Prescription drug pricing insanity

[Ron Citerone]

I am going to type this here knowing full well if I read this here I would be doubtful.

Rosuvostatin (Generic Crestor) 90 day, 20 mg. With my prescription plan and High deductable insurance plan $170 at the CVS who runs my prescription plan.

I call Walmart and they say cash price is $600.00

I go on GoodRX and Shoprite with coupon is $ 22................they were out of it till February which sound like the punch line from the old banana joke.

I go on GoodRX again and CVS accepts GoodRX coupon for $49.

So I go to the store and pay the $49 without my plan instead of the $170 with the plan................

I never really shopped scripts around because I thought going with the plan has to be the best price...........apparently not! Unreal.

[Doug Garson]

Not directly comparable but before Christmas I picked up some replacement supplies for my CPAP, new mask and hose and some Humidx filters. Bill came to $269, paid with my Visa. Supplier offered to submit the insurance claim for me. Yesterday I got the check from the insurance company for the full amount coincidently the same day my Visa bill arrived. I deposited the check using my phone app and I still have a few weeks before my Visa bill is due. That's the way it should work.

[Dave Lehnert]

My mom had an RX for some eye drops. The cost was something like $150. The same eye drops at the same pharmacy but double the strength was around $17. The pharmacy could not fill with the cheaper because of the strength difference.

Every time you get a RX you have to ask "Is this the lowest price available to me?" To my understanding they are then required to see if a lower price is available.

[Rich Engelhardt]

Please disregard....

[Bill Jobe]

Every time you get a RX you have to ask "Is this the lowest price available to me?" To my understanding they are then required to see if a lower price is available.

Yes. Insist on it.

[Wade Lippman]

Every time you get a RX you have to ask "Is this the lowest price available to me?" To my understanding they are then required to see if a lower price is available.

In NYS they are forbidden from telling you.
A few weeks ago I filled a prescription my insurance didn't cover. $500! Or $34 with a GoodRX coupon. Beats the hell out of me.

[John Stankus]

What is this GOodRX thing? It sounds like it is something I need to make my retired dad about

[Bruce Wrenn]

Years ago was put on Synthroid (Brand name.) Co-payment was $72. Pharmacist told me to just pay cash, as price would only be $54 retail. Asked where the extra money went. Was told, first insurance company doesn't pay retail, and anything more than their price was sent back to insurance company. So I was paying insurance company to use my benefits. I currently have a bill for lab work that is only $21, which insurance paid, but I have to pay a $40 co- payment. Care to guess who pockets the difference?

[Ron Citerone]

What is this GOodRX thing? It sounds like it is something I need to make my retired dad about

I just found out about it myself. Google GoodRX...........type in you med mg and count and a list of prices for various stores come up and you just print the coupon.

[Stan Calow]

Good Rx worked for me too. A $170 out of pocket prescription that insurance would not cover. $20 with GoodRx coupon. Sign up for it online, and the instructions are pretty straightforward. They provide price info at various mainstream pharmacies and you can pick the one you're going to use.

I had another prescription for an arthritis pain cream. $80 our pocket for a tube. Bought the exact same tube in a grocery store in Canada, off the shelf for $9.

[Ron Citerone]

Please disregard....


Hope you feel better soon!

[Alan Rutherford]

I think the law varied by state but as said, the druggist was not allowed to tell you that you could do better without using your insurance. I thought I read recently that there was a new federal law preventing that but can't remember the details. In any case, it's worth shopping around and asking questions. In some cases I believe they were allowed to tell you about different prices if you asked but could not volunteer the information.

About a year ago I was going to fill a prescription for the generic version of a drug I won't name but it's a guy thing. Walgreen's was going to charge me over $200. Acting on a tip from a confidential source, I went to the independent pharmacy down the street and got if for $30.

Drug pricing is a bad joke. So is the rest of our medical system. I just Googled health care ranking by country. We're #29 out of 60, right between the Czech Republic and Croatia.

[Edwin Santos]

I think the law varied by state but as said, the druggist was not allowed to tell you that you could do better without using your insurance.



