Vent on Prescription Prices

[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.

 

[egleys]

Have you tried HealthWarehouse? I get all my generics through them. It's cheaper than if I go through my insurance. Check it out.

 

[DatumPoint5]

Also, check prices for your drug at multiple pharmacies at https://www.goodrx.com/

 

[LakeRat1]

+1 on GoodRx ...... I have saved over $3600 over the past 3 years

 

[imoldernu]

Some earlier posts on the subject:

http://www.early-retirement.org/forums/f38/drug-costs-why-88080.html

 

[Freedom56]

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.

Several months ago my wife's doctor prescribed a cream she needed to use for about 6 months. The mail order pharmacy with our insurance wanted $470 per month. We took the prescription to Costco (Los Angeles area) and they wanted $380 per month. The drug has been around for 45 years. We had a planned trip to Europe in May with a stop over in Toronto. I got a doctor in Canada to re-write the prescription and took it to a Costco in Toronto and it cost $210 CDN (about $152 USD at the time) for a 6 month supply of the exact same drug from the same manufacturer (Pfizer). It is ridiculous what the drug companies and their distributors are getting away with here. Until someone does something about it, this will continue.

 

[Sojourner]

I got a doctor in Canada to re-write the prescription and took it to a Costco in Toronto and it cost $210 CDN (about $152 USD at the time) for a 6 month supply of the exact same drug from the same manufacturer (Pfizer).

Just curious... How did you get a doctor in Canada to write a prescription so quickly and easily? Did you have a pre-existing relationship with this doctor, or is it that simple to get Canadian doctors you've never seen before to write prescriptions for non-citizens?

 

[Sojourner]

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.

This happened to me recently, as well. In my case, the generic was cheaper initially (only about $3/month), but I saw roughly the same 400% increase over the past 10-12 months. I called my insurance company and asked what was going on, and they said they didn't have any details other than that the drug manufacturer had raised their prices. I protested that this was a common, long-standing generic, so it made no sense why the pricing would spike so dramatically. All they could offer was basically "Sorry, but that's just how it is."

I ultimately was able to mitigate the price increase by getting my doctor to write a new prescription for a stronger dosage of the drug. I had been on the lowest dosage, which had risen to around $12/month, but I found that the next highest dosage was available for about $7/month if I simply cut the pills in half. Obviously, we're talking about fairly small amounts of money here, but it was the principle of the thing that motivated me to take action. I find the complete lack of transparency and "rational" pricing in this arena to be utterly mind-boggling.

 

[Sunset]

....
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.

.....

This lack of transfer of prescription sounds like a pharmacy rule to keep your business. It also sounds to me like it should not be allowed (illegal).
It's your prescription, you should have the right to move it.
I wonder who rules over pharmacies regulations ?

 

[Texas Proud]

Another thing you can do is ask if there is something cheaper..

I believe it was on 60 minutes where the pharmacists cannot tell you that the price is cheaper IF you pay cash unless you ask....

It is not always cheaper... I am paying cash today because we are going on a trip and insurance says I cannot purchase till tomorrow.... cash price a bit over $5 with insurance $4.... but, the show showed examples of some big cost reductions....


Just ask!!!

 

[Freedom56]

Just curious... How did you get a doctor in Canada to write a prescription so quickly and easily? Did you have a pre-existing relationship with this doctor, or is it that simple to get Canadian doctors you've never seen before to write prescriptions for non-citizens?

The doctor is a relative and a specialist in Radiology and Nuclear Medicine. We use him always for second opinions on any issues. His track record in diagnosis is far better than any doctors at UCLA from our experience. UCLA is ranked one of the best healthcare system in the west coast. We use him for second opinions all the time. I brought a copy of the prescription from my wife's doctor. He generated a duplicate. You can also go to any walk-in clinic in Toronto and pay cash for a check-up and prescription for about $50 to $75. A lot of people from the northern states do just that. I can't blame them. In our case I could fly my wife first class to Toronto to get a 6 month refill and still come out ahead.

