Latest / Health with Hashimoto’s - Thyroid or Immune Education for Autoimmune Thyroid Disease / 187 // How to Save Money on Thyroid Medication: GoodRx vs Cost Plus Drugs vs TrumpRx

Transcript

187 // How to Save Money on Thyroid Medication: GoodRx vs Cost Plus Drugs vs TrumpRx · Health with Hashimoto’s - Thyroid or Immune Education for Autoimmune Thyroid Disease

• 0:00
  If you are like the majority of those who listen to Health with Hashimoto's,
• 0:03
  every single morning you open up a prescription bottle, probably for lipothyroxine,
• 0:09
  Synthroid, something like that, maybe also for a T3 medication,
• 0:13
  Synthroid, Lipothyroxine, or T4, and maybe every single time you refill that
• 0:19
  prescription, you're like, I wonder if there is a way that I can save money.
• 0:22
  That's what we're talking about today. Welcome to the Health with Hashimoto's
• 0:25
  podcast. This is where you will find clarity and simple, sustainable strategies to feel better.
• 0:31
  I want to help you figure out your root causes.
• 0:34
  My name is Esther Yunkin. I am a registered nurse. I know how exhausting it
• 0:39
  is to live with fatigue, brain fog, and the ups and downs of Hashimoto's. And that is why I'm here.
• 0:45
  I'm here to cut through the confusion and to give you practical steps that support
• 0:50
  your body, calm your immune system so that you can regain your energy, feel like.
• 0:55
  So today we are comparing three
• 0:57
  different pharmaceutical programs to find out how you can save money.
• 1:03
  First, let's talk about the most common medications that people with hypothyroid,
• 1:08
  which Hashimoto's typically causes, what are the most popular medications or
• 1:12
  most common medications that people with hypothyroidism take?
• 1:15
  Number one is a T4 medication.
• 1:19
  T4 is the hormone that your thyroid produces.
• 1:23
  It is the inactive thyroid hormone. Think of it like a key blank that you would
• 1:28
  get from the hardware store.
• 1:30
  You go and pick out the design of your key, what you want it to look like,
• 1:34
  what color the key is. That's the blank.
• 1:37
  And then you take it up to the counter, you give them your regular key,
• 1:41
  and then they duplicate that regular key onto the key blank.
• 1:46
  Your new key that they just made for you, that is the T3.
• 1:51
  That is the active key. That is what every single cell in your body needs to turn on.
• 1:57
  It needs that key. It needs the T3.
• 2:00
  Well, when your thyroid produces T4, your body is supposed to transform that.
• 2:06
  It's supposed to make the active key, which is T3.
• 2:08
  If you don't have all of the micronutrients that your body needs in order to
• 2:12
  make that conversion, it's not going to happen.
• 2:14
  And then, of course, you will need a pharmaceutical supplement, a medication.
• 2:18
  It's really just a supplement. But since it's not herbs and vitamins and things
• 2:22
  like that, we don't call it a supplement. We call it a medicine because that is what it is.
• 2:27
  But it is to supplement what your body cannot do.
• 2:30
  So T4 is the thing that your thyroid requires.
• 2:33
  Typically makes. T3 is what your cells use, and both of those are very common medications.
• 2:41
  So what kind of names do they go by?
• 2:43
  Well, T4, most commonly, is called Synthroid. That's the brand name.
• 2:46
  It's the most prescribed brand in, I believe, the world.
• 2:50
  Lavoxel is another one. Tyrosin or Tyrosin gel.
• 2:54
  These two, they don't have as many fillers. So if you are sensitive,
• 2:59
  these are good. They are a little bit more expensive, but it's a T4.
• 3:03
  Unithroid is another one, Levo T, Euthyrox. There's a couple of different other T4.
• 3:09
  T3 only medications, Cytomel and Triostat. Those are the most common T3 medications.
• 3:15
  There are also combination T4 plus T3 medications.
• 3:20
  Armor Thyroid is the most popular. We've talked about that one on this podcast
• 3:23
  before. and p-thyroid is another one, naturethroid.
• 3:27
  There are a couple that are those combination.
• 3:31
  So those are the most common medications, but there are other medications that
• 3:36
  are very common in the Hashimoto's world.
