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PostPosted: Mon Jun 02, 2014 2:42 pm 
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I just got a letter in the mail from one of my insurance companies, United Health Care saying after July 1st, 2014 they will no longer be covering Suboxone films. I've had a $30 co-pay for several months which will end. Bad news, the good news is I still have Blue Choice. I read that BlueChoice covers Suboxone as long as you are approved for it. "Coverage provided for members who are confirmed to be receiving treatment for opioid dependence in a valid opioid-addiction treatment program." Does anyone have any experience with this? It sounds like I need to be going to a treatment center to get approved and avoid paying out of pocket again.


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PostPosted: Mon Jun 02, 2014 2:45 pm 
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I'm on United Healthcare and I haven't gotten a letter like that. At least not yet! It might be the specific plan you are on under United Healthcare that is making the change. United Healthcare has a whole bunch of plans for different companies.

But I'll let you know if I get a similar letter soon!

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PostPosted: Mon Jun 02, 2014 3:00 pm 
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I hope not, I had Harvard Pilgrim with the United Health Care presciption plan I think. I just got the letter in the mail today. It's pretty lousy news. Thankfully I have another insurance, but it sounds like I'm going to have to jump through hoops to get BlueChoice to cover it.


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PostPosted: Tue Jun 03, 2014 3:52 pm 
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I'd find it hard to believe that they won't be covering buprenorphine/naloxone in some form, however. I've had a number of people tell me that this year their insurance providers have switched to the generic pill form of Suboxone (buprenorphine/naloxone) as the price is decreasing.

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PostPosted: Wed Jun 11, 2014 8:07 am 
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I too got a letter from United HealthCare about Suboxone Films and Tablets no longer being a covered item along with the generic form not being covered either. The only medicine they will cover now is Zubsolv. Pharmacy price is just the same as for Suboxone and it is a brand name, not a generic. But UHC will only pay for 60 every 30 days while they paid for 93 suboxone every 31 days. My doctor has agreed with me that we are going to try everything we can to make it clear that I cannot take the Zubsolv due to allergic reaction to whatever else is in it and see if they will pay under those circumstances for the Suboxone. But it is for real. I got physically sick when I got the letter. Up to now I have had a copay of $25 a month (which I could get free too if I had known about that coupon on the Suboxone website all this time). But now I have to buy Zubsolv or pay out of pocket.


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PostPosted: Sat Jun 14, 2014 10:58 am 
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I got my letter they said they would cover the generic Zubsolv but I wonder if I am going to have a hard time getting those from a pharmacy!


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PostPosted: Sat Jun 14, 2014 11:25 am 
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ZubSolv is not generic. It is a whole new brand name with a different patented formula. UHC will not cover the generics or the Suboxone brand. I asked. Also, if you search on the web you will find a published announcement that UHC's pharmacy service has signed a contract with Orexo, who makes ZubSolv, to sell only their brand. It comes out to the same price pill for pill but they are giving UHC a big kickback for doing this so UHC is able to save a bunch of money by not allowing Suboxone or generic anymore. If you don't believe me about the generic, just call and ask. But if for some reason you are not able to tolerate the new pills or the menthol makes you sick or you are allergic to one of the inactive ingredients you can appeal and most likely get them to pay for Suboxone again. My doctor said he is going to call them and write an appeal for me to stay on the Films. At this time UHC covers 93 Suboxone for 31 days. The limit for ZubSolv is 60 pills in 30 days so that is a major cutback since they say they are a 1 to 1 match for the Suboxones. Maybe they will change the limits on July 1st to match the Suboxone limits but I doubt it. Your doctor will have to intervene so that you can get 90 approved if that is what you are taking. That is what I take. So I am definitely not looking forward to this change.


