Drug Prices

[dennis thompson]

Difference, I can choose to use a Microsoft product, may not have that option for prescriptions.

I used Microsoft as an example, I could have used Google, or Nvidia,or any one of probably 50 companies that are so integrated into our daily lives that we cannot do without them. For example my last two doctor visits were Zoom calls, now you could say I could have gone to the doctors office but that would have required a 60 mile trip to the office and who, in the time of Covid, wants to go sit in a doctors waiting room.
Again my point is, people are quick to criticize the pharma companies, maybe too quick, without understanding all the financials of the companies.

[Tom Bender]

Yes what happens in Washington is important but local factors can still make a big difference. So if you have to pay for a medication you should shop.

1. You can ask for your script on paper and use it anywhere. This works with internet pharmacies.

2. Or when the doctor asks what pharmacy you use you can ask the doctor to hold on a minute while you check Goodrx. Doc may even have staff check for you or know another way. Or may have samples, especially if it is a new med.

3. You can ask your pharmacy if there is a better price.

4. If the script is for 30 or 90 days you can buy just a few pills. They will hold the rest of the script so you can buy more if the med works.

[Stan Calow]

3. You can ask your pharmacy if there is a better price.

In some states, pharmacists are not allowed to tell you. When I inquired once about what a drug would be with a GoodRX coupon, the pharmacist told me she could not tell me unless I presented the coupon to her. Contracts with the drug companies, who apparently are just victims.

[Alan Lightstone]

Let me throw in an even better choice than Goodrx. Look up Mark Cuban CostPlus Drugs. I believe a non-profit company setup to give amazingly low prices on a limited (but growing) number of drugs. Some of these saved us literally thousands.

https://costplusdrugs.com/?iss=https...usdrugs.com%2F

They didn't have all of our prescription drugs, but for the ones they did, the savings were truly amazing. Unfortunately, I had never heard of them until I read a recent article about saving money on prescription drugs from Consumer Reports. Worth looking for that article too, as they mentioned a number of companies setup to save you money on drugs.

And I'm not going to get into a rant about pharmaceutical companies and what they have done to insulin prices (though I should). Truly should be criminal.

[Jim Koepke]

There is one thing to remember about discounts, usually if you don't ask for one, you won't get one. Occasionally this has even worked in our local supermarket.

jtk

[John Goodin]

So the lesson is shop around and ask for a discount. Sure would help a lot of people if Medicare could take that advice.

[Curt Harms]

Difference, I can choose to use a Microsoft product, may not have that option for prescriptions.

Theoretically, you could choose to not use a Microsoft or Adobe product but if you digitally interact with most companies it might be difficult if not downright impossible. Looking almost the same may not cut it. I've had to buy generic drugs in the recent past. A doctor in New Jersey put me onto a neighborhood pharmacy whose prices were about 1/3 of Walmart pharmacy. I suspect their source(s) are in India but what are the sources of Walmart's generics?

[Bill Dufour]

So the lesson is shop around and ask for a discount. Sure would help a lot of people if Medicare could take that advice.

The drug companies keep lobbying so that medicare is not allowed to bargain for prices. I wonder if the military and VA are allowed to bargain for drug prices?
Bill D

[Michael Weber]

but what are the sources of Walmart's generics?

My understanding is that practically all generic drugs are made in India and China. It’s also my understanding the FDA has little or no resource or legal ability to inspect such facilities.

[Dwayne Watt]

My understanding is that practically all generic drugs are made in India and China. It’s also my understanding the FDA has little or no resource or legal ability to inspect such facilities.

I have personally met a person in China (in line at Beijing airport) that had a US government passport of a unique color (neither blue nor brown). He was there to inspect the suppliers of drug filler (essentially clay earth which makes up the bulk of the pills one takes). He told me that virtually all drug (pill) manufacturers use Chinese filler, not just generics. That said, those manufacturers probably use supplies from other countries as well.
The FDA can prevent import of drugs that do not meet US standards and do this by inspection of shipments, not inspection of the manufacturer directly.

[roger wiegand]

I worked in the pharmaceutical industry for a long time.

IMO, the innovators are getting paid too little, and the patent trolls and copycats too much. Much of current drug pricing is completely screwy, an artifact of mis-regulation and market manipulation.

