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Helping Americans Get The Truth About Prescription Drug Savings
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Specialty Drugs Are Not the Stuff of $4 Generic Drug Programs

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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Are old drugs safer than new drugs? The answer might be “yes” and they are cheaper too!

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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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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The Dirty Dollar Details About Sovaldi Drug Prices (Part 1 of 3): Paying in Cash

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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American Toprol XL…a Swedish Product of India?!

Toprol XL

Toprol XL, a prescription drug that treats high blood pressure and is shown to lower the risk of heart attacks, is in the news due to recalls of some generic versions and because some doctors are finding the generics doesn’t always work as well as the brand. Consumers taking a generic version (metoprolol succinate extended-release),  might want to switch back to the brand, but that could raise their drug bills substantially

The issue has also re-ignited the topic of problems with Indian drug quality. Wockhardt and Dr. Reddy’s Laboratories, both based in India, have pulled 100,000 bottles of their respective metoprolol succinate extended-release products because their pills were not dissolving properly. For extended release drugs, this can be a big problem with a drug’s efficacy.

So where can you buy an American made version of this drug? I believe that would be very hard to do. Brand name Toprol XL sold on U.S. pharmacy shelves is a product of Swedish company AstraZeneca and, according to the drug’s labeling, made in India. There are American companies that make metoprolol succinate as well, such as Mylan, but they manufacture the drug in India, too. Some Toprol XL generics were made in America, but that didn’t work out so well due to manufacturing problems here at home.

Dollars and Sense – You can save 70% on the brand!

In the U.S., generic metoprolol succinate costs about 45 cents a pill. If you want brand name Toprol XL (100mg), the cost is  about $2 apill.  However, if you only want the brand name product and want to spend a lot less, it can be purchased from a verified international online pharmacy for as little as 60 cents a pill, just a bit more than the cost of a generic in the U.S., and a 70% savings on the U.S. brand price.

Compare Toprol XL drug prices on all strengths on PharmacyChecker.com.

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