My condition is stable on maintenance medications.  I take three different
medicines.

My doctor would be willing to write for bottles of 1000 pills, which would
last for the better part of year.  One fill = one labor charge = lowest
possible price for drugs.

However, my insurance company has a one-month fill rule.  So, instead
instead of one labor charge for a year's supply, it's 12 labor charges for
a year's supply.  Not only that, the stock bottles have to be repackaged or
ordered in 100s instead of economical 1000s if the drug isn't a popular
one.  Small bottles are much more costly to the drug store than large ones.

All this means is I wind up paying 12 copays per year, the insurance
company pays 12 claims totaling up to three times the total cost of a
single bulk fill, providing the doctor is willing.  This makes no sense to
limit fills to one-month intervals, unless it is a new, untried
prescription or the patient is unstable, or the doctor is refractory to
ordering large amounts of drug per single fill.

Everybody, it seems, is cost conscious.  The doctor, the drug store, the
insurance company?, everybody is watching every nickel EXCEPT when it comes
to the patient/customers' nickels.  Then, price is no consideration at all,
the sky's the limit.

Despite this, cash pay is not an option.  Even with all the copays it is
still cheaper for me to live with the insurance company's rules rather than
go self-insured.  The biggest loser in all this is the insurance company,
which then passes its higher costs onto higher than necessary premiums.
The insured ultimately pay more for their folly.