The high cost of meds

[Ed62]

I was in Walgreen's yesterday, and there was an elderly lady picking up her meds. When the clerk told her it would be $118.00, she looked like she was going to cry. She paid for it, then just stood there looking at the meds. I told her about two other pharmacies who would certainly have better prices. Now I'm wishing I had given her the $70.00 or so I had in my pocket. If I were to see her today, I'd do just that. I have no idea who she was.

Ed

[cabinetman]

Ed, ya gotta watch out for the little old lady with a plan. Real tears helps a bit. Sooner or later somebody falls for that act.

[Jim1]

Ed,

First, I want to disclose that I've been involved in pharmacy for almost 40 years. This is in no way meant to insult you or others, but is in fact meant to provide an insider's look at what goes on behind the scenes.

You didn't say if the lady had an insurance program. I would think that since you said she was old, she most likely had medicare part d. If that is in fact the case, she would pay the same wherever she went (if she used her insurance) because the prices are determined by her part D carrier. From my perspective, over 95% of my patients have some type of third party intervention-either insurance, discount programs, or coupons. Many of the programs offered to senior citizens thru part d, don't explain in clear enough detail how the plan works. Many people don't understand their insurance coverage, exceptions, copays and how the "donut" hole works. Also, at least in Illinois, if a senior has an income below a certain level, he/she may qualify for the "circuit breaker program" which may help with premiums and copays. Like any other product or service, one must determine the value to the person. No one pharmacy or chain has the absolute lowest prices on everything. A person should certainly consider price, convenience, accesibility and hours the pharmacist is available. Just like your dr, dentist or lawyer, the relationship-trust, knowledge, concern and the ability to relate-to your pharmacist is important. It is always best to get your medicines in one place since the pharmacist can easily do a thorough evaluation of drug interactions and compatability with any existing health conditions.

I have to agree that the prices on many of the newer medications, are outrageous. In general, prices at retail are predicated by the costs the pharmacies pay for the medications. And like any business, a profit must be made, or the business will cease to exist. I understand the manufacturer's claims that R&D has associated costs that must be recovered, but I strongly disaprove of the way many of the drug companies market the products, inflating the prices of the drugs by covering huge dollars spent trying to influence prescibers, and the excessive budgets spent on trying to sway the general public.

And like the media sometimes portrays, I have witnessed patients, young and old alike, struggling with balancing their budget-trying to figure out how to pay for their medicines and still put food in their stomachs........

Oh, and just as you mentioned, I have seen good samaritans offering to help, or pay for needed medications. And also, so that no one here thinks I'm being a hypocrite, I've also helped-out of my own pocket-needy patients get their meds.

Jim

[Ed62]

Jim,

While I appreciate your perspective,

No one pharmacy or chain has the absolute lowest prices on everything.

the above quote may very well be true. But I know for a fact that there is a huge difference in price, for the same meds, among pharmacies. Case in point: My wife had a prescription that she needed to get filled. She called Walgreen's, the closest pharmacy for us. While I don't remember the exact figure, Walgreen's quoted the price around $175.00. For the exact same meds from Costco pharmacy, it was less than $20.00! That's about 1/9th the cost from Walgreen's. No, it's not always that way. Sometimes the difference is quite a bit less significant. But we have never had a prescription where Walgreen's wasn't higher. We drive close to 15 miles for most of our meds. The exception would be for very inexpensive meds, which is not usually the case.

Thanks for your post. It was an eye opener.

Ed

[herb fellows]

Jim, imho, marketing drugs which require a prescription to individuals through expensive tv ads is criminal, and should be illegal. I don't mind paying for R&D, but I would love to know the percentage of money paid for any drug I am buying that is going to pay for advertising to the public.
I, as the person who ends up using this drug, am paying for these ads where they are trying to convince me to 'ask my doctor' if xyz drug would be good for me.
How dare they!

[parnelli]

Jim, imho, marketing drugs which require a prescription to individuals through expensive tv ads is criminal, and should be illegal. I don't mind paying for R&D, but I would love to know the percentage of money paid for any drug I am buying that is going to pay for advertising to the public.
I, as the person who ends up using this drug, am paying for these ads where they are trying to convince me to 'ask my doctor' if xyz drug would be good for me.
How dare they!

