out- if they give a brand, they specify the price they obtained it at, and get paid that, otherwise it’s just the standard NHS-appoved price) The prices of the generics we get varies from month to month, depending on the current deal. For example, generic glucosamine and chondroitin tablets, something we give an awful awful lot out of, has varied over the last few months from £9.99 for a bottle of 28, up to £45. That’s quite a large change – most drugs aren’t usually quite that changeable, but it does give you an idea.

    If you go to the same pharmacy regularly and they come to know you, a lot of pharmacists will be happy to provide you with the medicines, and obtain the prescription off your doctor afterwards, and therefore will not charge you for the supply. Certainly that’s the case around here.

    As someone has pointed out, you can also access the out-of-hours GP service at your local hospital, but I suspect that’s rather more difficult where you are than it is where I am.

    Yeah, drugs are really really expensive, we’ve got a big campaign going in our area at the moment to try to stop people wasting drugs, where we’ve got displays up telling people the prices for a month’s supply of various common drugs, asking people to PLEASE only order what they need, and pointing out that if you return medicines to the pharmacy, even unopened, even if you only just walked out the door and came right back, we legally have to throw them away. We are not allowed to reuse them. So many people don’t realize that.

    As someone that works in a dispensary, it would be highly unethical for me to advise you to give your drugs to anyone else. However, if that someone else has also been prescribed those drugs and you don’t take them any more/have too many… kinda makes sense to me. Downside, though, is that the person you give your drugs to may well be marked down on their file as non-compliant with medicines if they only request a prescription for a month’s supply of medicine every three months :) Depends how organized your surgery is whether they’ll notice or not.

    Anyway, if anyone wants to know anything about any of their meds, or UK prices for anything, gimme a poke, I like being useful :)

  22. I got a private script when I left The Priory last time and the cost was crazy (For Venlafaxine and Quetiapine). Thankfully, my GP gave me an NHS prescription so I could get the meds on my pre-payment cert. Hoorah for the PPC!

  23. Just a stupid link i found on youtube:

    Yes,people THAT BLOODY STUPID live among us.

  24. PS:for all reading this,that guy needs his videos flagged.Videos like that should not misinform other people about psych meds.
    Sorry if this was so off-the-topic,but I had to put this somewhere.I think it’s just abusive.
    Anyhow,keep blogging Seaneen

  25. I live in the US. Thankfully my parents have damn good insurance now that my father is employed again, but for awhile I wasn’t taking advantage of it. I didn’t have my own copy of our insurance card because my mother kept “forgetting” to give it to me (I don’t know if this was genuine forgetting or an effort to keep me from getting cheap birth control. Either way it was stupid because generic birth control is only $9 these days). My mother also didn’t know about my depression, and I didn’t want her to find out. When my doctor added a brand name med, to my generic Wellbutrin, I flat out couldn’t pay for my medication. It cost more than my goddamn rent! I started pressing harder to get her to send the card, (I’m 600 miles away from home at college) but I still spent over a month begging samples off my psychiatrist. I would tell him I only needed one more week because she said she was sending the card, and then it would never come, and I’d have to go back and beg again. Twice I wasn’t able to find him when I ran out and spent several days withdrawing. Great fun.

    Thankfully, I finally have my goddamn card. Co-pay is still $60 though. My mother is supposed to give me money for that (now that she’s found out about my medication), but I’m not holding my breath.

  26. My Efexor retails in the states at $2.21 a pill. Which means I ingest over $65 of medication every month for just £7.20. God bless the NHS.

  27. Well that’s taking the piss innit? I pay nothing bc I’m British and on sickness but you have my every sympathy ;-<…

  28. I’m deffo gonna get one of those pre-pay certificate thingies on payday thanks to a response on here. Never knew you could pay by DD over the year – lifesaver!

  29. This will blow your mind. My brother didn’t have insurance for two years and we spent close to 10,000 dollars. Makes me sick to my stomach.