• 3:39
  One of those is LDN. We talked about this. I interviewed a pharmacist.
• 3:44
  I believe it's episode 129 if you want to know about that.
• 3:49
  And LDN helps, kind of helps everything work better.
• 3:53
  It decreases your inflammation and it really helps anybody who has an autoimmune condition.
• 4:00
  So that one is another common medication.
• 4:03
  That one, the LD stands for low dose.
• 4:07
  It is a very, very, very small amount of the medication. So you cannot get that
• 4:12
  one at a typical pharmacy because it is such a low dose.
• 4:16
  It has to be compounded. So for LDN.
• 4:20
  You most likely have to go to a compounding pharmacist. You can not get that
• 4:24
  one at your typical Walgreens or Walmart or local pharmacy.
• 4:30
  Another common medication for people with hypothyroidism is vitamin D.
• 4:35
  Now, this one you can get as a supplement. I get mine on Fullscript.
• 4:40
  That's where I get most of my supplements.
• 4:42
  But in addition to be an over-the-counter supplement, it, you can also get it as a prescription.
• 4:48
  The first time I got my labs done, including a vitamin D lab, it was pretty low.
• 4:55
  Now, I say pretty low because I know that the current recommendations is around
• 5:00
  80, 80 to 100, but that is not considered, you know, normal for the conventional medical people.
• 5:08
  When they would have seen my original labs, which was in the 40s,
• 5:12
  they would have been like, okay, cool, you are good. Well, I know that I'm not good.
• 5:16
  It has to be between 80 and 100 if I want optimal health as far as everything
• 5:21
  that the vitamin D produces in me and impacts.
• 5:25
  So when I got that result, my nurse practitioner wrote a prescription and
• 5:29
  And it was like massive doses of vitamin D. And it was like a once a week tablet,
• 5:35
  I want to say. And I got it from the pharmacy.
• 5:38
  So vitamin D you can get as a pharmaceutical or as a supplement.
• 5:41
  Those four are probably the most common things for the Hashimoto's world.
• 5:47
  And we have talked about all of them on this show before.
• 5:50
  The topic today is how do you get them the cheapest?
• 5:54
  Now, I don't know if you saw in the news, really depends on where you consume
• 5:58
  your news, the government came out with Trump Rx.
• 6:02
  My initial thought, I'm going to just be completely honest, my initial thought
• 6:05
  was why do we have to have the president's name assigned to this?
• 6:09
  And somebody was like, you mean like Obamacare? Like, oh, right.
• 6:13
  I mean, I guess there is precedence, right?
• 6:15
  We still talk about Obamacare and Obama hasn't been president in a very, very long time.
• 6:19
  So Trump Rx is the government program designed to get you most favored nation pricing.
• 6:27
  So it says on the website, America was being overcharged for medicine.
• 6:31
  The same drugs made in the same factories, the same dosages are costing Americans
• 6:36
  up to 1000% more than in any other country. This is unacceptable.
• 6:40
  So that is where TrumpRx came from, designed to get you the best price.
• 6:46
  It is not through insurance.
• 6:50
  TrumpRx is typically cash pay.
• 6:53
  If you have insurance, it even says on the website to check your co-pay and
• 6:58
  make sure that you're actually going to be saving money.
• 7:00
  Now, I had heard of Trump at Rx as soon as it, you know, hit the news because
• 7:04
  I am on X and I get news from a variety of sources on Twitter slash X.
• 7:11
  I also knew about the, there's two other things that I want to talk about, and that is Mark Cuban's.
• 7:20
  Program, and that's called Cost Plus. And then I also knew that there was GoodRx.
• 7:26
  I have used GoodRx before in looking up drug prices.
• 7:30
  So my initial thought was, how does TrumpRx compare to GoodRx and Cost Plus?
• 7:37
  Well, it turns out that TrumpRx and GoodRx are the same thing.
• 7:41
  Okay, so maybe they're not like identical. If you go on TrumpRx,
• 7:44
  it's probably not going to say we use GoodRx.
• 7:46
  But I talked to a pharmacist and I have done some more research and it looks
• 7:51
  like it's the same. It's the same prices.
• 7:53
  It's the same medications available.
• 7:56
  However, GoodRx has more.
