PharmacyChecker Blog

Helping Americans Get The Truth About Prescription Drug Savings
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Generic Drug Price Gouging Theory

It seems Americans are increasingly showing up at their neighborhood pharmacies to find out that their medications’ prices have increased exponentially, by as much as 100, 200, 300, 600%…2500%! Believe me, I’m not exaggerating. In an article with a similar title as this blog post, called “Drug Price Gouging,” Steve DeFillippo brings us two examples of sickening drug price spikes. In one instance, a Mr. Gary Loser showed up at the pharmacy only to find that the price of his prescription drug went from $5.50 to $34.50 – an increase of 600%. Mr. DeFillippo then one upped Mr. Loser by recounting his drug price blast-off, when the price of his medication, Nadalol, went from $10 to $252 for a  for a 90 day supply – a 2500% increase!

Americans frequently, and usually with good reason, blast big brand-name drug companies, like Eli Lilly, Merck, and Pfizer for charging much higher prices domestically than internationally. In this case we can’t slam big pharma because the medication at issue, Nadolol, is generic and has been around for 40 years. Generic drugs are usually pursued by consumers because their prices are so low. Moreover, generic drugs are usually less expensive in the U.S. than in Canada and many other countries.

So what the heck is up?

The “theory” I’m proposing is more or less just telling you what I’ve heard anecdotally from small U.S. pharmacy owners about these insane generic drug price increases. Over the last year or so, big chain pharmacies, such as CVS and Walgreens, have started to raise generic drug prices to maximize their profits. Now their profit margin is largely the difference between their costs, the wholesale price, and what they can sell it for to individuals, the retail price. Wholesaler pharmacies have apparently realized how much money the big U.S. pharmacy corporations are making on the large profit margins from some generic drugs. These wholesalers want a bigger piece of the pie so they are raising their prices, too. When that happens, good ole’ mom and pop pharmacies, ones that have tried to keep prices down, have to raise their prices, too. So it’s a vicious spiral.

You often don’t have to pay those crazy high prices but you’ve got to shop around. For instance, Nadolol 20mg can be purchased for much less, 100 pills for $52.22, using a prescription drug discount card at a local U.S. pharmacy.

I recommend calling your local pharmacy before you go pick up your medication. If the price is too high then go elsewhere to avoid getting gouged.

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What’s Happening to Medicare Part D? Part II

Last week, we reported on proposed changes to Medicare Part D that could have made it harder for millions of seniors to obtain prescribed medicine. One congressman from Pennslvania, Tim Murphy, went so far to say that suicide rates would increase as a result of the proposed changes, referring to a change that would have allowed insurers to reduce coverage for antipsychotics, immunosuppressants, and antidepressants. Other proposed changes included allowing the government to intervene in contracts between insurers and pharmacies, limiting the number of drug plans available, and also expanding access to community pharmacies.

Outcry from both sides of the aisle, as well as patient and consumer rights advocates, has resulted in the Obama administration reversing course on the changes. “We will engage in further stakeholder input before advancing some or all of the changes in these areas in future years,” wrote Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Services.

We are glad specifically that coverage for critical medication will remain strong and that the number of drug plans will not be limited in certain areas. We know that the intention of reducing drug plans was to help make it easier to choose a plan. On the other hand, we support expanding access to community pharmacies and hope for further action on that front.

Fortunately, there are online resources that can help with this. Not all Medicare drug plans are created equal. PharmacyChecker.com runs MedicareDrugPlans.com, which you can use to compare plans and read or write reviews on those plans available in your area.

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What’s Happening to Medicare Part D?

Future Changes to Medicare Part D may curtail access to affordable medication for millions of seniors enrolled in Part D prescription drug plans, according to Kaiser Health News and USA Today.

The Obama administration wants to remove three drug classes, immunosuppressants, antipsychotics, and antidepressants, from the list of specially protected drugs. What this means is that insurers would no longer be required to cover the majority of these drugs in those classes. What that means is that more  patients will struggle to afford – and even skip – medications due to high out-of-pocket costs at U.S. pharmacies.

An alliance of Democrats, Republicans, drug companies, and patient advocates oppose the proposal. Rep. Tim Murphy, R-PA, who is also a psychologist, fears the worst: “If you restrict access to these drugs you restrict the treatment of mental illness,” he said. “You raise suicide rates.” Murphy’s sharp statement suggests just how important drug coverage for Medicare beneficiaries is. Over half of seniors aged 65 or older take at least five prescription drugs, and a carefully organized prescription plan may have disastrous side-effects if a drug is switched for another. Such substitution would likely occur for many patients if drugs are removed from special protection. (more…)

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Seth Rogen’s Congressional Testimony Highlights the High Cost of Alzheimer’s

Testifying before Congress was the last place I expected to see Seth Rogen, star of movies Superbad and Knocked Up. But there he was, in front of the Senate Appropriations Subcommittee on Labor, Health and Human Services, speaking about his family’s experience with Alzheimer’s disease in order to raise awareness about its effects, including the high costs of treatment.

Although there is no known cure for Alzheimer’s or its progression, there is medication that can help alleviate symptoms, such as memory loss and confusion. Rogen points out that he can’t imagine how patients on limited incomes treat Alzheimer’s and that it is the most “costly condition in the United States…where in a country for a dollar and twenty-nine cents you can get a taco made out of Doritos.” We thought it would be helpful to show how much Americans can save on Alzheimer’s medication by ordering from a verified international online pharmacy. Looking at one brand name and two generic medications, we found an average savings of 72%.

