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Thread: Drug Prices

  1. #1
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    Drug Prices

    Not a rant about prices, there are plenty of those elsewhere. This post is about getting a better price. The whole industry is a scam but some solutions are not bad.

    Good Rx works

    Pharmawebcanada works

    If you know of others that you are sure of please add them.

  2. #2
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    What one has to be careful with about these prescription discount plans is that they have certain limitations, sometimes only covering a particular medication one time, making the refill a big financial surprise. Be sure to check the fine print VERY carefully!
    --

    The most expensive tool is the one you buy "cheaply" and often...

  3. #3
    Before I got on Medicare and the supplements that go with it I had a lot of prescriptions filled at canadapharmacyonline.com. The system they used was simple and it worked well for us. Saved close to 75% most of the time

  4. #4
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    I used GoodRX when the insurance company said they would not pay for something the doctor prescribed. My regular pharmacy said it would be $179 with no insurance. My doc suggested GoodRX. I went to their website, where they offered discount coupons for specific meds at specific pharmacies. They included choices of multiple local pharmacies (like CVS, Walgreens, Walmart, etc.) I printed out the coupon for my regular pharmacy and got the same meds for $20. So its not an online pharmacy or insurance to which you pay a premium, just a place that offers discount coupons. It worked for me.

    I think I learned through this, that in many states, the pharmacists are prohibited by law or by contract with insurance companies, to even hint there may be a way to get discount prices, such as GoodRX. Yes it seems to me that the pharmaceutical companies and insurance companies together have come up with this system, with the help of their politicians who could do something, but won't.
    Last edited by Stan Calow; 10-05-2019 at 2:02 PM.

  5. #5
    Quote Originally Posted by Stan Calow View Post
    I used GoodRX when the insurance company said they would not pay for something the doctor prescribed. My regular pharmacy said it would be $179 with no insurance. My doc suggested GoodRX. I went to their website, where they offered discount coupons for specific meds at specific pharmacies. They included choices of multiple local pharmacies (like CVS, Walgreens, Walmart, etc.) I printed out the coupon for my regular pharmacy and got the same meds for $20. So its not an online pharmacy or insurance to which you pay a premium, just a place that offers discount coupons. It worked for me.

    I think I learned through this, that in many states, the pharmacists are prohibited by law or by contract with insurance companies, to even hint there may be a way to get discount prices, such as GoodRX. Yes it seems to me that the pharmaceutical companies and insurance companies together have come up with this system, with the help of their politicians who could do something, but won't.
    I have had the same experience as above. Good Rx, at least the way I've used it, is not a plan with fine print or limitations Jim. You simply punch your prescription drug into their website, and it will spit back coupons and available discounts at pharmacies in your zip code and it is your choice whether to use them or not. Usually Walmart, Costco, Kroger and sometimes Walgreen's come up with coupons. Just two days ago I filled a prescription for $11, which was one third of what my insurance co-pay would have been and one fifth of what the retail price for the drug would have been. My insurance card stayed in my pocket and I was basically a retail off the street customer with no insurance for the purposes of that transaction.

    Yes, the whole system is a travesty, but at least there are now some tools available to allow us to become more astute consumers. Unfortunately you have to find them mostly yourself, because yes, in most states the pharmacist is not allowed to tell the patient about any alternative avenues by which they can save money.

    My family of four is pretty healthy. From what I can tell, my employer PPO health insurance premiums for the last year were about $18,000 of which I paid a portion and my employer paid a portion. According to the insurer's benefit overview, it looks like our family's utilization was about $2,000 of which we paid about $500 in copays. So the insurance company took in $18,000 and paid out $1,500 in direct costs. Go figure.

    By the way, I first heard about Good Rx here in the Off Topic forum, and it's saved me some decent $$ despite going to the pharmacy infrequently. I'm replying to the thread in the hope of paying it forward and that it will help someone else.