• 7:58
  TrumpRx is starting out with just a few. I think there's like around 50 right
• 8:03
  now as I record this. and GoodRx has a lot more.
• 8:08
  Both of these get you the cheapest price and both of them are not insurance.
• 8:15
  In other words, you cannot use your insurance if you are using these programs.
• 8:20
  You need to cash pay and if you cash
• 8:22
  pay, you cannot submit that to your insurance saying, I paid for this.
• 8:27
  You know, you do that with other things and you submit your receipt to insurance
• 8:30
  companies and they apply it to your deductible or something.
• 8:33
  You cannot do that with these two programs.
• 8:36
  All right, so both of these two programs are local. You're going to walk into
• 8:40
  the pharmacy and you're going to pick up your medications.
• 8:42
  You're going to pay cash. You're not going to use insurance.
• 8:45
  I will add a caveat that not all pharmacies accept these two programs.
• 8:51
  I called my local pharmacy and I live in a very, very small town.
• 8:55
  We don't even have a stoplight.
• 8:56
  We are a very small town. I talked to the pharmacist and she said that they do not accept it.
• 9:01
  It's more, these two programs are more for bigger pharmacies.
• 9:05
  And that is because of the bulk discount.
• 9:07
  She said, you know, if big pharmacy, let's say Walmart or Walgreens buys.
• 9:12
  You know, a medication and they buy it in bulk, so they get a really steep discount,
• 9:17
  they can charge you the good RX or the Trump RX price and still make money.
• 9:22
  She said for this particular pharmacy, because they are so small, they can't buy in bulk.
• 9:29
  And this means they have to pay a higher price. If they pay their higher price
• 9:33
  and then they charge you the price that's listed on GoodRx or TrumpRx,
• 9:36
  they end up losing money.
• 9:38
  She said if they accepted TrumpRx and GoodRx pricing, they would go out of business.
• 9:44
  So it really is dependent on your pharmacy.
• 9:47
  And you want to call ahead or look on their website or somehow figure out,
• 9:52
  are they going to accept this? Are you going to get the price?
• 9:55
  My local pharmacy, they did say that they have a cash program so that they can
• 10:01
  offer people the lowest price that they are able to offer without going out of business.
• 10:06
  But this pharmacy, as well as others around the country, they just fiscally
• 10:11
  cannot honor TrumpRx and GoodRx.
• 10:15
  So let's talk about the third option.
• 10:19
  There are three different pharmaceutical programs we're talking about.
• 10:23
  TrumpRx, GoodRx, And then the other one is Mark Cuban's program,
• 10:26
  which is called Cost Plus Drugs.
• 10:29
  And this one offers generics and it is an online pharmacy. So you're going to
• 10:34
  upload your prescription or have your doctor send it in and then they will fill
• 10:40
  it and they will ship it to you. Again, this is cash pay only.
• 10:43
  They do not deal with insurance, and their pricing is fairly straightforward.
• 10:48
  It is the manufacturing cost plus a 15% markup plus a $5 pharmacy fee plus the
• 10:55
  shipping, and that is your price.
• 10:57
  It's going to be a little different than TrumpRx and GoodRx,
• 11:01
  but it's going to be fairly consistent.
• 11:03
  You're going to get that lowest price, the manufacturing grain price,
• 11:05
  and then a 15% markup and $5 for labor.
• 11:09
  And then there's shipping, which is fairly standard, I believe,
• 11:12
  for most of the online pharmacies. So let's put this into the real world.
• 11:17
  Let's say you are taking levothyroxine every single morning and you take 100
• 11:22
  micrograms and you are going to fill a 90-day supply.
• 11:26
  Let's start out with the cost plus drugs because we can get all the numbers here.
• 11:31
  So the manufacturing cost for 100 microgram tablets, a 90-day supply, is $2.84.
• 11:39
  That's what it costs to make the tablets, which is not very much, right?
• 11:45
  A 15% markup on that is going to be $0.43 plus $5 of pharmacy labor and then $5.25 of shipping.
• 11:55
  Your total price for 90 days of 100 micrograms of levothyroxine is going to be $8.27.
• 12:04
  We're going to compare this to the same thing on GoodRx.
• 12:08
  So this is using the GoodRx and then you're going to take the like certificate
• 12:15
  or coupon that they give you and you're going to take it to the actual pharmacy.
