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.