 

[H2ODude]

Just browsed the GoodRx site. Amazing the difference in prices between pharmacies. The two scrips I have for blood p are variable and I'm paying the cash price for a generic on one at Walmart. The other one on our Medicare D is only a tad less than the cash price. Oh well. I'll take whatever Medicare gives me, especially upon reading what other youngsters are dealing with on HI. Why anyone finds US Healthcare acceptable is beyond me.

 

[SheitlQueen]

I used to order through Health Warehouse, and they were great, but found out WalMart was just as cheap.

Do you use insurance to purchase your meds? That might be one of the issues. One time I went to WM to refill my prescriptions they wanted $175 when the cost for three months had always been $25. Turns out they were trying to use my insurance. I told them I paid for them myself because it was cheaper. Price went back down to it's normal cost.

 

[Huston55]

Also, check prices for your drug at multiple pharmacies at https://www.goodrx.com/

I ultimately was able to mitigate the price increase by getting my doctor to write a new prescription for a stronger dosage of the drug. I had been on the lowest dosage, which had risen to around $12/month, but I found that the next highest dosage was available for about $7/month if I simply cut the pills in half. Obviously, we're talking about fairly small amounts of money here, but it was the principle of the thing that motivated me to take action. I find the complete lack of transparency and "rational" pricing in this arena to be utterly mind-boggling.

+1 on both these methods.

Also, other discount programs are WellRx & OptumRx. Membership in all (all I’ve found to date) Rx discount programs is free so, easy to enroll in them. Our experience is that the different discount programs usually offer about the same discount, which can be quite substantial but, sometimes one program is significantly cheaper and/or is accepted at another location with a better deal.

If you’re not already enrolled in Rx home delivery, that’s normally much cheaper for two reasons; prices typically less & 90-day prescriptions. I definitely recommend home delivery/90-day prescriptions if that’s available to you.

 

[littleb]

I was prescribed a cream that even going through BCBS plan was going to cost me 450.00 monthly and I needed to use it for almost a year.

Found out about the GoodRX app and downloaded it to my phone. I was able to get a drug card through GoodRX from the drug manufacturer and the cream cost 0.

Sometimes it pays to check around. GoodRX shows the prices of the drug at your local pharmacies.

 

[tfudtuckerpucker]

Goodrx works. Recently I needed a prescription refill at Walgreens, and they wanted $280. They told me they would honor the goodrx coupon, but when I picked up the prescription, they had only reduced the price in half. So I told them to keep it, and transferred the prescription to a nearby grocery store pharmacy. The price was $28.

 

[jim584672]

CBS had a news story on Rx pricing based on the plan you are on. They say the cash price may be a lot lower, even after your co-pay, but the pharmacy is not allow to tell you a lower price is an option due to a contract they have. You need to specifically ask for the cash price.

 

[Texas Proud]

I ultimately was able to mitigate the price increase by getting my doctor to write a new prescription for a stronger dosage of the drug. I had been on the lowest dosage, which had risen to around $12/month, but I found that the next highest dosage was available for about $7/month if I simply cut the pills in half. Obviously, we're talking about fairly small amounts of money here, but it was the principle of the thing that motivated me to take action. I find the complete lack of transparency and "rational" pricing in this arena to be utterly mind-boggling.

Yes... I was prescribed a pill at 1000 mg it cost in the $45 range....

But if I got the doc to write for me to take 2 500mg per day the cost dropped to $5....

So, I take two pills instead of one and save $40 per month....

I have to explain this to my new docs since I have had to change a few times since ACA....

 

[Ronnieboy]

The whole prescription industry is a game that every pharmacy has to play and the customer has to pay. Pharmacies have jacked their prices up so high because that is what they have to do to get the insurance companies to pay a shrinking reimbursement and the people who lose are the ones without insurance or that have to pay cash for prescriptions.

In theory your 'insurance price' can never be higher than the cash price that the pharmacy offers any person off the street. Here is an example: You have a script for amoxicillin 500mg capsules #40. The actual cost for the pharmacy for #40 capsules is $2. Now we are not adding in any labor, supplies, utilities, etc. Just 2 bucks for the actual medication. You take it to Walgreens, they tell you the "usual and customary" price for this prescription is $76. This the price you see printed on your receipt that will either say U&C or 'before insurance' or cash price.

