Vent on Prescription Prices

[audreyh1]

Quote:

Originally Posted by Ronnieboy Now take your rx to Wal-Fart and they have a magical $4 list and for #30 of the capsules it is $4, technically still above cost...but really a loss leader due to $4 not covering the out the door price, of course since you are getting #40 the price is $5.25. You run it through your insurance that has the $15 copay, you get it for $5.25. You run it through GoodRx who says the price will be $5.25 cause they can't get it any lower, you run it through your high deductible plan and it is $5.25. You take the same rx to CostyCo and their cash price is $7.99 because they don't believe in selling below cost, at cost maybe, but not below cost. Hey, I don't even need a membership to get Rx's there, what a bargain. I run it through my $15 copay plan, comes back at $7.99 because that is U&C, high deductible, $7.99, GoodRx $7.99 because it is at bare bones already. But wait, there is a Costco Member Prescription Program, which is free (if you are a member, which cost $55/yr but you get to shop all of costco) and that drops it to $6.49! What a deal.

Wow - that's quite an epistle and an amazing post! Tons of useful info.

I went to HEB to fill my Cipro prescription because I knew Cipro was cheap. And it was $4. Felt like a deal! I normally go to Costco.

I didn't know about the Costco Member Prescription Program

According to their application:

Quote:

Enrollment in the program is open to Costco members (and their dependents) who do not have prescription drug coverage available, or who are insured but their insurance does not cover all of their prescriptions. Any uninsured participant who later obtains any form of prescription drug insurance must inform Costco, and his or her participation in the program will be canceled, unless the insurance does not cover the medication prescribed.

https://www.costco.com/wcsstore/Cost...llmentform.pdf

I think we've both already run into situations where our insurance did not cover the medication prescribed. We don't have ongoing RXs - so it's been an occasional one time thing.

[Sunset]

I got a refill at Sam's .

The old company making the prescription was not available, so a different company making the same thing was used, the price went from $11 to $22.

I asked the pharmacist if HI would help, he said "if you have HI why did you not use it ?" .
He checked and told me it's not covered.

So I paid the $22 cash.

[Sue J]

Ronnieboy,

Were you a pharmacist? Or did you work in the pharmaceuticals industry?

I bet you've seen some interesting changes.

[imoldernu]

RonnieBoy
Special thanks for taking the time to explain.
Regards....

[limeyx]

Quote:

Originally Posted by growing_older Last month, my very common generic prescription cost me $15. When I went to pick up a refill this month, the price was $75. A 400% price increase in a single month for a long existing very common generic medication. I called to find out if a mistake had been made and was told that across the board huge price increases were taking place as suppliers were bargaining harder with insurance companies. This has nothing to do with costs or scarcity. This is just plain price gouging by suppliers where a second source for the generic doesn't exist. In fact, they told me that other medications raised their prices by as much as 1500% that month. I have no choice about this at all. I can explore other pharmacies and maybe find one with a discount program or loss leader. But every time I do so, I need to get the doctor to write a new prescription because once assigned to a pharmacy, I have been unable to transfer remaining refills elsewhere. The system seems to be deliberately designed to reduce price transparency and take advantage of captive consumers to jack up prices at will. And this is a relatively inexpensive common medication. I can hardly imagine the problems this will cause with specialty medications that can cost hundreds or even thousands of dollars a dose.

Yup. I take generics for blood pressure and GERD. Both increased from ~5 to ~15 dollars recently.

Doesn't seem like much but both are generics that have been around for ever and there is zero reason for them to go up like this.

[audreyh1]

Quote:

Originally Posted by limeyx Doesn't seem like much but both are generics that have been around for ever and there is zero reason for them to go up like this.

Clearly companies selling the cheap medications are raising prices because they can. As someone mentioned, there has been a lot of consolidation among companies producing generic drugs and so competition is reduced.

[Bamaman]

Lots of angles are being discussed here.

It went into Megapharm for a prescription of 6 vials of insulin. Price was $930. Because I am on Medicare and have a pump, the doctor should have put a specific code number on the prescription and Medicare Part B would have paid 80%. Needless to say this is a high volume drug that has experienced high price increases over the years. I got a new script with the right numbers on it.

But had I been a young, poor broke person, the pharmacy would find a way for me to get insulin free. It is a drug that will not be withheld for a lack of money.

