by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | Jun 5, 2015 | Drug Prices, Generic drugs, Online Pharmacies
The media rage these days when it comes to prescription drug prices is three-fold: 1) generic drug price spikes of literally thousands of percent, 2) specialty medications that cost $1.000/pill, and 3) cancer treatment costs in the hundreds of thousands of dollars per year! We’re glad the media is loudly covering the public health crisis of high drug prices, but its focus of late seems to take the heat off of never ending brand name drug price increases and the pharmaceutical companies that charge those prices. We haven’t forgotten. For us the heat is on: including a loud reminder that these brand drugs are sold much more affordably outside the U.S., and can be found and safely purchased online.
To help us, I looked to the research of David Belk, MD. Dr. Belk, who is concerned with, and voraciously researches the insanity of healthcare costs, publishes a website called True Cost of Healthcare. His research shows that brand name drug prices increased by 13 times the rate of inflation over the past two and a half years. These are medications for which there is no available generic in the U.S. He looked at 335 drugs, their wholesale prices and tracked their increases from the October 2012 to the beginning of 2015. Only one drug, Norvir, actually came down in price. Dr. Belk writes: “All other brand name prescription drugs on my list went up a minimum of 9% and an average of just over 40% in price in only 2 1/2 years.”
While these brand drugs aren’t $1,000 per pill like Sovaldi, many Americans really can’t afford them. Below are two examples of brand name drugs that if purchased outside the U.S., would potentially save an American $4,000 a year and/or prevent that American from going without a prescribed, essential medicine for Diabetes or Asthma.
Januvia 100mg (siptagliptin), a drug that treats type-2 diabetes could cost you $1,149 for a three month supply at a local U.S. pharmacy. With a prescription discount coupon, you might get it for $963. If that’s too much, then brand name Januvia, marketed by MSD (a subsidiary of Merck), can be purchased online for $103.50 from an international online pharmacy– a percentage savings of 91% and a cost savings exceeding $1,000 over 3 months. Over a year, the cost savings is about $4,000.
Another example is Advair Diskus (fluticasone propionate/salmeterol), a popular asthma medication that is out of reach for many Americans due to cost. A three month supply of the 250/50mcg inhaler can run you $1,050 in a local U.S. pharmacy. With a discount card the price might be reduced to $874. At a verified international online pharmacy, the drug called Seretide Accuhaler, the name brand used by GlaxoSmithKline to market fluticasone propionate/salmeterol in several countries, is only $105: another three-month savings of $1,000 and annual savings of $4,000.
This summer at PharmacyChecker.com we’re going to keep the heat on the pharmaceutical industry with lots of examples of the crazy costs of normal brand name drugs in the U.S., and cooling things down for consumers with lots of savings you can find online.
Tagged with: Advair Diskus, Cancer medication, Dr. David Belk, generic drug prices, Januvia, Merck, Seretide Accuhaler, Sovaldi, speciality medications
by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | May 29, 2015 | Drug Prices, Generic drugs, Online Pharmacies
Yesterday, AARP published its latest Rx Price Watch report, which highlights generic prescription medication price changes from 2006-2013. Generic medication is considered the best avenue towards lower taxpayer and consumer drug costs. In the mid-1980s, passage of the Hatch-Waxman Act helped bring lower cost generic medication to the market faster and fueled intense price competition among generic manufacturers. The result was 1) much lower drug prices on medications that have lost their patents (often 90% lower) and 2) an exceedingly high generic penetration rate with generics comprising 85% of all medication use. AARP’s report suggests that generic drug prices continue to decrease, which is good, but at a much slower rate, “indicating that the era of consistent generic drug price decreases may be coming to an end.”
Stay calm. Generics are still usually much lower cost than the brand names and that will continue to be the case. AARP’s report notes that 2013 had the lowest average generic price decrease (4.1%) since 2006. However, AARP’s data also shows considerable fluctuation in this rate, enough to question whether or not we’re really experiencing a new normal in which generic drug prices no longer decline year after year. For example, the decreases in average generic drug prices that occurred in the prior two years, 2011 and 2012, 9.1% and 14.5%, respectively, were the highest since 2006. These numbers, however, most likely reflect what’s referred to as the “patent cliff” – a time when many patents on blockbuster brand name drugs, such as Lipitor and Plavix, lost their patents, thus allowing much lower cost generics to enter the market. As I see it, we don’t really know the future trend of generic drug prices.
Again, most generic drugs are way cheaper than their brand name counterparts and just as safe and effective. The big generic drug problem is that the cost of some generics has spiked outrageously over the past few years, sometimes beyond the reach of the American consumer. Usually when we talk about insane price increases of brand name drugs year over year the percentages are 10, 20, 30 or even 40%. But the increases for some generics have literally been in the 2000% range! One crazy example, reported by the People’s Pharmacy, showed that the cost of the antibiotic doxycycline skyrocketed from six cents ($.06) to $3.30, a 5500% increase.