  6. #6
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    Edwin, I have been told by multiple sources that sometimes a subsequent purchase of the same medication may not get discounted...it really comes down to whatever deal the manufacturer struck with the discount provider. But that could certainly be wrong and just hearsay. My comment was just to be sure that folks take into consideration that sometimes things change. I've personally never used the service due to lack of need--our copays for medications are small with our insurance, but for many folks, it could be useful.

    You are correct that pharmacists are sometimes not permitted to pass on certain ideas and information, although there are some that care about their clients enough to do so anyway, albeit quietly. I actually have experienced that!
    --

    The most expensive tool is the one you buy "cheaply" and often...

  7. #7
    Jim,

    You're a lucky man with better insurance than I!
    My story -
    My copays for drugs used to be low, like $10.00.
    Then they went to $20.00. Then they went to $30.00.
    Then the insurance company set up tiers where tier 1 stayed at $30 but tier 2 and tier 3 went considerably higher.
    Then they progressively moved more and more drugs out of tier 1 and into the higher tiers. And this is with a PPO plan under one of the biggest health insurers whose name starts with United and ends with Healthcare.

    It was an insidious progression and now I find I am almost always better off printing off the GoodRx coupon and walking in the retail pharmacy with the prescription in hand and my insurance card at home or in my pocket. Even if you have a $20 copay and GoodRx can get you the drug for $10, it's a 50% savings in my book.
    One thing you say is true though, there is no guarantee that the coupon or discounted price for a drug would still be there in the future if you needed a refill. So far I have always found that it is, but if it were not, then you'd be back to where you were if there were no GoodRx. Also, their discounts are not as broadly available for compounded (custom prepared) medications which most retail pharmacies are not set up to prepare anyway.

    I'm astounded when I hear talk in the political debates that there are ostensibly millions of people who are terrified of "losing" their excellent company provided insurance. Everyone in my circle of contacts has shared my experience of diminishing coverage, rationed care and increasing cost thrown back on the insured in the forms of copays and deductibles. And it would be one thing if all this were happening and company paid premiums were going down, but most small to medium size employers I know have seen their premiums go in only one direction and it's not down or sideways.

    No connection with GoodRx by the way, I'm just a very disillusioned health care consumer. Makes me think about an old consumer advocacy TV show from the 70's called Fight Back with David Horowitz. We need a health care version of him to help people navigate the alligator swamp.
    Last edited by Edwin Santos; 10-06-2019 at 12:15 AM.

  8. #8
    Quote Originally Posted by Tom Bender View Post
    Not a rant about prices, there are plenty of those elsewhere. This post is about getting a better price. The whole industry is a scam but some solutions are not bad.

    Good Rx works

    Pharmawebcanada works

    If you know of others that you are sure of please add them.
    A lot of what you pay for prescriptions goes to lawyers and people trying to get rich quick off the system.

  9. #9
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    Sep 2016
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    Modesto, CA, USA
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    For me the link below works well. Canadian Phamarcy kings, I only use it for one medicine that would cost over $1,000 for a 90 day supply. It is shipped from Mauritius? to me through Switzerland for about $120 delivered. The other meds cost less then the copay so I get them at CVS. The insurance company keeps sending letters about I need to take my meds.
    My old kaiser plan paid for drugs after you paid a certain amount (thousands). Their pharmacy is by far the most expensive around so we paid less then half at walgreens.
    Bill D.
    Checks only no credit cards. They send several E-mails confirming orders to make sure the prescription is correct.

    https://www.canadianpharmacyking.com/Login.aspx

  10. #10
    Join Date
    Mar 2010
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    Quorn United Kingdom
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    I live in the United kingdom and have the following system

    Each prescription item costs a fixed price of $11 approx (and the pharmacist has a professional responsibility to inform you if it can be purchased cheaper)
    If you have a large number of items you can purchase a prepayment certificate $36 for 3 months or $120 for 12 months and all prescriptions are free

    Separately prescriptions are free if any of the following criteria apply

    https://www.nhs.uk/using-the-nhs/hel...ription-costs/

    The cost of this is funded from national insurance pot of money

    https://en.wikipedia.org/wiki/Nation...er%20benefits.