I have to go through blood tests and see my endocrinologist every 90 days in order to get my supplies paid. My doctor suggested I go on the pump pre Medicare because they don't want to pay for $6800 insulin pumps. But when I reorder pump supplies every 6 months, Medicare Part B is charged $1063.

I am very impressed with the administration of my Medicare Part B. I have to provide the description and serial number of my insulin pump and provide the last date of my doctor appointments. Blood sugar standards have to be met too before getting on the plan. I must closely follow their protocol or they won't pay.

[scrabbler1]

It's not drugs specifically, but I have been buying my diabetes testing supplies through Amazon since late 2015. After a little checking I saw that the insurance deductible would greatly exceed what I pay off the insurance. The major pharmacy charges way, way more. For long-lasting items such as the finger poker and testing meter, my endocrinologist can give me freebies when mine need replacement.

[MikeD]

Quote:

Originally Posted by growing_older Last month, my very common generic prescription cost me $15. When I went to pick up a refill this month, the price was $75. A 400% price increase in a single month for a long existing very common generic medication. I called to find out if a mistake had been made and was told that across the board huge price increases were taking place as suppliers were bargaining harder with insurance companies. This has nothing to do with costs or scarcity. This is just plain price gouging by suppliers where a second source for the generic doesn't exist. In fact, they told me that other medications raised their prices by as much as 1500% that month. I have no choice about this at all. I can explore other pharmacies and maybe find one with a discount program or loss leader. But every time I do so, I need to get the doctor to write a new prescription because once assigned to a pharmacy, I have been unable to transfer remaining refills elsewhere. The system seems to be deliberately designed to reduce price transparency and take advantage of captive consumers to jack up prices at will. And this is a relatively inexpensive common medication. I can hardly imagine the problems this will cause with specialty medications that can cost hundreds or even thousands of dollars a dose.

I suggest that you open up a drug producing company and run it your way and charge rational prices.

Mike D.

[travelover]

Quote:

Originally Posted by MikeD I suggest that you open up a drug producing company and run it your way and charge rational prices. Mike D.

That's right. If you don't like getting ripped off, just open your own company and buy a few congress critters while you are at it to make sure you can get away anything.

[growing_older]

Quote:

Quote: Originally Posted by MikeD I suggest that you open up a drug producing company and run it your way and charge rational prices. Mike D.

I do remember reading somewhere that Puerto Rico has a substantial generic drug manufacturing business and that recent hurricanes could affect supplies. However in discussing price changes, no one I talked to indicated that there was a supply issue, only that producers were negotiating new prices with insurers, considerably higher than previous prices.

There was also speculation that a recent round of price hikes was needed to set the going rates higher in anticipation of pressure to negotiate down. A big hike followed by some price concessions could still leave suppliers with favorable pricing. But that sounds like politics and not business.

[Ronnieboy]

Quote:

Originally Posted by Sue J Thank you for the detailed explanation. For how much GoodRx has saved us on Rx costs, they can have my info. If they would like my blood type, library card number, first pets name, shoe size, and car VIN number they can have those, too.

Yes, I agree for the most part, but there are both sides of the extreme on this board. From why do you need my date of birth to the above

[Ronnieboy]

Quote:

Originally Posted by audreyh1 Wow - that's quite an epistle and an amazing post! Tons of useful info. I went to HEB to fill my Cipro prescription because I knew Cipro was cheap. And it was $4. Felt like a deal! I normally go to Costco. I didn't know about the Costco Member Prescription Program According to their application: https://www.costco.com/wcsstore/Cost...llmentform.pdf I think we've both already run into situations where our insurance did not cover the medication prescribed. We don't have ongoing RXs - so it's been an occasional one time thing.

For the most part, Costco is one of the all around cheapest places to get your medications, as Consumer Reports has shown. But there are one off's that are hard to beat, one is the $4 for some 30 day or less items. Those can really be a deal. If it is the $12 for 90 days, some of those can be better priced at Costco and of course Brand Name with no generics available are going to be expensive/highest copay no matter where you go (not including Canada )

Also Wal-Mart has teamed up with Novartis, the manufacturer of Novolin brand insulins to make their own house brand of OTC insulins called Reli-On available in R, NPH, and 70/30 mix. We're talking ~$30/vial vs. $120 for Lilly or Novolin brands. Great if you are on those or a pet.