• 12:20
  Now GoodRx gives you a bunch of different pharmacies to go to.
• 12:25
  So when I type in levothyroxine, 100 micrograms, 90 day supply,
• 12:29
  I get 1, 2, 3, 4, 5, 6, 7, 7, 8 different pharmacies.
• 12:34
  And the price ranges between $10 at Walmart and the highest one is CVS, which is $46.
• 12:43
  And there's all different prices in between. So that is via GoodRx.
• 12:49
  And when I'm using TrumpRx, then the price is $45.90.
• 12:57
  All right, so let's try T3. So those medications, that was T4,
• 13:00
  that was your generic Synthroid.
• 13:03
  T3 is Cytomel. That's the brand name. The generic is Liothyronine.
• 13:08
  And on GoodRx, it says, like when I type it in, it tells me those two things.
• 13:13
  The brand name is Cytomel and the generic is Liothyronine.
• 13:17
  And you would think the brand name is always more expensive, right?
• 13:21
  But this pop-up pops up to tell me that the brand name might actually be cheaper.
• 13:26
  So according to the pop-up, it says that the Cytomel brand name,
• 13:30
  if you're using their exclusive discount, it'll be $18 versus the generic, which is $38.55.
• 13:37
  And those two prices, I think, were for the 30-day supply of a 5 microgram.
• 13:42
  But we are comparing a common dosage, which is 25 micrograms,
• 13:46
  and we're 90-day supply.
• 13:48
  So on GoodRx, the brand name, which is cheaper on GoodRx than the generic,
• 13:53
  the brand name Cytomel, 25 micrograms, 90 tablets, that ranges from $25.20 all
• 14:01
  the way up, nope, every single one across the board is $25.20.
• 14:05
  And that is if you print email or text this coupon to yourself and present it
• 14:11
  to the pharmacy that you're going to.
• 14:14
  The Cytomel on a Trump RX, 25 micrograms, and a.
• 14:19
  Oh, they're not doing a 90-day supply. They will only do 30-day supply. That one is $8.40.
• 14:26
  So quick math, if you multiply that times three, you're going to get about the
• 14:30
  same price on TrumpRx and GoodRx.
• 14:33
  What about on the Mark Cuban Cost Plus?
• 14:37
  It feels silly to have to say his name every time, but his name is right in the name of the website.
• 14:44
  It's Mark Cuban Cost Plus drug company. Anyway, on this one,
• 14:49
  same thing, 25 micrograms and a 90-day count, you're going to pay only $16.93.
• 14:58
  I tried to do a comparison of the LDN prescription on these three sites and
• 15:03
  none of them offer it, which is what I expected.
• 15:06
  That is something that I have found in the past because it has to be compounded.
• 15:10
  So you have to talk to a compounding pharmacy and they will typically ship it
• 15:14
  to you, or you can go and visit.
• 15:16
  The compounding pharmacy that I use for my LDN is like an hour and a half,
• 15:20
  two hours away, and so I pay for them to ship it.
• 15:23
  Super easy peely. These three pharmacy sites do not have LDN as an option.
• 15:29
  So then I turned to vitamin D. We're looking at the four most common things
• 15:34
  that I see people with hypothyroidism take for their health.
• 15:39
  Vitamin D, like I said before, it does come over the counter.
• 15:42
  You can get it from Fullscript.
• 15:43
  You You can get it from, you know, your local drugstore. You can get it from
• 15:47
  anywhere. You can get it from Target, Walmart.
• 15:49
  It is a vitamin. You can also get it as a prescription.
• 15:53
  Vitamin D comes in D2 and D3.
• 15:57
  Now, when I am talking to somebody and we're looking at their labs and we see
• 16:00
  that their vitamin D lab is not ideal, so between 80 and 100,
• 16:05
  then they want to know how they can get it up.
• 16:08
  And they can get it up with a prescription vitamin D or an over-the-counter.
• 16:14
  There are two different forms, D2 and D3. I always recommend D3 with K2.
• 16:22
  Now, this is because of the way that vitamin D and vitamin K and calcium all work together.
• 16:28
  They have to be like they have to all be there in order to tell the other ones to do their job.
• 16:32
  So D3 with K2 is what I will always turn to for vitamin D.
