Prescription cost conundrum

[Shaun @ Tru6]

My doctor just prescribed a medication that they thought my health insurance would cover but they don't, cost is $1000/month. I asked about alternatives. They sent the prescription to an out of state compounder that my insurance would honor, cost is $45/month.

How does that work?

[Turbo_pro]

Originally Posted by Shaun @ Tru6

My doctor just prescribed a medication that they thought my health insurance would cover but they don't, cost is $1000/month. I asked about alternatives. They sent the prescription to an out of state compounder that my insurance would honor, cost is $45/month.

How does that work?

On a lower scale I encountered the same thing. A prescription of mine went generic so I thought the $ 280 co-pay would go down.
It didn't so I shopped around. CVS, Savon and Riteaid were all the same, give or take a buck or two.
Just for grins I asked Costco and there price for the exact same prescription was $ 16.85. That was the price not the co-pay.
In California, pharmacies are prohibited from advertising prescription drug prices, why is that?

Big pharma and their political allies are not our friends. The largest contributes to lobbyist, control life saving technologies paid for by tax deductions.

BTW: the price at Costco went up $ 2.50 right after Obysmalcare was enacted.

[1990C4S]

Just an FYI: Where I live some doctors are telling their patients not to use Costco's pharmacy. The prices are better, but the number of errors made are significant.

If you do use Costco make sure you check your prescription matches your pills.

[pwd72s]

Obysmalcare...lol...I'm going to steal that!

[wdfifteen]

Have you checked the price on Good Rx?
Their web site is a real eye opener. They show you the price at various chain pharmacies. The price can vary by 1000 per cent.

Can you imagine going car shopping and finding prices anywhere from $25,000 to $250,000 for the same car?

To answer your question "How does that work?"
Who the hell knows.

[Turbo_pro]

Originally Posted by 1990C4S

Just an FYI: Where I live some doctors are telling their patients not to use Costco's pharmacy. The prices are better, but the number of errors made are significant.

If you do use Costco make sure you check your prescription matches your pills.

Good advice for anyone taking prescription drugs.

What do you think the odds are that derogatory Costco warning is a direct result of the pharm-reps coaxing?

Or maybe the issue is prescription verification systems.

Costco customer
So at the end of that week I picked up the prescriptions while shopping at Costco with my family. As usual, I glanced at the list to make sure they were the right drugs. However, what I didn’t notice then – and actually didn’t notice until three days later when I went to use one – was that one of them was the right drug, wrong dosage. It was the 15mg version but I’m on the 30mg version. Of course, it was the brand-name, no-generic-available one so I’d paid the bigger $30 copay.

I phoned Costco the next morning and explained the problem to the pharmacist. I figured that since I had signed for the pickup and then taken three days to notice the error, that they’d a) tell me it was my new doctor’s fault and to call him myself, and b) too bad on the $30.

I was wrong! The Costco pharmacist was extremely pleasant and helpful. He could see that they had faxed the request properly to the doctor, but said that the electronic prescription filing system my doctor uses (which is apparently a big national one) is highly prone to errors, and that the doctor had probably clicked on the wrong dosage in a list of choices. The pharmacist went on to say that they have tons of problems with that system, from wrong dosages like this to wrong directions to even the wrong patients with same or similar names. He said the system is set up in a way that makes errors easy.

[908/930]

I think the difference is the $1k is from the original manufacturer, who did all the work to develop the drug and bring the drug to market and once the patent for that drug runs out all the generic copies arrive for $45. If they could not make some return on investment for the initial cost they would just stop the research. Think of the cost per year for all the chemists and doctors and other support staff.

$1k a month is not too bad compared to some of the more exotic drugs at $30k + month.

[MBAtarga]

I've mentioned Mark Cuban's costplusdrugs.com company before. I get 3 different 90 day RX's delivered for about $25. That even beats the GoodRx app pricing (which I have been a big fan of.)

[1990C4S]

Originally Posted by Turbo_pro

Good advice for anyone taking prescription drugs.

What do you think the odds are that derogatory Costco warning is a direct result of the pharm-reps coaxing?

Or maybe the issue is prescription verification systems.

Neither of those problems apply where I live. It is definitely pharmacy errors, probably from being overworked as a result of their low cost strategy.

[Turbo_pro]

Originally Posted by 908/930

I think the difference is the $1k is from the original manufacturer, who did all the work to develop the drug and bring the drug to market and once the patent for that drug runs out all the generic copies arrive for $45. If they could not make some return on investment for the initial cost they would just stop the research. Think of the cost per year for all the chemists and doctors and other support staff.

$1k a month is not too bad compared to some of the more exotic drugs at $30k + month.

That seems to be a pretty common misconception. Big Pharma is a business and as suck can expense research on their tax returns.
We pay for their research in the form of tax breaks. Every dollar they spend on research is deducted from taxes owed.
They also write off the bribes (I mean lobbying money) they spend on K street influencing politicians for favorable regulation.