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PostPosted: Sat Jun 14, 2014 11:30 am 
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Oh yeah, I forgot. On the subject of your pharmacy carrying them, just do what my pharmacist told me to do. He said to come in a couple days before my doctor visit and let him know I will be needing them on that day and if he does not have them, he can order them and have them in within 24-48 hours. That is at my Rite-Aid pharmacy. Walmart told me that they sell them too. So we can get them, but you would be wise to forewarn the pharmacy that you will be needing them in a couple days to give them time to order them in.


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PostPosted: Sat Jun 14, 2014 11:33 am 
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Also, if you are lucky enough to be able to get a 4-Tier United Health Care Plan, they still cover Suboxone but are moving them to Tier 4, the most expensive. They have eliminated them completely from all 3-Tier plans. Just thought I would mention it. My wife's work does not offer the 4-Tier programs, only the 3-Tier so I have to work around the system in order to try to continue to get Suboxone.


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PostPosted: Sat Jun 14, 2014 1:25 pm 
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I have a copy of my letter, maybe my employer plan is different but it says that they wi cover Zubsolvs for me...Everyone may have different types of plans...I would be happy to upload a copy of the letter when I get home tonight.

I wonder if my Dr. is able to write a script for zubsolv?
Is that gonna be a problem too, I am always over thinking but you know I feel like a suboxone bitch...
Because I have to always worry is the dr going to cancel, is the pharmacy going to have my meds, etc....there is always a problem. I have to walk from the bus stop about 3 miles to get to the dr.

LOL FMLS


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PostPosted: Sat Jun 14, 2014 3:07 pm 
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Yes my letter says they will cover ZubSolv too. But you said ZubSolv is generic. It is not generic. It is Brand Name owned by Orexo. It is under a completely different patent than the Suboxone Brand name because it uses a totally different formula even though it contains the same active ingredients. I was just pointing out that it is not generic. I know that they are covering it. They have since it came out in July of 2013.

As far as your doctor being able to write the script for them, the law is that if they are certified to treat with Suboxone they can write scripts for ZubSolv because it is the same medicine. The only thing that would prevent it is if he decides personally not to write it. My doc already said he will. He has for some others because some other insurances have switched people over before UHC did this to us. Just warn your pharmacy a few days before you get your script so they can order them and have them on hand by the time you bring it in.


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PostPosted: Sat Jun 14, 2014 6:52 pm 
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I just recieved the same letter demanding that I switch to Zubsolv by July 1st 2014. I have a friend who was recently switched to this new medication and he hates it.

The problem is that they do not contain the same amounts of buprenorphine/naloxone as Suboxone does. The 8mg/2mg in suboxone is said to be the equivalent of Zubsolv's 5.7mg/1.4mg tablet. They claim that their delivery system is improved and that it allows you to get the same amount of medicine as if you were taking an 8mg/2mg suboxone.

My friend has told me that it disolves way too fast and that he started experiencing witdrawl symtoms after switching. I looked up reviews for Zubsolv and found that a large percentage of people that have switched have made the same claims. I do not know from personal experience but will unfortunately be finding out soon enough. I will be picking up my last one month prescription of Subozone right before the July 1st deadline. By the end of July I will have to switch over to Zubsolv unless my doctor can find a reason to convince United Health Care that I need to continue taking Suboxone.


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PostPosted: Sat Jun 14, 2014 11:55 pm 
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My doctor told me that in his experience with his patients it seems just as good. A lot of what we will be hearing is going to be in people's heads because they have never known anything but Subs. They trust them and thus they will over examine and think too much about this switch. Plus, when it comes to reviews for anything, the ones who do not have a complaint are not usually motivated to get online and tell their experiences. It is more the people who have a negative experience. So I am not surprised that most of what you read is negative. The only way to know for sure will be to try it yourself. But I am a real fan of Subs so I will probably find something wrong with the ZubSolv's. But I am hoping my doctor can convince UHC that I can't tolerate the new pills and get them to agree to keep me on the Subs.