1) Well you tell them you have insurance and your generic copay is $15, pharmacy runs it through, insurance pays $0 to the pharmacy and you pay $15. All is done and depending on expenses after adding in everything the true cost is $10 and the pharmacy made $5.

2)Well you tell them that you have insurance and it is a high deductible plan. The pharmacy run the insurance and the insurance spits back a price of $44 because that is the maximum they will allow the pharmacy to charge on that particular drug, so the insurance paid $0 to the pharmacy and the patient paid $44 thinking that they got a deal because the insurance knocked off $32 off the u&C.

3) You have zip insurance and when you get the price either before or after filling the rx you tell them no thanks, they offer you the "Walgreens Savings Plan" I think they used to charge $15 a year for that or something but now I think it is free with all the other free discount cards...surprise the price dropped to anywhere between the $15 and $44, dang you got a great deal.

4) You go in with no insurance but you have your handy dandy GoodRx card. It gets processed and due to the contract with the pharmacy the price comes out somewhere between $15 and $44. Wow huge savings!! GoodRx is the best thing since sliced bread.

You can easily replace Walgreens with CVS or Rite Aid in the above example.

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.

This post is getting long in the tooth, but I will drop some info on you with 27 years in the pharmacy biz.

1) Whatever you think you are getting a good deal on by shopping at a $4 list place, they are making it up on the non $4 listed items. Either through higher prices from you or your insurance company. If you have the attitude that it doesn't matter because I have a flat copay or hey as long as I don't have to pay it (the insurance company does). Then don't complain about your premiums gong up every year.

2) If you shop at a pharmacy who 'matches prices' they do that so they can over charge you on everything you are not price matching. Plus, do you want to go to a pharmacy that is purposely trying to over charge you on the medications but then try to cover their arse by saying, "Well, we'll price match" when you find out their price is more than double another pharmacy

3) Be nice to the pharmacy staff, they are under constant pressure to increase script count, do vaccinations, counseling, etc. etc. with less help. The mantra 'more with less' is always heard. So is you catch more flies with honey than vinegar.

4) Call your prescriptions in at least 3 BUSINESS days before you need them (a week is even better) that gives them time to get it filled, call your Dr if you are out of refills, work through stock issues, etc. Avoid Monday's if you can, that is the busiest day of the week for Pharmacies. Waits can be long on Sunday's or overnights when the staff is low.

5) Find a overall well priced pharmacy to get all your prescription from. That way they can check for drug interactions on all your meds. If you got your cholesterol med from Wal-Fart, your BP medicine from Walgreens, and your viagra from CVS they can't check if there are drug interactions between the 3 because they were at 3 different places. Costyco and Sam's Club seem to be overall well priced pharmacies.

6) Just an observation on generic drugs raising in price by 500+%. Generic drug companies have been merging and causing single source drugs for a number of cheap generic drugs. It gets crazy some times. For instance there was a cheap beta blocker, propranolol, that was $5 for #100 pills, it was made by Mylan, Watson, Teva, Activas, Sun, Dr Reddy's, and Apotex drug companies. That was why the price was so low. Well a couple of those companies stopped making it because it just wasn't worth it to them (they didn't make enough $$), Mylan bought out Watson, Teva bought Activas. Before you know it only one company is making propranolol and the price shoots up to $60 a bottle. Why? Did the cost of making the drug go up? Did the chemicals to make the drug go up? No, the manufacturer is the only game in town and they upped the price because they could.

7) Remember when you use GoodRx or some other free discount card your information, health info and purchasing history goes to GoodRx for them to use/sell/market as they see fit.

 

[Sue J]

Thank you for the detailed explanation.

7) Remember when you use GoodRx or some other free discount card your information, health info and purchasing history goes to GoodRx for them to use/sell/market as they see fit.

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.

 

[audreyh1]

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:

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/CostcoUSBCCatalogAssetStore/rx/cmppenrollmentform.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]

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.