The opinions and research of two Americans, published this week in local newspapers, epitomize the position of millions of Americans: drug prices are too high and safe personal drug importation is a smart way to afford medication. Tom Kennedy compared prices between the U.S. and Canada in 2003, and he is doing it again 11 years later. His guest opinion in the Billings Gazette has shown that U.S. prices have increased 153% for the drugs he tracked since 2003, far outpacing the rise in income and cost of living. He has some good economic insight and analysis, and I recommend reading his whole opinion, which you can find here.

David Di Saia, from North Providence, Rhode Island, found that he could save $480 a year by using a Canadian pharmacy instead of the pharmacy associated with his Medicare plan. And that’s just the savings for one medication! Imagine the savings if he had to order more than one drug. You can read his story, which is “sad, but true” on the Valley Breeze website.

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Will your private health insurance cover Sovaldi? (Part 2)

Back in July, we brought you Part I of a series of posts about how to afford Sovaldi (sofosbuvir), the new Hepatitis C (Hep C) cure in the form of a $1,000 pill — $84,000 for the standard 12-week treatment. We focused on consumers paying for Sovaldi in cash. It wasn’t pretty.

Thankfully, most Americans who are taking and will take Sovaldi are covered by health insurance. And if Sovaldi is on the drug list of your health insurance plan then the cost can be a co-pay of $75/month or sometimes $175/month, which is not too bad all things considered. However, as we know – health insurance policies don’t cover all medications, even ones that are far less expensive than Sovaldi. Not surprisingly, health insurance companies are resisting open coverage policies for Sovaldi. In fact, there’s a big battle brewing between Big Health and Big Pharma about who is to blame for problems with affordable access to Sovaldi and other specialty meds – but that’s for another day.

The short answer to the blog title question is – Sovaldi coverage depends on multiple and often technical variables, such as, your age, current health, efficacy of other treatments, intolerance to treatments that are recommended to be taken with Sovaldi, Hep C genotype, history of drug abuse, and more! Herein I do my best to shed some light on what’s up. I believe you’ll find below that most privately insured Americans with Hep C are not guaranteed access to Sovaldi. (more…)

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Specialty drugs have been in the news for their exorbitant prices lately. Gilead Sciences’ Hepatitis C cure Sovaldi has received media exposure for costing $84,000 and in 2012, when Memorial Sloan-Kettering Cancer Center refused to use the colon cancer medication Zaltrap because of its $11,000 a month price, the manufacturer responded by offering discounts of 50%. Will these high prices come way down once the medications go generic?

A new study from the National Bureau of Economic Research, examined costs and utilization of specialty drugs (specifically cancer meds) as generic versions are introduced. Generally, prices for generic drugs drop as more manufacturers produce them due to price competition. This should presumably happen for specialty drugs, but there’s a catch. Many specialty drugs have a small user base and some of them are formulated as solutions or injection, which may require more specialized and expensive manufacturing processes compared to traditional oral drugs (i.e pills, liquids). For those reason, the drugs price discrepancy between brands and generics is not as great among specialty medications compared to regular medications.

The study didn’t analyze the best way to actually pay for these medications. But a recent analysis by HealthPocket took a look at Obamacare plans and specialty meds. Check that out here. We are still researching paying for specialty drugs and will have our own analysis and tips for saving at some point in the future.

Keep in mind that over time specialty drugs, such as Sovaldi, will go generic in the U.S. and be prices considerably lower than the brand. But unlike many pills for high blood pressure, depression, or cholesterol, you won’t find $4 Zaltrap at your local Rite-Aid anytime soon.

I wish I had a more concrete answer and analysis on the prices and access to specialty meds. It’s something that we here at PharmacyChecker.com are keeping an eye on, and we will certainly have updates in the future.

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TechDirt Founder Mike Masnick Hits the Nail on the Online Pharmacy Head

In writing about the web domain company EasyDNS’ online pharmacy policy, Mike Masnick, founder of award-winning technology and business innovation blog Techdirt, makes the following observation:

“Fake and dangerous drugs from rogue pharmacies are a real (if relatively small) problem. Legitimate foreign pharmacies selling into the US at cheaper prices are a made up problem by US drug companies. But those US drug companies like to take the “small” problem, and blame it on any non-US pharmacy in an attempt to block out the competition.”

Thank you Mike for expressing that so clearly! The essence of TechDirt is to “analyze and offer insight into news stories about changes in government policy, technology and legal issues that affect companies’ ability to innovate and grow.” Innovation via the Internet has allowed consumers who can’t afford their medicine domestically to access it through foreign pharmacies. The pharmaceutical industry and its well-funded agents are getting away with murder by pressuring online “gatekeepers” such as domain registrars, search engines, and credit card companies to disallow service to pharmacies that American consumers have come to rely on.