    • Unfortunately I am not surprised.

      I had 2 ICU stays that came out to about $150,000. Wiped out! Granted, some of it was “forgiven” and classified under charity. Each doctor billed highest rate (no “contracted” rate was applicable since I had lost my insurance) and were ferocious with bill collectors.

      Don’t get me wrong. Doctors should be making a good living with all the training they go through and have to pay for, pharmaceutical companies are here to make money and patients should make all efforts to be informed (sometimes difficult to do in times of crisis though). I am a capitalist pig too after all!

      But the system is not working now. Any ideas? How can we make our voices be heard?

  30. no website, but I doubt there would be as prices change depending on where you fill your scripts at.

    generic xanax is normally 19.62/mo – 10 dollar copay
    generic wellbutrin sr 163.78/mo – 10 dollar copay
    no generic for strattera – 35 dollar copay/mo
    3 days is 16.74, the rest of the month is 150.62

    those prices are at walmart.

  31. Just worked out the NHS has saved me 13.70 quid on today’s prescriptions.

    it’s a shame you don’t get on with zopiclone – It’s only 1.53 per pack!

  32. I’m just going to add to the discussion here that paying full-price for name-brand drugs is just not possible in the US. If you actually need one of these medications, you probably not going to be able to afford them. (Price according to drugs.com) It looks like your prescription would be about $13/day in the US at full price.

    I am so very glad that all of my meds are now available in the US as generics.

  33. Yea, what people have said/are saying about medication prices in the states are right. I was diagnosed bipolar II (the slightly nicer kind, if that’s possible) four years ago, when I was fifteen. At the height of the cocktail mixing, I remember feeling humiliated and ashamed, watching my father pay for $900 worth of prescriptions a month…. and that was the co-pay, until we hit the $5000 deductible, I think. It was for a fairly unchanging prescription: 300 mg Wellbutrin XL (buproprion), 300 mg Lamictal (lamotrigene), 10 mg Abilify (aripiprazole), and 50 mg Seroquel (quetiapine)…. for a year and a half.

    To repeat, $900 a month.
    It wasn’t pretty.

    • The famous Donought Hole! That’s what they call this “gap”.

      I had to beg my father, who lives in Europe, to pay for my meds. He was telling me that I was lying to him and that there was no way that it could cost that much.

      The irony: he used to sit on the board of one of the big pharmaceutical company. Go figure!

  34. Holy buggery. Yeah, OK, much as I complain about the health system that’s a wake up call. Feeling lucky now, punk that I am ;)

  35. Oh God!

    I live in the US and it can get get pretty ugly here.

    Seroquel (800mg/day) without insurance, since you lost your job, to add insult to injury= $1,400 per month! I was on 6 meds at one point. That was after 2 long ICU stays, psych ward stays, some voluntary and some not, and I’m probably forgetting something.

    Anyway, that was 18 months ago.

    Today I am on only 1 med that recently went generic and because I finally qualify, i.e. have been wiped out, I qualify for state medicare (meant for retirees; for those not reading from the US) my cost is $10 per month!

    And some people say I am the crazy one. I don’t get it. Not to mention the huge collateral damage (family, and, oh almost forgot, divorce).

    I wish the US learned from Europe. There is room for improvement in both systems but the US has just sold itself to special interest.

    Anyway, hope this helps to put some perspective and that you are all having a good day

  36. 50% of bankruptcies in the US are tied to unexpected healthcare bills.

  37. Hey, you know if you ring up the out-of-hours you can normally get an emergency script? Just for future ref.

    Ellen
    x

  38. I pay about $30/month in canada for a supply of
    50mg seroquel – but I used to have 300mg and the price wasn’t that different
    1050mg lithium
    150 mg effexor

    (all the generic versions)

    But I have insurace through university. It covers 80% of the drug cost. So without it, it would be ~ $150 … which is no where near how much you are paying.

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