In fact, directing you back to our research from November 2014, we found that even brand name versions sold in foreign pharmacies can be MUCH lower cost than the generics sold here! Please keep in mind that those same generics mentioned in our analysis may have already come down in price domestically. So before you buy from an international online pharmacy, check your local pharmacy first.
Tagged with: AARP, brand name drugs, Doxycycline, generic drugs, Hatch-Waxman Act, Lipitor, Plaxvix, The People's Pharmacy
by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | Mar 20, 2015 | Drug Safety, FDA, Generic drugs
As we all know, an unaffordable drug is neither safe nor effective. No less true, an ineffective drug, whether dirt cheap or super expensive, can have hazardous health consequences, even death. That’s why consumers seeking low cost medication online look to avoid bad meds by finding accredited online pharmacies with a PharmacyChecker or VIPPS seal. But that might not always be good enough…
People don’t like to talk about it but sometimes switching from a brand name med to an “equivalent” generic can lead to serious health problems. And this happens at your local U.S. pharmacy, not just online. Tod Cooperman, MD, president of PharmacyChecker.com, knows about this more than most people. In his capacity as president of ConsumerLab.com, he participated on an expert panel at a Congressional briefing this past Wednesday, organized by a new group called the Safe Medicines Coalition led by economist and counterfeit drug expert Roger Bate, PhD. The panelists and others are authors of a new paper called “Drug Inequality: Allowable Variations and Illegal Underperformance in Off-Patent Drugs.”
Dr. Cooperman’s main contribution to the panel comes from his experience testing a generic version of the anti-depressant Wellbutrin XL. To make a long story short, in 2007 ConsumerLab.com tested Teva’s FDA approved generic of the 300 mg version called Budeprion XL – an extended-release product. A generic drug that is bioequivalent to the brand name drug is supposed to work pretty much the exact same way as the brand. Consumerlab.com found that Teva’s generic did not dissolve like Wellbutrin XL – it released the drug much too quickly. It took the FDA more than 5 years but it finally conceded that the product was not bioequivalent to the brand product because it released the active ingredient much faster.
According to the People’s Pharmacy, people taking this generic were feeling more depressed, and even suicidal – until they switched back to the brand or to a different generic. The People’s Pharmacy and ConsumerLab.com shared this information with the FDA back in 2007 only to be ignored.
In order for the FDA to approve a generic drug for sale in the U.S., it must be proven to be bioequivalent to the brand name drug –delivering approximately the same amount of drug over the same amount of time in a group of healthy volunteers. It turns out that Teva never did this for the 300 mg version of Budeprion XL. The FDA approved the drug anyway, based on the data and approval for a lower strength version, Budeprion XL 150mg. What’s more amazing is that generic medications, even though they are not the exact same as their brand name counterparts, under U.S. law, must have the exact same clinical data in their package inserts as the brand name drug. That is, the data shown in the insert is NOT actually the data for that generic. This is meant to give the impression that all generics are the same as the brand name product, even though that’s not the case. If that doesn’t seem to make sense then you’re thinking clearly.
In 2012, the FDA admitted ConsumerLab.com had been right, and stated that Budeprion XL 300mg is was not bioequivalent to Wellbutrin XL 300mg.
Dr. Harry Lever, a cardiologist, talked about patients who were not responding well when switched to certain generic heart medications, such as beta blockers. Most interestingly, problems not only occurred when patients switched from brand to generic but even from generic to generic, which takes us back to the efforts of ConsumerLab.com above and moves us into a new point: Not all generic drugs are equal to each other, and a particular generic might work better in one patient than another!
The key takeaway from Dr. Lever’s and Dr. Cooperman’s presentations is that if a certain generic drug is working for you, then try and stay on that exact same medication. You’ll find it’s not easy because pharmacies often interchange generic drugs in their dispensing practices. You can avoid this by making sure you ask for the same generic, meaning the same manufacturer, each time you visit the pharmacy.
Mr. Bate focused on the fact that drug quality, generally, is not equal from manufacturer to manufacturer, brand to generic, generic to generic, country to country, etc. Mr. Bate is not saying that most generic drugs don’t work but simply that they are not exactly the same. Dr. Preston Mason supported this by presenting data based on testing generic versions of Pfizer’s Lipitor. He found that different versions were not all equal. The lowest quality products, based on number of impurities, were made in India for export to poorer countries.