• 16:38
  As far as dosing goes, vitamin D used to come in international units and now it has shifted.
• 16:45
  So back when it was international units, you might still see your bottles,
• 16:49
  say IU, the standard was anywhere between 1,000 international units a day.
• 16:54
  I had some doctors say 5,000 international units per day.
• 16:59
  When I was pregnant with all of my babies, that is what the recommendation was
• 17:03
  for pregnant women, was 5,000.
• 17:06
  And then as I was breastfeeding, then it was at least 5,000 because you need
• 17:10
  enough for you and for baby. There's different recommendations.
• 17:14
  It really, you really need to know your lab on this one. And so I recommend
• 17:18
  getting your lab checked at least once a year and adjusting from there.
• 17:22
  But international units are no longer typically used on vitamin D.
• 17:27
  Now it comes in micrograms. So 1,000 international units is 25 micrograms,
• 17:34
  which means 4,000 international units is 100 micrograms.
• 17:37
  And that is what I take five days a week for, you know, based on my lab results
• 17:43
  over the last couple of years and experimenting with how much D I'm taking in
• 17:47
  order for me to stay between 80 and 100.
• 17:50
  Personally, I take 4,000 micrograms of five out of every seven days,
• 17:59
  and that keeps me in that range.
• 18:01
  Some people need more. Some people need less.
• 18:04
  If you are going to get vitamin D with a prescription, it's probably going to be D2 instead of D3.
• 18:11
  It's probably not going to come with the K2.
• 18:13
  Like I said, I always want D3 with K2. If you're going to get it with prescription.
• 18:17
  It's typically D2, and it's going to be a massive dose, and you're going to
• 18:21
  take it about once a week.
• 18:23
  I'm at 12 capsules, so that would be 12 weeks of vitamin D2 at a dose of 1.25 milligrams.
• 18:32
  That is 50,000 international units. You're going to pay $10.07 on GoodRx and
• 18:40
  $7.64 on Mark Cuban's Cost Plus drug company.
• 18:46
  So what are the biggest things that you want to walk away from this episode
• 18:49
  from? Well, you want to do your research.
• 18:52
  Always do your research. You are the CEO of your own health.
• 18:55
  You make the decisions your doctor is recommending based on the best of his
• 19:00
  or her ability, and you get to take that information and apply it to what works right now.
• 19:07
  And so what is important to you? Is supporting the local pharmacy important to you?
• 19:12
  If that was my top thing, I would go to my local pharmacy, which does not participate
• 19:16
  in GoodRx or TrumpRx, and obviously the cost plus is mail order.
• 19:22
  So if supporting a small business, a family business, a community business is
• 19:26
  important to me, then that is what I'm going to pick.
• 19:29
  If you value online ease, doing everything virtually,
• 19:33
  having your stuff come in the mail, 90-day supply, you don't really have to
• 19:36
  think about it, then maybe you're going to want to use the cost plus because
• 19:41
  just upload the prescription and get a 90-day supply in your mailbox.
• 19:45
  It depends on what you value and what works for right now in this season of life.
• 19:51
  But thankfully, it does not take long to compare these so that you can figure
• 19:54
  out what is the best situation for you right now. You can even just type it into AI.
• 19:59
  I personally use Grok because I feel like it gives me the most reliable stuff.
• 20:03
  It hallucinates less than the other AIs at this time.
• 20:06
  And you can just say, this is my medication.
• 20:08
  This is my dose. This is how many days I want in my supply, please compare the costs.
• 20:13
  And it will. I will add that for thyroid medication specifically.
• 20:18
  It is advised to stick with one manufacturer, one brand, after you find a version
• 20:24
  that keeps your symptoms and your TSH stable.
• 20:27
  It is the one medication that I have noticed throughout my years in the ER that
• 20:32
  so many people say, I have to have the brand name.
• 20:35
  I have to have this specific one. So find one that works for you,
• 20:39
  stick with that, and find the best price. I hope this has been super helpful.
• 20:50
  Provider. To take your next step, join our school community and explore the
• 20:54
  courses available there. You do not have to figure your health out alone.
• 20:58
  So that is school, S-K-O-O-L.com, and it is the Health with Hashimoto's community.
• 21:04
  I'll see you next time on the Health with Hashimoto's.