  11. #11
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    Ok so that's two more Canadian options and some hearty endorsements for GoodRx

  12. #12
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    Quote Originally Posted by Edwin Santos View Post
    My family of four is pretty healthy. From what I can tell, my employer PPO health insurance premiums for the last year were about $18,000 of which I paid a portion and my employer paid a portion. According to the insurer's benefit overview, it looks like our family's utilization was about $2,000 of which we paid about $500 in copays. So the insurance company took in $18,000 and paid out $1,500 in direct costs. Go figure.
    Health insurance is just like any other insurance. Most will pay in more than they get back, but some will get back way more than they paid in. One bout of cancer can cost $300,000. My co-worker was told his cancer would cost around $300,000. I suspect it was more than that as he had a lot of complications including regular visits to a hyperbaric chamber.

  13. #13
    Quote Originally Posted by Brian Elfert View Post
    Health insurance is just like any other insurance. Most will pay in more than they get back, but some will get back way more than they paid in. One bout of cancer can cost $300,000. My co-worker was told his cancer would cost around $300,000. I suspect it was more than that as he had a lot of complications including regular visits to a hyperbaric chamber.
    Valid point.. to a point. For example seeing as how United Healthcare saw a trailing twelve month net income of just under $13 billion as of June 2019, I'd say they're on the right side of the equation more than not. On average a 22% increase year over year over the past five years.
    Of course I realize the insurance company's primary duty is to it's stockholders, more so than to the insureds or the contracted providers in their network. So in this regard they're delivering epic numbers and thus doing a very good job.

    The idea that some will get back way more than they paid in is a bit of a fallacy, at least these days in practice. Every commercial group will be experience rated at time of renewal. The key number is the loss ratio, i.e. % of cost paid out against premium for the group. If the loss ratio is above a certain level, the carrier will basically get it back through increased premiums for the coming year. So why not switch carriers? Well the loss ratio is shared so the new prospective carrier will see it and price accordingly so there's really no escape. If the group is big enough, then hopefully the losses will balance out against those who paid in more, but it is surprising how few outliers it will take to wreck the loss ratio for even a large group. They call these shock losses. A good example would be a single complicated neonatal ICU case.
    The term inside the industry for the practice of recouping by raising premiums is called "trading dollars" with the insurance carrier. As a side note, not that long ago, groups were not individually evaluated in this way because carriers used community rating as their guideline whereas they now use individual group experience rating. Under community rating, where an entire geographic community is considered, there is still a possibility of trading dollars (with the group of carriers that serve that community), but actuarial science will level out the distribution curve and the changes should be less extreme. For the same reasons, a very large institutional group, like a University, will have the actuarial benefits of something approaching community rating due to their sheer size, not to mention other techniques like self-insurance risk retention features. But even for a huge group like this, a negative loss ratio cannot persist without something having to give.

    I see the OP didn't intend for the thread to be a price rant and I've probably taken us way into the weeds, so I'll drop it, but it's easy to see why health care cost is something so many people feel strongly about and I hope this info is interesting to someone.

    No disrespect or quarrel with your comment BTW, it's a subject that's been on my mind lately hence the lengthy response, and of course I realize mine is only one person's opinion.
    Last edited by Edwin Santos; 10-06-2019 at 3:06 PM.

  14. #14
    Watch out for your insurance company, they are NOT on your side. Several years back, doctor prescribed a name brand drug only. Co payment was $72, but pharmacist said I should check to see what the "off the street price was." So I asked, and it was $54. Pharmacist said first insurance doesn't even to begin to pay "off the street price," and any excess funds between what they paid and what I paid was returned to insurance company. This means every prescription filled was ripping me off. Similar, but different. New drug (to me), but couldn't get it to go thru on insurance, so I paid out of pocket Bill was $62. Next month insurance refunded me $62, less $20 copay, plus filled prescription. Then they send me a statement stating that by having insurance , I had saved over $200 on this prescription. Remember when I paid for it, it was only $62, so how the heck did I save over $200 on a $62 prescription?

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