Am I reading that correctly? There is a law that prevents the pharmacist from letting you know you there is a less costly alternative way to buy the drug without your insurance?

[Alan Rutherford]

Am I reading that correctly? There is a law that prevents the pharmacist from letting you know you there is a less costly alternative way to buy the drug without your insurance? Yes. Absolutely. Apparently gone now, in October. See this: https://www.pharmacytimes.com/conferences/ncpa-2018/legislation-signed-into-law-prohibiting-gag-clauses-for-pharmacies

[Barry McFadden]

I just got my 90 day supply of Crestor (not a generic brand) and it cost me 68 cents....

[Bill Dufour]

I take januvia which my insurance does not cover. Cvs is about $10 A PILL. I found a online place for $140 delivered for 84 pills. They are made in Trukey, shipped from Switzerland, and somehow a pharmacy in Mauritius is the listed seller. About two weeks lead time and you have to fax/email a prescription.
I could pay $1000 a month more for the silver insurance which would cover my meds with co-pays but it would drop hospitalization from 100% TO 70% coverage. ALL MY OTHER MEDS COST LESS THEN THe COPAY WOULD BE.
I used to get them from India but there was a lawsuit and India no longer makes them as a slightly different chemical. I think it was like sodium salt vs carbonate salt of the active ingredient.

[Brian Deakin]

The cost price to the National health service in the United Kingdom for
84 Rosuvastatin 20mg is $9
This would equate to a retail price private prescription charge of $13.50

[Mike Henderson]

Thanks for the pointer to GoodRx.com I had not known about that. Could be valuable for me.

Mike

[Jay Jolliffe]

Two years ago I took a prescription for 12 weeks & the cost was 96,000....No shopping for cheaper & I'm glad it was covered by insurance after a short fight by the hospital...

[Steve Eure]

Ought to be against the law for some of these pricing differences. I once had a prescription with a co-pay of $35. Walgreen's charged me the $35. Found out later that the drug only cost $8 without using insurance. I asked the pharmacist why? He said they had to charge what the insurance companies said to charge if I used my insurance. You would think the insurance company would have been happier paying the $8 outright instead of me being charged the $35. No telling what the pharmacy charged the insurance company.
Just doesn't make good business sense to me.

[Bruce Wrenn]

Ought to be against the law for some of these pricing differences. I once had a prescription with a co-pay of $35. Walgreen's charged me the $35. Found out later that the drug only cost $8 without using insurance. I asked the pharmacist why? He said they had to charge what the insurance companies said to charge if I used my insurance. You would think the insurance company would have been happier paying the $8 outright instead of me being charged the $35. No telling what the pharmacy charged the insurance company.
Just doesn't make good business sense to me.Makes perfect business sense to insurance company. With insurance, $35 for an $8 drug, insurance company gets $27 every time prescription if filled. Sounds like you had a Blue Cross / Blue Shield plan.

[John Goodin]

I think we all know healthcare is the similar. Several years ago I had an accident and spent a night in the hospital and was billed 112,000 dollars. Insurance settled for just under 50 grand. The part that irked my the most was the scans. A doctor that never saw me ordered an extra set of scans of my torso. They took an extra five minutes and billed 14,000 dollars.

[Ken Combs]

I take januvia which my insurance does not cover. Cvs is about $10 A PILL. I found a online place for $140 delivered for 84 pills. They are made in Trukey, shipped from Switzerland, and somehow a pharmacy in Mauritius is the listed seller. About two weeks lead time and you have to fax/email a prescription.
I could pay $1000 a month more for the silver insurance which would cover my meds with co-pays but it would drop hospitalization from 100% TO 70% coverage. ALL MY OTHER MEDS COST LESS THEN THe COPAY WOULD BE.
I used to get them from India but there was a lawsuit and India no longer makes them as a slightly different chemical. I think it was like sodium salt vs carbonate salt of the active ingredient.