Savings on 3-month Supplies of Alzheimer’s Medication

Drug Name U.S. Pharmacy Price International Online Pharmacy Price Percent Savings Annual Savings
Rivastigmine (Exelon) – 3 mg, 180 pills – generic $959 $106.40* 89% $3,410.40
Namenda – 10 mg, 180 pills $1,139 $207+ 82% $3,728
Galantamine(Razaydne) – 8 mg ER, 180 pills – generic $546 $293.40+ 46% $1,010.40
U.S. Pharmacy Price from Rite-Aid in New York City. International Online Pharmacy Price  taken from PharmacyChecker.com.
*Price calculated from 90 pills
+Price calculated from 100 pills
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Struggling To Afford Meds, Americans Spend More On Drugs than Other Countries

As recently reported by PBS, America continues to outspend other rich countries on pharmaceuticals, spending almost $1,000 per person on prescription drugs in 2013. Canada, the second highest spender, spent about $700 per person. This is despite one in five Americans skipping doses or a script due to cost, as well as an extremely high percentage (84% in 2011) of prescriptions being written for generic medications.

So what’s up? Well, for one, our drug prices are much higher. Our latest analysis of brand-name drugs sold by international online pharmacies found that their prices were 88% lower when compared to a pharmacy in New York City.

Major drug price differences aren’t the only reason for higher U.S. spending. PBS explains that Americans, sadly, fill more scripts due to higher rates of obesity, diabetes, and high blood pressure, which of course equates with greater numbers of prescription drug purchases. Another factor is that it’s relatively easy for drug companies to get new drugs approved and in to the U.S. market.

I was a bit surprised that PBS didn’t mention direct-to-consumer advertising as a possible reason for why we use more drugs. New Zealand is the only other country that allows direct-to-consumer advertising, but they have much lower drug prices than the U.S.,  due to government regulations.

For the newly insured, Obamacare might mean lower prices for consumers, but that doesn’t mean overall national spending will go down. Lower out of pocket costs from better co-pay or co-insurance models will likely just mean higher premiums and increased reimbursement to drug manufacturers by insurance companies. Look at it this way: if you spend $20 less on a drug per month, but your premium is $20 more, you’re not really any better off.

Interestingly, U.S. drug spending decreased slightly last year, thanks largely to patent expirations resulting in more generic drugs penetrating the market. While PBS mentions that the decline is expected to last another 2-3 years, I’m not so optimistic. For one, generic drug prices are rising, sometimes by thousands of percent. Second, more coverage under Obamacare means more prescriptions, and naturally more spending. Only time will tell…

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CVS’ New Policy on Smokes Reminds Me of Its Past Support for Drug Importation

Let’s give a big round of applause to CVS, the second largest chain pharmacy (behind Walgreens), for its decision to stop selling cigarettes and other tobacco products! To its credit, CVS is not being overly self-righteous, as it largely attributes the policy change as necessary to accommodate legal restrictions on tobacco sales in places where healthcare services are provided: this is in view of its plans to open up more healthcare clinics in its pharmacies throughout the country. So, come October, as per the company’s plans press release, Americans will no longer be able to buy cigarettes or other tobacco products at any of the 7,000-plus CVS stores nationwide.

Unfortunately, removing tobacco products from CVS’ shelves won’t help Americans afford their medicine. According to a survey by Consumer Reports, CVS has the highest drug prices (Costco had the lowest prices, especially on generics). While executives at U.S. pharmacy corporations have steadfastly opposed reforming drug importation laws to bring down drug costs, CVS’ former Chairman and CEO, Thomas Ryan, bravely supported it. To quote Mr. Ryan:

While many in our industry believe that importation is a fundamentally flawed concept and oppose it without exception, I have come to a slightly different view…Millions of Americans already have opted to import drugs because they can’t afford not to. We owe it to them to face this issue head on and not look the other way.

 

That statement was provided by Mr. Ryan in 2004. Since that time, access to affordable medication in the U.S. has only become more difficult due to higher drug prices, and Americans continue to personally import their medication, often from international online pharmacies.

The reason that those online pharmacies are a lifeline is provided by none other than…CVS! CVS/Caremark surveyed their pharmacists about a year ago; 61% cited high drug costs as the number one reason Americans don’t take their meds. Canadian and other foreign pharmacies have much lower prices and so Americans need them.

To be intellectually honest, Mr. Ryan’s idea was not for Americans to buy directly from Canadian or other foreign pharmacies but for CVS to import less expensive medication from verified foreign wholesale pharmacies and then sell it to Americans. Not a bad idea to help bring down drug costs, while keeping American pharmacists employed and corporate profits humming. Thus, understandably, Mr. Ryan’s position was dedicated to the public health and his business interests.

The heart and soul of Mr. Ryan’s position, however, is the public health alone – and not business interests. Once again, he said: “Millions of Americans already have opted to import drugs because they can’t afford not to. We owe it to them to face this issue head on and not look the other way.” They opt to import because brand name drugs are often 90% less expensive internationally. That’s why it’s best to help Americans safely buy medications where they can best afford it instead of looking the other way.

So you can put out that cigarette, get your flu shots from CVS, your generics from Costco and your brand name drugs overseas!

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