If nothing else get Your Spiriva out of Canada.Look up list of Canadian pharmacys and go through it till You find one that works for You.Spiriva is manufactured by Boehringer-Engelheim in Germany and I get mine for about $33 a month.Here in the U.S. it is over $300 without insurance.
Go to the Incruse website
Most people can get a coupon for a year free!
Boehringer Ingelheim has a patient care program, ask you doctor for the forms to fill out and script. They will check your income etc and if you qualify you can get low cost or no cost. Have been with them for three years and it is a life and money saver!
I can't manage without this - it is a chronic medication that has to be taken if you have COPD.
What i find amazing is that i live in South Africa and we have never run out meds. I have been on Chronic for 5 years plus about 12 other COPD meds and i am never out of my meds. American surely needs to look at their medical schemes. I have heard from many people on this sight that the meds are not always available - only last month someone posted monte air was not available. This is a med a could not cope without!!!