I take a med that is filled and shipped through that exact path. Strange to see a Swiss postmark on a Turkish prescription filled on a French island in the middle of nowhere. BTW, that island is where the first piece of flight 370 washed up.
I

[Wade Lippman]

I take januvia which my insurance does not cover. Cvs is about $10 A PILL. I found a online place for $140 delivered for 84 pills. They are made in Trukey, shipped from Switzerland, and somehow a pharmacy in Mauritius is the listed seller. About two weeks lead time and you have to fax/email a prescription.
I could pay $1000 a month more for the silver insurance which would cover my meds with co-pays but it would drop hospitalization from 100% TO 70% coverage. ALL MY OTHER MEDS COST LESS THEN THe COPAY WOULD BE.
I used to get them from India but there was a lawsuit and India no longer makes them as a slightly different chemical. I think it was like sodium salt vs carbonate salt of the active ingredient.


You gotta do what you gotta do, but I would be terrified to take anything that went that route.

Years ago my son got pneumonia from contaminated medicine. The FDA forbid a certain manufacturing process because it was too easily contaminated. The producer did it anyways because it was cheaper. They were fined, but no one went to jail despite 4 people dying. If that happens here under FDA supervision; what happens in Turkey? (or wherever it really is made...)

[John Cole]

I think you would be shocked to find out that most medicines in the US supply system are manufactured outside of the country, India and China.

[Alan Rutherford]

You gotta do what you gotta do, but I would be terrified to take anything that went that route.... How much choice do you have? Look at all the ....sartan heart medicine recalls recently and try to find an alternative that sounds much better. Just out of curiosity I looked into the company that makes a drug my wife was switched to (third or fourth switch in about two months) and eventually found that despite their US address and office, they're a wholly-owned subsidiary of a company in India. Still don't know where they make that particular medicine.

Our system is broken. We pay several times as much for health care as any other country and get less for it.

[Brian Henderson]

Our system is broken. We pay several times as much for health care as any other country and get less for it.

That's because a lot of other countries place artificial caps on drug costs and drug development costs billions. That money has to come from somewhere.

[Edwin Santos]

It's an unpleasant fact that the health care industry in the United States is a multi-trillion dollar locomotive where the patient/end-user is the caboose.

Edwin

[Alan Rutherford]

That's because a lot of other countries place artificial caps on drug costs and drug development costs billions. That money has to come from somewhere. Are you saying we're covering the money drug companies lose selling in other countries? Not likely. Those companies are not in business to cover their costs. Their goal is to make money for their shareholders. They are entitled to do that. In fact if you have drug company stock in a mutual fund, you want them to do that but it's gotten out of hand.

See episode 3 ("Drug Short") of the Netflix series "Dirty Money" or Google Valeant Pharmaceuticals.

Drug prices are not the only way our sytem is broken. We're 11th out of 11 countries in one organization's ranking of overall health care. According to the World Health Organization's 2018 report, maternal mortality in the US is 14 deaths per 100,000 births. In 33 European countries it's between 3 and 11. 12 in Kazakhstan, 16 in Turkey. IIRC, we're paying 3 to 4 times as much for our heath care as anyone else.

There are many dedicated, hard-working, honest people in the health care system. It's not their fault. I still say it's broken.


It's an unpleasant fact that the health care industry in the United States is a multi-trillion dollar locomotive where the patient/end-user is the caboose. Edwin

[Wade Lippman]

Drug prices are not the only way our sytem is broken. We're 11th out of 11 countries in one organization's ranking of overall health care. According to the World Health Organization's 2018 report, maternal mortality in the US is 14 deaths per 100,000 births. In 33 European countries it's between 3 and 11. 12 in Kazakhstan, 16 in Turkey. IIRC, we're paying 3 to 4 times as much for our heath care as anyone else.


I expect we have many more drug addicted mothers than Kazakhstan. That radically increases both the maternal mortality and the cost of health care; but isn't really a medical problem.

Not that I know anything about drug use in Kazakhstan... just making a reasonable assumption.

[Brian Henderson]

Are you saying we're covering the money drug companies lose selling in other countries? Not likely. Those companies are not in business to cover their costs. Their goal is to make money for their shareholders. They are entitled to do that. In fact if you have drug company stock in a mutual fund, you want them to do that but it's gotten out of hand.

See episode 3 ("Drug Short") of the Netflix series "Dirty Money" or Google Valeant Pharmaceuticals.