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PostPosted: Tue Jun 17, 2014 10:57 pm 
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Today my Dr said that she is going to fight for me to keep Suboxone Strips, our argument is I have a 4 and 5 year old and the zubsolv is very dangerous, if they by ANY CHANCE GOD FORBID got one in their mouth, they would die- My son has impulse problems- it doesn't help that they smell like orange and taste like it either she said,

She also said that they are NOT as effective for some people. SOme of her patients are taking 3 tablets to 1 strip but the insurance companies are getting it almost at cost--

She said her biggest concern is that people are doing SO good on suboxone- she had about 12 zubsolv relapses...and 4 overdoses ( of course she can say who) but she said that you CAN appeal Caremark and United Healthcares Perscription company with a letter-

Say- you have kids and grandkids or nieces and nephews living with you and you don't want to risk it.
Or Try it for a month and have your appeal letter going...Its our damn insurance- its expensive- if people lowered the cost of meds cause we know they shouldn't be that expensive- or FORCE Zubsolv to make a strip instead of a Tablet.

:twisted: :roll: :wink: :x :lol: BASTARDS


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PostPosted: Wed Jun 18, 2014 6:27 am 
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Your doctor is wrong. ZubSolv is menthol flavored not orange. Orange is just Suboxone. And the medication is no more dangerous than Suboxone. It is the same exact medicine. I too wrote about my doctor and me appealing this a post or 2 back. But the appeal has to be for a health reason such as an intolerance of the ZubSolv. They will come in child-proof containers and it is considered your responsibility to keep them in a safe place as with all your other pill-form medicine.

As far as the success of ZubSolv. There are always people who do not do as well on a different med because of the formula or inactive ingredients. Some people do better on ZubSolv and some on Suboxone. My doctor and myself are appealing because I get physically sick whenever I take in anything menthol, even cough drops. I am going to do a first month prescription but immediately appeal. I called UHC and they told me to write the appeal letter and to get my doctor's backing. Every little bit helps. My doctor says he is going to fight to keep me on the films. He has had the same success on ZubSolv as Suboxone, but with the films he said it is easier to wean people because you can cut them to an exact size and control how much you wean them down at a time.

So make sure that you have a great MEDICAL reason for your appeal because if you get denied you won't get another chance that is as good as the first one. So make that first one count. If you have any other medicine in pill form in the house or ever have, then UHC can deny a claim based on the pill form being dangerous since you use pills for other medicine. Plus as I said earlier, it is the consumer's responsibility to keep medicine out of reach of children. It is usually written on the container. Go with a health reason. Allergy to one of the inactive ingredients or to the menthol or just do one script and say they make you seriously nauseated and you can't tolerate them. That way they see you tried. I did that when my insurance refused Nexxium until I tried another med first. I tried it for one month and then the doctor wrote that it did not work for me and they then approved the Nexxium.

I am just trying to prepare you because I have been through this before and I want to see you get to stay on the Subs. I want to also, so I am going to appeal. I have been on them for 4 years and they work great and I do not want to change a successful formula. They did that with my depression medicine and then never were able to get me back to normal even after they switched me back. So I REALLY want to stay on the Subs too. So do not take what I say as argumentative. I am trying to help prepare you. I know for a fact that the ZubSolv is menthol and not orange flavored. They gave my doctor some sample placebo so he could test the texture in his mouth and the taste. So, please, do not get angry. But take this to heart and plan accordingly. I hope it works out for you. I am in the same boat.