To some in the public health community and in government, Mike’s expression of rogue online pharmacies as a “relatively small” problem” may come across as flippant and even naïve – but it cuts much deeper than that. The question is relative to what? If he means relative to the public health crisis of high drug prices in America then Mike is entirely correct: rogue online pharmacies are a small problem compared to high drug prices in America. Far more Americans are getting sick and/or dying because they can’t afford medication at home than they are from dangerous online pharmacy purchases.

That does not excuse the actions of rogue pharmacy websites that endanger the health of consumers. That’s precisely why EasyDNS’ decision to only provide service to online pharmacies if they are approved by LegitScript or PharmacyChecker is visionary. It does not let dangerous pharmacy websites exist, but it refuses to succumb to a protectionist, anti-consumer, big pharma initiative to snuff out innovative business models – safe international online pharmacy – that hinder their profit-making machine and grossly disadvantage consumers.

Rock on TechDirt!

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EasyDI’m writing this blog post to say thank you to a domain registrar called EasyDNS and its CEO, Mark Jeftovic, and to talk about what’s up with registrars and online pharmacies, as it could affect your online access to safe and affordable medication. EasyDNS’s new online pharmacy policy denies service to rogue online pharmacies but not safe online pharmacies.  It will accomplish this policy by providing service to online pharmacies only if they are approved by LegitScript or PharmacyChecker.

In short, domain registrars are companies that help people obtain website names; names such as www.rxrights.org, www.doctorswithoutborders.org, www.WebMD.com, www.nytimes.com, etc.  The most popular of these registrars in America is Go Daddy. If all registrars deny service to a person or a company, such as a rogue online pharmacy, then it cannot reach the public. If all registrars deny service to safe online pharmacies with very low drug prices then the public will not have access to them.

Our friends at RxRights gave a strong shout out to EasyDNS this week as well.

You might be thinking that this is no big deal. Who wouldn’t want to stop rogue pharmacy sites but allow safe, low-cost online pharmacies to operate? Well, earlier this year the National Association of Boards of Pharmacy (NABP) sent letters out to 200 registrars telling them to take down websites that NABP doesn’t recommend. No matter how safe it might be, the NABP does not recommend any international online pharmacy that sells to Americans, instead unfairly calling them rogue sites.

Popular Internet freedom blog Techdirt published an article about NABP called, “Pharmacy Group Lies To Registrars: If We Complain About A Site, It Must Be Taken Down No Questions Asked.”  It wrote: “The NABP is basically an organization designed to artificially inflate the price of drugs in the US, cynically using highly questionable claims to pretend that they’re focused on ‘public safety.’”

For the record, there is not a single reported death by a person who ordered from an international online pharmacy, ones that NABP calls “rogue,” that requires a valid prescription and fills orders through licensed pharmacies. The industry has been around for about fifteen years now. (more…)

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Most people think newer is better, but according to a study published in Health Affairs that might not be the case for prescription drugs. In short, the new study shows that drugs approved by the U.S. Food and Drug Administration after enactment of the Prescription Drug User Fee Act of 1992 (PDUFA), a bill that led to more expeditious drug approvals funded by drug companies, were more likely to have safety problems than ones approved before PDUFA.  These findings are not only relevant to drug safety, but also to drug savings.  Older drugs are often sold as generics and, thus, will have much lower co-payments than new drugs.  For those paying out-of-pocket, the cost of a generic is often 80% less than the brand.

The study analyzed 748 drug approvals between 1975 and 2009. The approvals were of new molecular entities not for generic versions of existing brand-name drugs. Before PDUFA the chances that safety issues would arise involving approved new drugs was 21.2%; after PDUFA it increased to 26.7%.

According to the lead author, “The FDA needs to make sure drugs are safe before they’re approved, not rush to judgment in order to meet artificial deadlines.” Not surprisingly, FDA and the Pharmaceutical Researchers and Manufacturers of America, take issue with the study. Their main points are that PDUFA helped speed up important drug approvals and get medications to patients faster and it improved the predictability of FDA’s system of drug approvals.

Regulations for marketing and manufacturing new drugs can save people and they can kill people. If the regulations are too rigid then patients won’t get needed medications fast enough. Or regulations can increase manufacturing costs resulting in unaffordable drug prices. If regulations are too weak then drugs will be less safe and effective.  While in my opinion the study clearly has merit, PDUFA is helpful. Before its passage, drug approvals were lagging far behind other advanced economies in Europe.

Furthermore, the study does not show “causality,” meaning it does not prove that faster drug approvals after PDUFA led to less safer drugs. Nonetheless, it’s understandable that a drug with a long history of safe and effective use, accompanied by few side effects, is more trustworthy than a newly approved drug since the long term effects of the latter are unknown.

But what does this all mean for consumers and drug savings? (more…)

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New study on Medicare Part D reveals reversing fortunes for the most vulnerable seniors

The journal Health Affairs recently published an article titled “Medication Affordability Gains Following Medicare Part D Are Eroding Among Elderly With Multiple Chronic Conditions.” The article is about changes in and problems with affordable access to medication for all Medicare enrollees who are 65 and over, not just those with chronic conditions. It focuses on two different time periods, 2007 to 2009 and 2009 to 2011. The data shows that while Medicare Part D initially improved access to affordable medication, some of those gains were lost, and for seniors taking the most medications, the most vulnerable, improvements may have disappeared entirely.