Drug prices are not the only way our sytem is broken. We're 11th out of 11 countries in one organization's ranking of overall health care. According to the World Health Organization's 2018 report, maternal mortality in the US is 14 deaths per 100,000 births. In 33 European countries it's between 3 and 11. 12 in Kazakhstan, 16 in Turkey. IIRC, we're paying 3 to 4 times as much for our heath care as anyone else.

There are many dedicated, hard-working, honest people in the health care system. It's not their fault. I still say it's broken.

Of course they want to make money for their shareholders, that's the purpose of any publicly held company. But the fact still remains that there are a lot of countries out there that are putting artificial limits on how much drug companies can charge in their country and that doesn't stop these drugs from costing a tremendous amount to bring to market. The vast majority of drugs put through development never reach market at all. but their cost still needs to be paid for. The point is, drug development is insanely expensive, these are not mustache-twirling villains trying to screw widows and orphans, they are business people doing the best they can with what they're given and the overwhelming majority of drug development on the planet comes from the U.S. The fact that U.S. health care is broken, and I agree that it is, that doesn't change the costs for drug development. People complaining about how much it costs don't get how much it actually costs.

[Scott Donley]

Considering this thread started out about GoodRX I thought I would mention that most of the coupons are not good if you are 65 or older and on Medicare, at least none of the meds I take Good RX will help.

[Edwin Santos]

Of course they want to make money for their shareholders, that's the purpose of any publicly held company. But the fact still remains that there are a lot of countries out there that are putting artificial limits on how much drug companies can charge in their country and that doesn't stop these drugs from costing a tremendous amount to bring to market. The vast majority of drugs put through development never reach market at all. but their cost still needs to be paid for. The point is, drug development is insanely expensive, these are not mustache-twirling villains trying to screw widows and orphans, they are business people doing the best they can with what they're given and the overwhelming majority of drug development on the planet comes from the U.S. The fact that U.S. health care is broken, and I agree that it is, that doesn't change the costs for drug development. People complaining about how much it costs don't get how much it actually costs.

Brian,

There's cost and then there's cost. And then there's price.

From your comments, I'm thinking your definition of cost would be the hard development costs associated with the drug i.e. research, equipment, testing, clinical trials, etc.
Yes, this is one category of cost.

But wait, there's another - between the drug company and the patient, there is a complex labyrinth of players including distributors, brokers, drug wholesalers, pharmacy benefit managers. These are not some guys, they are all billion dollar companies. This chain and the cost that goes with it is unique to the US healthcare system, whether the drug was created by an American company or a foreign company like Roche, GlaxoSmithKline or Novartis.

Ultimately all these costs trickle down to you and I as end user/patients. I will predict from your post that you accept the first layer of cost. Are you as comfortable with the second?

Then there is price. A federally mandated pricing tier system fixes pricing categories that result in vastly different prices among insurers, hospitals, retail pharmacies, wholesale pharmacies, indigent care providers and end users. Generally speaking, the largest of these categories (in terms of industry leverage and lobbying power) gets the best pricing tier and the smallest of them pays full boat. It is illegal to give the benefits of one pricing tier to another. There is also a dark system of rebates that comply with the pricing rules on the surface, and then opaquely circumvent them by rebating money back from the drug company to the favored buyer on the back end. By rebates, don't think $5 bucks here and there, think billions.
I "think" GoodRx has found ways to extend best pricing to consumers partly using the rebating system to pass savings on that would otherwise be usurped by someone in the distribution chain. When you hear of someone going across the border to obtain the same drugs made by the same manufacturer for radically lower prices, it is usually because in doing so, they are essentially circumventing the domestic distribution channel and pricing tier system.

By the way, of the 10 largest pharmaceutical companies in the world, 5 are from the US. The other five are from France, Switzerland (2), Israel, and the UK. So I think it's fair to say the US is #1 in terms of drug development but it is not accurate to call it an overwhelming majority. But again, the distribution system paraphrased above is uniquely American.

Not trying to criticize you or your post Brian, but just adding another dimension on the subject. My perspective comes as a veteran of the industry, admittedly from the provider services side more so than the pharma side.