[Flatbutt1]

Originally Posted by Shaun @ Tru6

My doctor just prescribed a medication that they thought my health insurance would cover but they don't, cost is $1000/month. I asked about alternatives. They sent the prescription to an out of state compounder that my insurance would honor, cost is $45/month.

How does that work?

Part of the reason is that the compounding pharmacy is not a huge business, so they don't have the overhead, nor do they have the "beard" of recouping research costs.

[908/930]

Originally Posted by Turbo_pro

That seems to be a pretty common misconception. Big Pharma is a business and as suck can expense research on their tax returns.
We pay for their research in the form of tax breaks. Every dollar they spend on research is deducted from taxes owed.
They also write off the bribes (I mean lobbying money) they spend on K street influencing politicians for favorable regulation.

Hmmm, they still need to pay a lot of research people, I don't think tax breaks will cover that. I bet the top three people on each drug project are earning at least $250k each, likely at least 15 people work under them, could take 15 years before a product hits market if it ever does. Lab equipment is not free and keeping it running is not cheap.

Without the research we would not have Sildenafil to treat cardiovascular problems.

[Arizona_928]

Originally Posted by Turbo_pro

Good advice for anyone taking prescription drugs.

What do you think the odds are that derogatory Costco warning is a direct result of the pharm-reps coaxing?

Or maybe the issue is prescription verification systems.

The pharmacy works like this.

Techs fill the bottles with pills, pharmacist confirms the pills are correct…

There’s some incompetence from the pharmacist.

[Arizona_928]

Originally Posted by 1990C4S

Neither of those problems apply where I live. It is definitely pharmacy errors, probably from being overworked as a result of their low cost strategy.

Overworked my ass. Incompetent.

You know how easy it is to confirm the pill in the bottle, to the one on the label of the bottle?

That 26 y/o DEI pharmacist is going to kill someone…

[wdfifteen]

Originally Posted by Flatbutt1

Part of the reason is that the compounding pharmacy is not a huge business, so they don't have the overhead, nor do they have the "beard" of recouping research costs.

In addition, if the prescribed drug was a combination of existing drugs it could be re created by a compounding pharmacy. When their patent runs out a lot of drug manufacturers will combine that drug with something else to create a “new” drug (actually just a new product) that sells for some ridiculous price.
There was an infamous case of a manufacturer whose patent ran out on a pimple cream they had developed. To maintain market share they repackaged it into a kit with some skin cleaner and antibacterial wipes and doubled the price. Doctors were actually prescribing the kit - at something like $600 per script, when the generic version, a bottle of alcohol and some cotton balls would do the same thing for $25.

[908/930]

Originally Posted by Arizona_928

Overworked my ass. Incompetent.

You know how easy it is to confirm the pill in the bottle, to the one on the label of the bottle?

That 26 y/o DEI pharmacist is going to kill someone…

Hmmm, do you actually know any pharmacists that can confirm how easy it is?

[wdfifteen]

Originally Posted by Arizona_928

Overworked my ass. Incompetent.

You know how easy it is to confirm the pill in the bottle, to the one on the label of the bottle? …

They do a lot more than that. My cousin is a pharmacist. Like doctors, he spends most of his time on the phone dealing with insurance companies rather than practicing the job he was trained to do. He can’t wait to retire.

[Arizona_928]

Originally Posted by 908/930

Hmmm, do you actually know any pharmacists that can confirm how easy it is?

To double check their techs… it’s that easy. Confirm pills in the bottle match the label and script. Ever notice how the bottle will give a description of the pill?

[Arizona_928]

Originally Posted by wdfifteen

They do a lot more than that. My cousin is a pharmacist. Like doctors, he spends most of his time on the phone dealing with insurance companies rather than practicing the job he was trained to do. He can’t wait to retire.

Yes. I know a few.

The biggest and most important task a pharmacist does is the drug-drug interactions of each patient. They double check the prescribing provider’s script to make sure the drug they just wrote for won’t kill the patient. They fill the controls, give flu shots, deal with insurance, and double check that the pills match the script… if you’re a pharmacy manager… you make the schedules, cover, paperwork (dea), ect. A lot of young kids go into pharmacy thinking it’s a 6 figure jobs and not much work. They quickly switch to part time and do the bare minimum…


I don't think I've met a pharmacy manager that wasn't ready to retire

[908/930]

Originally Posted by Arizona_928

Yes. I know a few.

The biggest and most important task a pharmacist does is the drug-drug interactions of each patient. They double check the prescribing provider’s script to make sure the drug they just wrote for won’t kill the patient. They fill the controls, give flu shots, deal with insurance, and double check that the pills match the script… if you’re a pharmacy manager… you make the schedules, cover, paperwork (dea), ect. A lot of young kids go into pharmacy thinking it’s a 6 figure jobs and not much work. They quickly switch to part time and do the bare minimum…


I don't think I've met a pharmacy manager that wasn't ready to retire

So they are not overworked? just incompetent? You forgot a couple other details from your list.