In 2005, before Part D plans were available, the study noted that an estimated 14.9% of seniors experienced cost-related problems accessing prescription drugs (meaning they did not take medicine as prescribed due to cost), also called cost-related prescription non-adherence (CRN). CRN decreased to 11.3% in 2007. Then, surprisingly, following the worst economic downturn since the Great Depression (during which the average wealth of the elderly dropped 20%), the number decreased further to 10.2%.

During the economic upturn, however, the CRN figures crept back up to 10.8 by 2011. The same trend – a decline then an increase – happened for the percent of seniors forgoing other needs to pay for medicine (such as food and heat): 8.8 percent in 2005, 5.6% in 2007, 4.0%, but back up to 5.3% in 2011.

The CRN numbers are much worse for seniors with four or more chronic conditions, such as diabetes, cancer, hypertension, and asthma, among others, representing about 27% of all beneficiaries. (more…)

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Do You Really Need That Prescription Drug You’re Taking? Is Placidex Right for You?

PlacidexWe wanted to take a break from talking about prescription savings, online pharmacy, big Pharma this, the FDA that, personal drug importation, etc. You know how strongly we feel about your right to find medications you need at affordable prices.  We’ll take this time to remind you about the problem of overprescribing in America. In other words, millions of Americans may be taking medications that they don’t even need!  America’s crazy spending on prescription drugs – which is the highest in the world – is in part due to high prices, but it’s also partly due to patients, health plans, and government buying medication that is not even needed.

The satirist website The Onion just published a piece that pokes fun at the problem of overprescribing and we thought we’d keep it light this Friday afternoon.  They cover GlaxoSmithKline’s “release” of Placidex – a drug used to treat people who just “feel sort of weird sometimes.” If you think you might need Placidex, or know someone who does, read more about it here. Of course, you can expect that if this were an actual drug, its price would be untenable, at least for Americans.

And if you are feeling less silly, here’s one more infographic on overprescribing in America.

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Ever since the FDA approved Sovaldi (sofosbuvir), and its price was announced – $1,000 per pill – healthcare advocates, health insurance companies, pharmacy benefit managers, consumer groups, and politicians have been up in arms. Its cost, for the usual prescription of 84 pills, is about $31,000 more than the median annual household income in the United States, which is about $53,000. How could a 12-week drug treatment plan cost $84,000?! Well, the manufacturer of Sovaldi, Gilead Sciences, can charge whatever it wants since there is no equivalent brand drug or generic on the market and the U.S. government, by law, cannot legally negotiate drug prices for Medicare.

The costs to treat Hep C don’t stop with Sovaldi by the way. Depending on the genotype of a person’s Hep C, Sovaldi is prescribed as part of a medication cocktail that also includes either ribavirin or ribavirin and an Interferon treatment. Total prices for treatment can reach $160,000 but we’ll just focus on Sovaldi so as not to bite off more than we can chew.

This Twilight Zone approach to pricing Sovaldi and other specialty medications pumps up the rage volume to a frightening anti-pharma crescendo, but now a moment of silence: Thank you scientists, medical researchers, and dedicated people at Gilead for developing this truly awesome medication and bringing it to market. Sovaldi actually cures Hepatitis C, a disease that afflicts about 3.2 million Americans! Rock on Gilead! Gilead and its shareholders should and shall be rewarded handsomely.

Despite this, Gilead and the Big Pharma Gang should not be allowed to threaten the American healthcare system with obscene prices, even for their wonder drugs. Is Gilead really expecting to be paid $84,000 to treat 3.2 million people: a cost of $268 billion? That is more money than the gross national products of 150 countries! Finland’s annual economic output in 2013 was $257 billion. On to the dirty dollar details… (more…)

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In online pharmacy news, the major story today is that FedEx was indicted for distributing controlled prescription drugs for Internet pharmacies to people who did not have valid prescriptions. FedEx claims it is not guilty and that its indictment and potential prosecution threaten a key principle of its business ethics and federal law: don’t open the mail. FedEx also says that for years they have asked the DEA for a list of targeted illegal online pharmacies but have not received one and that it cannot be expected to act as a law enforcement agency. The U.S. Department of Justice alleges that FedEx specifically “conspired” with two online pharmacies selling controlled drugs without proper prescriptions.

I’m departing from this media hot topic (better you read it in Bloomberg, USA Today, etc) to give you some backstory on controlled drugs and Internet sales. Our blog’s usual focus is on consumers seeking non-controlled prescription drugs online, and the PharmacyChecker.com Verification bans online pharmacies that sell controlled without a valid prescription, and all international online pharmacies that sell controlled drugs into the U.S. However, some Americans try to obtain prescription narcotics and other controlled drugs without a prescription online, which can turn out deadly. (more…)

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