Includes Expert Content
Cymbalta-Dr. Schwartz do you know....
psychkt posted:
A month or so ago my insurance sent me a letter saying after this year they won't be covering cymbalta. The reason stated was that its expected to be available in generic form by then. My pdoc said he thought he heard something about December but I haven't seen or heard anything more about a generic version. Have you (or anyone in the group) heard anything more about it? I know all about the patent ending in dec 2013 but I'm just wondering if I am going to be able to stay on it after Dec 31.
beautifulbuffalo responded:
My daughter in laws insurance stopped paying for her cymbalta also. No word why. Cymbalta seems to be the only medicatioin that works for her. She's in a bind also.
Good Luck BB
rohvannyn responded:
If they are late in releasing the generic, then you still have options. Call your insurance and ask for prescription benefit information, then ask if a "prior authorization" will be available for the Cymbalta if it isn't covered by the plan. If the agent doesn't know, ask for a supervisor because they may have more information. If nothing else, call them after the new year and ask the same question. You may have a long hold time, but they will have extra people working to take the extra people calling in. A pretty good time to call is early afternoon because there is a lot of overlap with shifts.

I work for a mail order pharmacy, so if you need advice about the best way to inquire about prescription coverage, I'm happy to help.
psychkt replied to rohvannyn's response:
Thanks for the info. I will give it a try. I appreciate the offer for more help. I'll let you know what I find out.
psychkt replied to beautifulbuffalo's response:
I know the feeling. I've tried so many and so far this is the only one that works for me too. You might fight with your insurance, sometimes they will cover it if you keep after them. Appealing can help.
Thomas L Schwartz, MD responded:
Good responses from folks below. Ask your doctor to call your insurance and get it prior authorized.... He can state you will go into SNRI discontinuation and may relapse into depression, anxiety, pain and they should cover it... the co pay may go up
It goes off patent by end of this year. So your insurance won't cover brandname- but they will cover generic.. So there is likely a generic sitting on the shelf in most pharmacies and they will substitute that AND it should be a lower co pay than cymbalta brand
psychkt replied to Thomas L Schwartz, MD's response:
Thanks for the response. I asked at my pharmacy and they haven't heard anything about a date for a generic version. I'll call my insurance and talk with them. Crossing my fingers as its very expensive for my prescription without insurance covering it. Thanks for all the suggestions.