The scientific staff at FDA are very good, and do the best they can with limited resources and limited political sway. I can't say so much for the leadership that bends the science to fit the assorted lobbying groups that assail them from every side.

Insulin seems to me to be the perfect opportunity for a patient-driven co-op to disrupt the current madness. Some group (the diabetes association for example) could create a co-op, hire a toll manufacturer to make and package the product, and sell it at a very reasonable price to co-op members, bypassing those who currently profit outrageously on this very generic product. Even just the threat of such a solution would probably drop current prices significantly. There's no reason for patients not to band together to create non-profit alterntives to getting gouged.

[roger wiegand]

The FDA can prevent import of drugs that do not meet US standards and do this by inspection of shipments, not inspection of the manufacturer directly.

FDA routinely inspects overseas manufacturing facilities (I know this from direct experience), they must meet the same standards as US-based facilities. FDA is woefully underfunded to do this comprehensively, either in the US or abroad.

[Brian Deakin]

I live in the Uk, the charges for prescriptions regardless of the cost of the drug are set out below


My question

Would you swap the system you have in the USA for the system available in the Uk

Other I am a retired pharmacist and the most expensive drug i dispened which was free of charge cost $3500 per month


NHS Prescription Prepayment Certificates (PPCs)


A PPC could save you money if you pay for your NHS prescriptions.
The certificate covers all your NHS prescriptions for a set price. You will save money if you need more than 3 items in 3 months, or 11 items in 12 months.
The prescription charge in England is £9.35 per item. A PPC costs:

• £30.25 for 3 months
• £108.10 for 12 months
• Who can get free prescriptions
  
  
  
  You can get free NHS prescriptions if, at the time the prescription is dispensed, you:
  
  • are 60 or over
  • are under 16
  • are 16 to 18 and in full-time education
  • are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)
  • have a specified medical condition and have a valid medical exemption certificate (MedEx)
  • have a continuing physical disability that prevents you going out without help from another person and have a valid medical exemption certificate (MedEx)
  • hold a valid war pension exemption certificate and the prescription is for your accepted disability
  • are an NHS inpatient
  
  You're also entitled to free prescriptions if you or your partner (including civil partner) receive, or you're under the age of 20 and the dependant of someone receiving:
  
  
  • Income Support
  • income-based Jobseeker's Allowance
  • income-related Employment and Support Allowance
  • Pension Credit Guarantee Credit
  • Universal Credit and meet the criteria
  
  If you're entitled to or named on:
  
  
  • a valid NHS tax credit exemption certificate – if you do not have a certificate, you can show your award notice. You qualify if you get Child Tax Credits, Working Tax Credits with a disability element (or both), and have income for tax credit purposes of £15,276 or less
  • a valid NHS certificate for full help with health costs (HC2)
  
  People named on an NHS certificate for partial help with health costs (HC3) may also get help.
  Read more about who can get free NHS prescriptions.
  Check you're eligible for free prescriptions
  
  There's a simple way to find out if you're eligible for free NHS prescriptions and any help with other NHS costs.
  Use the eligibility checker.
  Free prescriptions for certain medical conditions
  
  People with certain medical conditions can get free NHS prescriptions.
  Medical exemption certificates are credit-card-size cards. They are issued if you have:
  
  
  • cancer, including the effects of cancer or the effects of current or previous cancer treatment
  • a permanent fistula (for example, a laryngostomy, colostomy, ileostomy or some renal dialysis fistulas) requiring continuous surgical dressing or an appliance
  • a form of hypoadrenalism (for example, Addison's disease) for which specific substitution therapy is essential
  • diabetes insipidus or other forms of hypopituitarism
  • diabetes mellitus, except where treatment is by diet alone
  • hypoparathyroidism
  • myasthenia gravis
  • myxoedema (hypothyroidism requiring thyroid hormone replacement)
  • epilepsy requiring continuous anticonvulsive therapy
  • a continuing physical disability that means you cannot go out without the help of another person (temporary disabilities do not count, even if they last for several months)
  
  Find out more about medical exemption certificates.
  How to apply for a medical exemption certificate
  
