My $9,600 prescription skin cream

[lucky penny]

My dermatologist recently prescribed an ointment called Alcortin A to treat a bothersome rash. His assistant told me she would call the prescription in to ScriptsRX, which would ship it to me after checking to see whether it is covered by my insurance. When I asked what the cost would be if it isn't covered, she laughed and said I wouldn't want to pay it, it's "thousands of dollars." I then did some research (there's a lot of publicity about this on the internet), & sure enough: Alcortin A cost around $120 until a few years ago, when it was purchased by a pharmaceutical company, Novum, which promptly raised the price of a single tube to $1,500, and then raised the price earlier this year to $9,600!

Then I called Scripts &, yes, they had my prescription & would ship it to me that day. I asked if my insurance covered it & the guy said no, but "No problem, we have a program" that will cover the charge. So the cost to me is zero! (and no cost for shipping either).

I just received it.

Obviously someone's making money from all this, but I'm flummoxed. What a strange world we live in.

On its website, Novum has a notice that the co-pay for "all patients" is $0 for this drug. So why the high price? A tax write-off so they don't pay taxes?

I just hope it works!

 

[audreyh1]

My god this is truly bizarre!!! And crazy making!

 

[travelover]

.........On its website, Novum has a notice that the co-pay for "all patients" is $0 for this drug. So why the high price? A tax write-off so they don't pay taxes?.........

I believe I read about this practice. The insurance companies put a percent co-pay on drugs to make the patients feel some of the pain for high priced drugs. The drug companies fight this by paying the co-pay so the patient doesn't care if the price is ridiculous (as in your example). One more reason that I think the government needs to get on Big Pharma's case to end such abuse.

 

[24601NoMore]

Had a similar situation..needed some Duexis (pill) for my knee pain. It's an anti-inflammatory that's basically a mix of ibuprofen and an OTC stomach protector (Zantac if I remember right). Basically about $25 worth of ingredients if you were to buy them over the counter. Doctor says "don't worry - there's a pharmacy we work with that will ship them to you, no cost". Cool!

Checked with my insurance co after I got the pills. $2,600 for a bottle of 60 pills. $0 co-pay to me. But $2,600 for ibuprofen and zantac mixed together?

Next one (same Dr) was a topical gel - Pennsaid. $5,700 (!) for 30 days worth. Same pharmacy, same "co-pay" (ie: $0).

Fortunately, insurance co paid both with no issues - but then made me jump through flaming hoops to get my $650 or so MRI approved, and denied my $200/visit PT after I had only done about 5 visits - even though I'm supposed to get something like 40+ visits a year. They deemed it "not medically necessary" even though I was still having lots of issues. But, they paid $8,300 for the Duexis and Pennsaid without any hesitation whatsoever. Yeah..that makes sense.

No wonder our insurance costs so much, and the HC system is so totally gorked.

 

[mystang52]

A tax write-off so they don't pay taxes?

I just hope it works!

For sure:

 

[EarlyBirdly]

" In this country, on some level, everything is some form of a Lie or a Racket driven by money, greed, and a general lack of Morals. Everything. "

 

[LARS]

" In this country, on some level, everything is some form of a Lie or a Racket driven by money, greed, and a general lack of Morals. Everything. "

EarlyBirdly, Now there’s a pleasant thought to start my morning... ugh.

 

[Jerry1]

Unfortunately the healthcare industry is built on cost shifting. They get enough people to pay the $9,600 that they can take less from others. It’s not the write off mentality but it’s working the system. I think Medicare establishes prices based on average wholesale pricing and my guess is that this high level of pricing ultimately gets them more from Medicare and many insurance companies. So much more that even with forgiving the co pay and even giving away to some they’re still making out. Crazy.

 

[RetMD21]

Hard to understand but the high price is not designed to help the consumer. They must be getting insurance payments from some companies.

 

[Bamaman]

It sounds as if they're writing off the $9,600 uncollected from their corporate income taxes. Write it up, write it off (the taxes).

 

[kitesurfer2]

$30 over the counter CBD crème has cured my cousins skin condition that normal prescribed cremes couldn't fix.

 

[EastWest Gal]

One wonders what’s in it for the doc who prescribed the stuff. Especially the story about Duexis. Wow. Just wow.

 

[audreyh1]

It sounds as if they're writing off the $9,600 uncollected from their corporate income taxes. Write it up, write it off (the taxes).

I don’t think it works that way. You can’t write off some imaginary price you list.

This has been discussed before. Accounting rules don’t allow it.

 

[Masquernom]

I just went through something similar. I had a doctor visit and some blood tests. Saw the bill to insurance for the blood tests, $9,600. I about passed out. Wondering how in the world it could be that much, and how much I'd have to pay. Turned out the insurance company marked it all way down and paid their standard rate. The testing company didn't even send me a bill.

I have lost all faith in the US health care industry. Between the providers and the insurers, it's all an evolving scam.

 

[travelover]

...........I have lost all faith in the US health care industry. Between the providers and the insurers, it's all an evolving scam.

It all makes a lot more sense when you receive the $9600 instead of owing it.