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PostPosted: Wed Jun 18, 2014 6:43 am 
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One more thing. ZubSolv is supposed to be equal 1-to-1 with a Suboxone 8mg Film. So why does UHC approve 3 Subs a day and only 2 ZubSolvs a day? This whole thing is not right. It is a scam. ZubSolv could not break into the market controlled by Suboxone so they signed a contract (you can read it in the news section of UHC's website, or at least you could last week) with UHC to have them only cover ZubSolv, not even generics. Now the upfront cost that insurance has to pay the pharmacy is the same as for Suboxone, but because of the contract Orexo (makers of Zubsolv) give the insurance company a big kickback. So it is the same as if they were paying a whole lot less for the meds. Orexo still sells them for the same price to the pharmacy, but to get them prescribed they give the insurance company a kickback. Without that, they could never make a dent into the market. Suboxone has too much of a strangle-hold on it. And they deserve to because they came up with the first formula and put in all the work and saved so many people's lives, such as yours truly. To knock them out now is a travesty. So I am appealing. I hope everyone does. I think it is ridiculous in the first place that we cannot choose the drug we want to take since we pay so much for insurance.

Oh, and BTW, if you are lucky enough to have access to a 4-Tier plan from UHC, you can still get Suboxone. They moved it to Tier 4, the most expensive. But that is only a max of $75 I think. But for all 3-Tier programs it has been eliminated.

And the fact that almost every major insurance company is switching coverage to ZubSolv is a sure indicator that something is up. They are all doing it in the last 6 months and ZubSolv has been out since last July. So, that in itself tells you that Orexo had to do something all of a sudden to get insurance to switch to them all at the same time.


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PostPosted: Tue Jul 08, 2014 7:16 pm 
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I too got the dreaded letter from UHC telling me they would no longer cover the strips, but that they would cover Zubsolv. After getting the letter I called a few pharmacies in my neighborhood to find out if they stock Zubsolv. None of them regularly carry it, and it has to be ordered. This process can take 1-3 days. I took the letter to my Dr. We discussed the situation, and he was none to pleased with UHC over this. He's a good guy, and wrote me a prescription for three days of strips and a one month supply of Zubsolv. I'll use the strips to keep from getting sick while I wait for my pharmacy to get my order for Zubsolv in. I'll report back on my experience with Zubsolv. What angers me greatly is that Zub isnt readily available. None of the pharmacies I called in the Atlanta(I called four places) area regularly stock Zub. I'm lucky, my Doc wrote me an extra prescription for a few days of strips while I wait. Thousands of people are going to get very, very sick because Zub is hard to find. That's what really angers me!! Thats really reckless behavior on UHC's part to switch people to a drug that is not readily available.


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PostPosted: Fri Jul 11, 2014 12:40 pm 
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My pharmacy (major national chain) was able to get the Zubsolv in one day. So, while they don't stock it and for now don't plan to stock it, the wait wasn't too terrible. Hopefully with so many of us UHC'ers being put on Zub, they will soon keep it stocked in stores. As for the drug itself, I have no complaints. In fact, I like the menthol taste much better than the bitter orange after taste of the strips. It does seem to dissolve a bit faster than the strips, and so far seems just as effective. Obviously we are all different, and YMMV. One thing I do hate is the Zub's packaging. It's a blister pack, and I hate blister packaging. You have to rip a dose out of the package, fold a corner of it, peel off the backing, and then gently tear off the plastic to get to the pill. The challenge is to not crush the pill while folding, or have it fly across the room and roll under the refrigerator when trying to open the thing. I used to keep a strip or two in my wallet, and Ill miss that convenience.


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PostPosted: Fri Jul 11, 2014 7:54 pm 
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I received the letter the day after I posted that I hadn't received a letter yet!

I go to my doctor's on Tuesday, and I'm curious about what they'll say. However, I did email them to ask if they were starting to switch people over to Zubsolv and they said that a couple people were now on it. From what I remember hearing, Zubsolv has a lower amount of burprenorphine in it because the formula is better absorbed. I hope that's true!

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PostPosted: Wed Jul 23, 2014 7:43 pm 
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UHC also denied me and I'm in the process of appealing. I have a letter y doc stating why suboxone is medically necessary and all that. Anyone have the same issue? Thoughts on what else I can provide to make my appeal stronger? I found a couple case studies on suboxone that I might toss in there as well.


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