[Ronnieboy]

Quote:

Originally Posted by Sunset I got a refill at Sam's . The old company making the prescription was not available, so a different company making the same thing was used, the price went from $11 to $22. I asked the pharmacist if HI would help, he said "if you have HI why did you not use it ?" . He checked and told me it's not covered. So I paid the $22 cash.

Yes, some meds are not covered, that is when GoodRx might save (or might not since Sam's is competitively priced) and if not, I think Sam's has a Sam's member discount program like Costco's.

[Ronnieboy]

Quote:

Originally Posted by Sue J Ronnieboy, Were you a pharmacist? Or did you work in the pharmaceuticals industry? I bet you've seen some interesting changes.

Pharmacist, still pill pushing

Yes, many interesting changes, I've seen Pharmacy go from a relaxed, take your time to make sure everything is 110% right mentality both from the patients and owners/bosses to being treated like a fast food joint.

Low margins for the pharmacy, which is ironic to talk about when we keep seeing crazy price jumps, has led to fill 100x as many scripts since they are now making 100x less on each one.

All I can say is I'm glad I'm on the down hill side of my career.

[Ronnieboy]

Quote:

Originally Posted by Bamaman Lots of angles are being discussed here. It went into Megapharm for a prescription of 6 vials of insulin. Price was $930. Because I am on Medicare and have a pump, the doctor should have put a specific code number on the prescription and Medicare Part B would have paid 80%. Needless to say this is a high volume drug that has experienced high price increases over the years. I got a new script with the right numbers on it. But had I been a young, poor broke person, the pharmacy would find a way for me to get insulin free. It is a drug that will not be withheld for a lack of money. I have to go through blood tests and see my endocrinologist every 90 days in order to get my supplies paid. My doctor suggested I go on the pump pre Medicare because they don't want to pay for $6800 insulin pumps. But when I reorder pump supplies every 6 months, Medicare Part B is charged $1063. I am very impressed with the administration of my Medicare Part B. I have to provide the description and serial number of my insulin pump and provide the last date of my doctor appointments. Blood sugar standards have to be met too before getting on the plan. I must closely follow their protocol or they won't pay.

Yes, you can even be an old poor broke person to get super discounted insulin and injectable diabetes meds. There is a low income program called 340B, I am not that familiar with it as we do not normally participate but you can get insulin, byetta, victoza, and other injectable meds for as little as $5-$25 vs the $400+ cash prices.

Medicare part B is great for insulin supplies, but as you have mentioned you and the MD have to jump through a ton of hoops and keep detailed records, but it is worth it.

[Ronnieboy]

Quote:

Originally Posted by scrabbler1 It's not drugs specifically, but I have been buying my diabetes testing supplies through Amazon since late 2015. After a little checking I saw that the insurance deductible would greatly exceed what I pay off the insurance. The major pharmacy charges way, way more. For long-lasting items such as the finger poker and testing meter, my endocrinologist can give me freebies when mine need replacement.

Yes, the lancet device and meter are nice and easy to get, you can even call the manufacturer to get a free one. They love to hand those out because once you get *their* machine, you have to buy *their* strips and that is where the money is

[Ronnieboy]

Quote:

Originally Posted by MikeD I suggest that you open up a drug producing company and run it your way and charge rational prices. Mike D.

For some of the cheap ones that have gone up big time, I often think it would be nice to open your own drug Co and start making them for a nice profit at half the price. Too bad there are too many hurdles to jump through... and too many government associates to buddy up to

[scrabbler1]

Quote:

Originally Posted by Ronnieboy Yes, the lancet device and meter are nice and easy to get, you can even call the manufacturer to get a free one. They love to hand those out because once you get *their* machine, you have to buy *their* strips and that is where the money is

You got that right, Ronnieboy! Lancets are very cheap, maybe 4 cents apiece, and are compatible with any finger pokers. It's those dang test strips which will getcha!

[sengsational]

There's a pretty simple solution to the generics that jump up in price...just buy them from outside the US. No need to get a different doctor...just have your doctor fax your prescription to a legit international pharmacy. And what always comes up next is a bunch of hand wringing about counterfeits, which, in the case of cheap generics, isn't a problem because there's not enough money in it to interest the bad guys.

Not all drugs are cheaper outside the US, but I've found that generics that go bonkers here tend not to go bonkers worldwide.