Edwin

[Mark Bolton]

Welcome to the world of self pay. I have been prescribed a medication that when landing at the pharmacy the pharmacist says "you dont want this". For instance an earache and prescribed a medication that was $380 dollars a dose and when the pharmacist called the doc he said "oh I didnt realize he was self pay" and then its $11.

Our system is completely fragged. And its fragged by the flippant users of the system. The people who are on 15 medications a day. Who believe that a life worth living is determined by how many "specialists" you see weekly. These people live their lives day in and day out by their doctor and medication schedule.They usually have great payment options, which is why they continue to uphold a half dozen doctor visits daily. They are the people that when confronted with a lifestyle change... uhhh.. nope... Ill take the meds.

We live in a medicated world in the US. And the people who truly need them suffer for those who are too lazy to get themselves off them.

There are a lot of people with no other recourse than medication. And there are the bulk of people funding the advertisements we all see on TV daily who run in to their doctor to add another script to their list.

When there is so much that can be done individually to NOT have to be on a script we have a society that is far more willing to sit in the recliner and take another med as opposed to getting out, moving, getting your blood pumping, to get OFF a med or two on your list.

Its rampant. And those of us who are healthy *by the grace of god* bear the burden.

[Ron Citerone]

Of course they want to make money for their shareholders, that's the purpose of any publicly held company. But the fact still remains that there are a lot of countries out there that are putting artificial limits on how much drug companies can charge in their country and that doesn't stop these drugs from costing a tremendous amount to bring to market. The vast majority of drugs put through development never reach market at all. but their cost still needs to be paid for. The point is, drug development is insanely expensive, these are not mustache-twirling villains trying to screw widows and orphans, they are business people doing the best they can with what they're given and the overwhelming majority of drug development on the planet comes from the U.S. The fact that U.S. health care is broken, and I agree that it is, that doesn't change the costs for drug development. People complaining about how much it costs don't get how much it actually costs.


Brian, there is no doubt drug development is expensive. However the issue at hand is not about that on 2 counts. #1, the drug rosuvastatin is a generic drug. Drug companies get payed for their development cost by having exclusive rights prior to the drug going generic. The company that developed Crestor tried everything it could to keep delaying the generic substitute. Companies also buy up generic drug makers and raise the price after the exclusive rights run out. e.g. epipen and vytone.

#2, The price variances seem to be more about insurance and drug retailers than the cost of the drug development as was illustrated in the original post.

[Malcolm McLeod]

And when totaling the various costs, don't forget to include the drug companies legal bills. USA is a bit litigious. ...Maybe more so than other nations???

Also fascinating that some from places not-USA, seem to think their cost is what they paid to the pharmacy; ignoring their tax contribution for same.

[Wade Lippman]

Considering this thread started out about GoodRX I thought I would mention that most of the coupons are not good if you are 65 or older and on Medicare, at least none of the meds I take Good RX will help.

I found it worked twice, and I am on medicare.
The first was not covered by insurance and I got about 90% off.
The second was covered and was a half dollar less then my copay.

[George Bokros]

Considering this thread started out about GoodRX I thought I would mention that most of the coupons are not
good if you are 65 or older and on Medicare, at least none of the meds I take Good RX will help.

We are on Medicare and it works for my wife and me. We DO NOT have Medicare Part D.

[Scott Donley]

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[Bruce Wrenn]

Had a colonospy today. The Suprep bowel prep kit costs $120, It's mainly EPSOM SALTS, with two other salts. Total cost to make is most likely less than five bucks, based upon cost of epsom salts in drug store. Wonder how much of a kick back doctor gets for prescribing it?

[Brian Henderson]

Considering this thread started out about GoodRX I thought I would mention that most of the coupons are not good if you are 65 or older and on Medicare, at least none of the meds I take Good RX will help.

I was picking up some prescriptions a couple of days ago and a couple were asking about GoodRX. They wanted to combine the coupons with insurance and they couldn't do it. I checked a while back and even with the coupons, most of my prescriptions would still be prohibitively expensive without insurance, they might take $10-15 off the cost, but that's all.