Pharmaceutical Rape
The cost of pharmaceuticals in the United States have been a bad joke for a long time. No other country in the world pays as much for medications as we do. Adding insult to injury, most of those medications are made right here in the USA. Yes, even the ones bought by people in other countries who pay much less than we do.
Think I’m making it up or repeating what I’ve read on the internet? Wrong. I’m stating fact. Let me give you a first hand, first person, no “I heard it on the grapevine” story. Our own story. Unfortunately, I know we are not an isolated case.
In 2010 we were living in Tucson, Arizona. Both my husband and our Australian Cattle Dog were diagnosed with Valley Fever. The medical name for this disease is Coccidioidomycosis. According to the Free Medical Dictionary “Coccidioidomycosis is an airborne infection. The fungus that causes the disease is found in the dry desert soil of the southwestern United States, Mexico, and Central and South America. Coccidioidomycosis is sometimes called San Joaquin fever, valley fever, or desert fever because of its prevalence in the farming valleys of California. Although commonly acquired, overt coccidioidomycosis is a rare disease. Chronic infections occur in only one out of every 100,000 people.”
As luck would have it, both of them had the rarer, sometimes lethal form, of the disease. There was no question about whether we’d treat it or ride it out. As the doctors told us, the complications can kill you. We laughed about the fact both of them were put on identical medication. We were being prescribed large enough doses that we got the drugs in their original bottles rather than the orange pill bottles the pharmacies usually use.
Fortunately, my husband’s case responded fairly quickly to the $250/mo. medication and he recovered in just over a year. Yes, his cost $250/mo. The dog’s was “only” around $80/mo. Same dosage, same medication, identical bottles, same manufacturer. Go figure. But the story gets better… or worse…
Unfortunately, here we are in 2014 and the dog’s case is still active and being treated. She has a blood sample drawn every 3 months to check her blood titers that is sent off to Arizona, because that is the only place in the country with labs that do the test, or so we’ve been told.
This disease has never been seen here in Washington and the labs practically went ballistic when our vet sent a sample to them to be tested. She ended up being contacted by all sorts of government agencies over it. Turns out, coccidioidomycosis is considered to be a potential biological weapon of war and having it turn up in a Seattle lab started a tempest in a teapot. But I digress…
The large, national chain pharmacies go on about how they can give us better prices for our medications because they can shop around, buy in bulk and thereby save us money.
When it was time to have her checked after we returned Washington State in 2012, after the dust-up with the labs and government settled, the vet handed me a prescription to take to my usual pharmacy. She did not carry Fluconazole and figured I’d get it cheaper and faster from a commercial pharmacy.
I called Walgreen’s since we have all our other prescriptions filled there. I was told a month’s supply (60 tablets) would cost me just under $1000 without any kind of insurance. Of course if we had their saver’s card (which we do) it would “only” be around $485.
Insanity! We’d been paying $250 for the exact same thing in Arizona from the same pharmacy chain. And paying $80 for the same thing from the vet there.
So I went back to my vet and told her what had happened. She said she’d see if she could get it in for me for less. The next week I had TWO months worth of Fluconazole waiting for me at her office. She showed me her invoice from her supplier. $8.12 per bottle. Yeah, PER BOTTLE! She charged me $12.50 per bottle and I was a very happy camper.
Jump forward to yesterday, January 3, 2014. I went to the vet’s office to pick up Lady’s meds and the first thing I got was an apology. Why? Again, I was shown the invoice from her supplier. What had cost her $8.12/bottle for the past year and a half is now $98/bottle! She asked the supplier why it had gone up so much and they could not explain it to her. Basically they just told her, “Sorry but that’s what it is now.”
I know there are people reading this who will say, “Well just put the dog down and you won’t have that expense.” What if it were my husband instead of the dog who has not recovered. Should I put him down? And that isn’t the issue. The issue is that we are all being financially raped every time we buy a prescription and no one is doing anything about it!
