cost of Lidocaine ointment & insurance coverage

[quilter]

For those who use compounded lidocaine ointment, can I ask the cost and if your insurance pays ny portion?

I previously used 5?% lidocaine ointment, 90 gm (packaged in two 30-gm for home and two 15-gm tubes for purse), rather than a single jar for the sake of convenience and sterility. None of my insurance plans have ever contributed, though interestingly they've always kicked in something for compounded suppositories (the past few years Valium/Baclofen - I get 48 for $39). Currently I use 7% lidocaine with 0.5% Bupivicaine for vulvar irritation, fortunately less than needed before my last PN surgery. The cost just keeps going up (currently $99.50 cash price for 90 gm). The pharmacist didn't raise the price when Bupivicaine was added or the % of lidocine increased. We have only 3 compounding pharmacies in the entire county, all are a 25-45-minute drive one way, and this is the cheapest. I have a hard time believing that two drugs that have existed for decades cost so much.

If you've gotten insurance to contribute, what's required? Thanks!

[ezer]

My insurance would not cover anything. The compounding pharmacy wanted to charge me $210 for a similar formulation.

[Blossum]

I just had my compounding pharmacy fill a prescription for a lidocaine/ketamine cream. Cost was $180. The pharmacist types up a note stating that this cream is prescribed and needed for a medical condition. My insurance covers the full amount for all compounded medications when I submit them and attach the letter from the pharmacist. Hope this helps.

[nyt]

My insurance paid for my ketamine/lidocaine/gabapentin compounded cream up until this month. My insurance company is now requiring prior approval for all compounded medications. We have done the first left of appeal since they denied the first request. I will go to the next level of appeal but while I'm working on the 2nd level of appeal I will have to pay out of pocket $150.00. I am not optimistic they will pay even with the next level of appeal since this is Medicare.

[Violet M]

Quilter I can't answer your question but I just wanted to mention that I used 20% benzocaine OTC Walmart brand of Extra Strength Vagisil and it was just as effective (actually more effective) than the prescription lidocaine I tried. I think the Walmart brand is called Equate Vagicaine. It's also very cheap compared to what you are getting so might be worth a try.

Violet