Question- since pharmaceuticals are a very small part of the healthcare budget-lets say drug advertising does again become prohibited- should Doctors and Hospitals also have their advertising declared illegal? While we're on the topic of healthcare and advertising- why should Blue Cross get to advertise- or maybe even Walgreens? I'm not trying to be obnoxious, but where do we draw the line?

Disclosure- I used to be in advertising and personally if something is legal then I have a difficult time understanding why they shouldn't be allowed to advertise. And yes, goes for smoking too.

[parnelli]

J But I know for a fact that there is a huge difference in price, for the same meds, among pharmacies. Case in point: My wife had a prescription that she needed to get filled. She called Walgreen's, the closest pharmacy for us. While I don't remember the exact figure, Walgreen's quoted the price around $175.00. For the exact same meds from Costco pharmacy, it was less than $20.00! That's about 1/9th the cost from Walgreen's. No, it's not always that way. Sometimes the difference is quite a bit less significant. But we have never had a prescription where Walgreen's wasn't higher. We drive close to 15 miles for most of our meds. The exception would be for very inexpensive meds, which is not usually the case.

Agree 100%. There's a way that Walgreens has been able to afford to build one on nearly every street corner. There are 12 within 5 miles of my house. (Unless they've built another one while I was typing!)

[MilDoc]

One recent article estimated that in 2004, the Pharm industry spent more on drug promotion of all types (24.4% of sales) than on R&D (13.4% of sales).

http://www.plosmedicine.org/article/...l.pmed.0050001

And I agree that in my area, with only one Walgreen's, their prescription costs are far higher than WalMart or HEB Supermarket.

[Richard in Smithville]

If you're a senior in Canada, the govenment pays for most meds. I'll gladly pay a little extra in my taxes for that.

[crokett]

One of the meds my MIL is taking costs 60 bucks per pill. AFIK that is all R&D - there is no marketing of the drug.

[jackellis]

I also object to the idea of advertising prescription drugs, though as far as I can tell, most of the ads are not for the most expensive meds.

At some point I expect I'll have to start taking cholesterol and blood pressure medication - at the moment I'm a borderline case. When that happens, we'll start with cheap, old-fashioned, tried-and-true generics. From the little I know, new blood pressure and cholesterol drugs are no better than the old ones.

BTW, I pay for my own, high-deductible insurance and at the moment, my plan does not include medications.

[herb fellows]

Question- since pharmaceuticals are a very small part of the healthcare budget-lets say drug advertising does again become prohibited- should Doctors and Hospitals also have their advertising declared illegal? While we're on the topic of healthcare and advertising- why should Blue Cross get to advertise- or maybe even Walgreens? I'm not trying to be obnoxious, but where do we draw the line?

Disclosure- I used to be in advertising and personally if something is legal then I have a difficult time understanding why they shouldn't be allowed to advertise. And yes, goes for smoking too.

Every thing you stated is something where YOU have to make the ultimate decision. Drugs that you take are essentially the decision of the doctor, not you. He's the one who has the degree that supposedly makes him an expert in deciding what drugs you need.
Would you go to your auto mechanic and tell him you saw an ad for transmissions and you would like to try one? Of course not. He's the professional, he's the one who is trained to tell you what you need. God knows they spend enough on marketing to doctors to try to convince them to push their drugs. The difference is that the doctor has the training and knowledge to sift through the bs , we as lay people don't.
Trying to get the 'customers/patients to go to the doctor and say 'hey, I saw this wonderful product on tv' is tantamount to sneaking in the back door. If they can't convince the doctor, they'll have the patient bring it up to him/her. To me, that is sleazy marketing. We're not talking about Ginzu knives here, this is an area where you need the advice of a professional who hopefully doesn't have a bias as to which drug you take. IMHO, the drug companies are trying to subvert that process.

[herb fellows]

Hey, Ed, nobody here, including me up till now, has mentioned that you have a good heart.
Even though it turned out to be too late, your heart was in the right place. Good on ya!

[just started]

I also agree there is no valid reason to advertise drugs, and there is also no valid reason for hospitals to advertise either. If it is a planned admission you will be going to the hospital your doc is associated with and has privileges at, and in an emergency you are going to be taken to the nearest ER or Trauma center as necessary.

[herb fellows]

While that is essentially true, I have gone to a different doctor on one occasion because I didn't care for the hospital he was associated with for the particular need that I had at the time. Obviously, this is the exception rather than the norm.