I have a sinking feeling this is part of a trend. I also suspect ObamaCare is going to be blamed for it. But let me point out a couple of things…
- The disparity between what pharmacies pay and what they charge us is a long standing problem.
- Now pharmacies are being charged more so we are going to be hit even harder.
- The people who are being hit the hardest are the ones who can least afford it… the sick, the elderly, the working poor, the people who cannot afford health care coverage.
- As we have seen in the past months, health care coverage prices are skyrocketing.
- Those of us who can least afford coverage and our prescription costs are still being hit the hardest.
I don’t have any brilliant answers to the problem. I just want you to know, if you’re in the same boat, you’re not alone. Who will go to bat for us? Who will put a stop to the insanity? Pharmaceutical companies have been holding us hostage and financially raping us for years. When and how is it going to stop?
Check out this guy’s video… http://www.youtube.com/watch?v=dqLdFFKvhH4#t=142 The end is a flagrant pitch but I’ll bite. He makes that much sense!
Here’s another real life example. This time of medical procedure and health care costs: http://www.app.com/article/20140105/NJBIZ/301050005
It's All in the Perspective! 
Okay… education will help ALOT here, but perhaps only for your sanity. You might not be able to do anything about it after you know better.
The price is set by distribution, which is the supply chain to the local business you asked for a price. That distribution system is NOT controlled by the drug companies nor the store — it is set by a number of players in the “supply chain” business. They study trends, demand, supply, etc. and set prices according to their profit targets and distribution goals.
Many people don’t know that pharma companies hire other companies to manage the wholesale distribution of their drugs. McKesson is one of the big ones… it handles the distribution of a huge amount of our pharmaceuticals, and is the ONLY place many pharmacies can buy certain drugs.
The AVAILABILITY of a drug (at whatever the price is) is set by the store you go into, when they decide what to carry or reorder. This is the tricky part. There may be dozens of generic drugs all suitable for a prescription, but they can only sell you the ones they have in stock. If the Dr. wrote a scrip for Drug A, the store may choose to only stock the one that is $500 even though there is another one that is $10. It’s their choice.
The $500 one might be $500 because there is a shortage of it on the region (from that distributor). The price may have nothing to do with the suitability of the drug for you. There might be PLENTY of the $10 one available… but that store didn’t stock any. When you ask that store for a generic equivalent, they may say they see any available…. but it is because they don’t stock it (right now).
Sometimes when the price of a popular drug skyrockets (due to temporary distribution problems) the store will choose to carry a very profitable equivalent… that same $10 drug but this time $70. Because next to the $500 sticker shock, $70 looks like a good deal. But it’s not a deal at all.. it’s just what their business manager chose to stock, knowing the temporary price problems would make it look more of a deal.
The key is to shop around… and you can’t. You have to know more about the drugs and molecules and doses. In actuality, your Dr. or pharmacist are the only ones qualified to shop around for you. The former is to busy, and the latter is restrained by his employer to sell you what they carry.
If you have an ongoing need for the same drug, you may be able to slowly develop the expertise (working with your Dr.) to know what equivalent drug brands/names are, in what doses. Then you shop all of your options by phone (Costco, Walgreens, local pharmacy, etc) to get costs and availability, BEFORE calling the Dr. and asking him to write the script for X or Y (this time). In my experience, the Dr. is happy to do so, and thrilled to see someone doing the work to get what they need despite the “system”.
Keep in mind new generics come and go all the time… I’ve had pharmacists happy to tell me of alternatives that are cheaper and widely available, when they knew my script as written couldn’t be filled with those options. I guess that let them off the hook for any conflict of interest…. the state boards require them to answer questions and they want to help when they can. It was my job to then find that drug somewhere at a good price, and get my dr to agree to change the script on the phone at filling time.
Related to this is how pharmacies are often required by law to sell at a loss… it’s not under their control when Medicaid is involved http://johnsaddiction.com/6335-pharmacies-fill-medicaid-scripts-at-a-loss/
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