  Ask your doctor for an FP92A form to apply for a medical exemption certificate.
  Your GP will sign the form to confirm that your statement is correct. At your GP's discretion, a member of the practice who has access to your medical records can also sign the form.
  Your certificate will be valid from 1 month before the date the NHS Business Services Authority receives the application form.
  The MedEx lasts for 5 years and then needs to be renewed. You may receive a reminder that your certificate needs to be renewed.
  If you do not receive a reminder, it's your responsibility to make sure it's renewed.
  Check if your exemption certificate is valid
  Free prescriptions for pregnant women
  
  If you're pregnant or have had a baby in the past 12 months, you get free prescriptions if you have a valid maternity exemption certificate.
  To apply for a maternity exemption certificate, contact your doctor, midwife or health visitor.
  Your certificate will be sent to you by email or in the post.
  The certificate will last until 12 months after the expected date of birth of your baby.
  If your baby's born early, you can continue to use your certificate until it expires.
  If your baby is born late, you can apply for an extension.
  If you apply after your baby is born, your certificate will last for 12 months from your baby's birth.
  Find out more about maternity exemption certificates.
  Free prescriptions if you have a low income.
  
  If you have a low income, you may be eligible to receive financial help through the NHS Low Income Scheme.
  To apply for an HC2 certificate, complete form HC1, which is available from Jobcentre Plus offices or most NHS hospitals. You might also be able to get an HC1 form from your doctor, dentist or optician.
  You can also get an HC1 form by calling 0300 123 0849.
  You qualify for a full help HC2 certificate (which includes free NHS prescriptions) if your income is less than or equal to your requirements, or your income is greater than your requirements by no more than half the current English prescription charge.
  You qualify for a limited help HC3 certificate if your income is greater than your requirements by more than half the current English prescription charge.
  The HC3 certificate shows how much you have to pay towards your health costs.
  Certificates are usually valid for between 6 months and 5 years, depending on your circumstances.
  Find out more about the NHS Low Income Scheme
  How can I claim a refund on a prescription charge?
  
  Ask the pharmacist, hospital or doctor for the refund form (FP57) when you pay for your prescription. You cannot get one later.
  You must apply for a refund within 3 months of paying the prescription charge.
  If you receive Universal Credit and meet all the criteria to be entitled to help with health costs but did not get a refund form (FP57), contact the NHS Business Services Authority. They'll consider applications for refunds on a case-by-case basis.
  
  
  If you paid for a prescription prepayment certificate (PPC) and have become exempt from paying for prescriptions, you may be able to get some or all of the money back for your PPC.

[Ken Combs]

Let me throw in an even better choice than Goodrx. Look up Mark Cuban CostPlus Drugs. I believe a non-profit company setup to give amazingly low prices on a limited (but growing) number of drugs. Some of these saved us literally thousands.

https://costplusdrugs.com/?iss=https...usdrugs.com%2F

They didn't have all of our prescription drugs, but for the ones they did, the savings were truly amazing. Unfortunately, I had never heard of them until I read a recent article about saving money on prescription drugs from Consumer Reports. Worth looking for that article too, as they mentioned a number of companies setup to save you money on drugs.

And I'm not going to get into a rant about pharmaceutical companies and what they have done to insulin prices (though I should). Truly should be criminal.

I'll second this recommendation, at least with some reservations. I placed my first order but haven't yet received it. But, I see no reason to believe I won't.

$12.50 for 90 pills. Same prescription from a Canadian online provider is $120. Local well over $200.

It's my understanding that they sell all drugs at 15% over cost.

The price list on the web site is eye-opening.

[Alan Lightstone]

I'll second this recommendation, at least with some reservations. I placed my first order but haven't yet received it. But, I see no reason to believe I won't.

$12.50 for 90 pills. Same prescription from a Canadian online provider is $120. Local well over $200.

It's my understanding that they sell all drugs at 15% over cost.

The price list on the web site is eye-opening.

Being a physician, I was able to save some time by sending them the prescriptions myself, instead of waiting for my doctor to send them (still can't believe that we're faxing medical stuff instead of e-mailing it. Welcome to the 21st century folks. Thanks, HIPAA).

Assuming your doctor faxed them the prescription, it was my experience that the send the medicines out quite quickly.