The final presenter was Dinesh Thakur, the whistleblower that outed major manufacturing problems and corruption at Indian drug manufacturer Ranbaxy. Ranbaxy was actually granted the first go at marketing generic Lipitor in the U.S., but their version was eventually recalled due to small particles of glass that may have contaminated the product. You might find FDA’s nuanced position on the recall instructive and of great interest: “Patients who have the recalled medicine can continue taking it unless directed otherwise by their physician or health care provider….To date, FDA hasn’t received any reports of injury….The possibility of adverse health problems related to the recalled atorvastatin is extremely low.” I don’t recall hearing that the drug was not effective either but its recall was precautionary.
So what the hell are average consumers and even their healthcare providers to make of all of this? I’m going to copy and paste from ConsumerLab.com:
- If a generic doesn’t work like the original drug, be concerned, particularly if it is an extended release (often called “XL”) product.
- Be aware that the labeling on a generic drug describing its performance is copied from the labeling of the original product and may not reflect the performance of the generic. This is a deception required by the FDA, perhaps to create the perception of generics as interchangeable.
- If a generic works for you, look carefully at the label and identify the manufacturer. Request the same manufacturer each time you refill that prescription. Other generics may not behave the same way.
From my perspective, despite the FDA debacle with generic Wellbutrin XL discussed above, the FDA is one of the best drug regulatory agencies in the world. Following the advice above, you can and should trust generic drugs sold in the United States. What about generic drugs sold over the Internet from foreign countries? Pharmaceuticals sold in the most highly regulated countries are generally equivalent in quality and efficacy to those sold in the United States. What about from Indian pharmacies? The highest quality medications sold in Indian pharmacies are on a par with those sold in the U.S., too, but there’s more deviation and far too little oversight from the Central Drugs Standards Controller Organization, India’s FDA.
For all of these reasons, if you’re buying online and getting a drug internationally stay away from websites that are not credentialed by PharmacyChecker.com. And remember, despite crazy price increases in a good number of generic drugs, most generic medications approved for sale in the U.S., sold at local pharmacies are less expensive than International online pharmacy prices – even cheaper than India! However, brand name products are usually far less expensive outside the U.S. (and apparently sometimes safer than generics) – and you can check those prices on www.PharmacyChecker.com.
Tagged with: Consumerlab.com, Roger Bate, Safe Medicines Coalition, Tod Cooperman, VIPPS
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Mar 13, 2015 | Drug Prices, Generic drugs, Pharmaceutical Industry, Specialty Drugs
A new report by Express Scripts has found that medication spending by commercial health plans grew by 13.1% last year, primarily due to the release of high cost Hepatitis C meds. Spending also increased significantly for compounded drugs. In the prior decade, total spending ranged between three and six percent.
Keep in mind that the headline statistic of 13.1% applies to how much was spent on drugs; it actually doesn’t tell us anything about the prices of the drugs. If drug utilization, which refers to the amount of drugs taken, increases while prices stay the same, then there’s more spending. As it turns out, utilization decreased by a marginal 0.1 % and d prices increased by 13.2%, demonstrating that drug costs were the primary cause of increased drug spending. In fact, a vice president at Express Scripts referred to the drug price increases as “unprecedented and unsustainable.”
Specialty drugs, which often require careful handling, administration, or monitoring, saw a dramatic 30.9% increase in spending. As mentioned earlier, spending on hepatitis C treatments was the primary driver in overall spending, skyrocketing by 742.6%. Other notable (though nowhere near even 100%) increases include 20% for oncology drugs, 24% for treatments for inflammatory conditions, and 17% for hemophilia drugs. It’s not uncommon for these medications to cost many thousands, even tens of thousands of dollars per month. Sovaldi, a hep C drug, costs $1,000 per pill. We covered the Sovaldi saga in depth.
The story for traditional medications, such as those commonly used to treat asthma, depression, diabetes, GERD, high cholesterol, and pain is much more mixed. Despite drug prices rising by 6.4% overall, prices dropped for five out of ten therapy classes. Depression medication prices, for example, plummeted by 18%. Interestingly, the report noted compound drugsas a therapy class, even though they treat a variety of conditions. These drugs had an unusually large price increase of 128%! Excluding compound drugs, drug prices for traditional meds were up only 2.3%. (more…)
Tagged with: AbbVie, Express Scripts, Gilead Sciences, Harvoni, Hepatitis C, Sovaldi
by Gabriel Levitt, President, PharmacyChecker.com and Prescription Justice | Mar 5, 2015 | Drug Importation, Drug Prices, Generic drugs
At the beginning of this year, we brought you the story of Lu Yong, a Chinese citizen with Leukemia who was facing severe financial hardship due to the $3,783 monthly cost of his cancer medication, Gleevec. Mr. Lu found out he could order Veenat, a generic version of Gleevec, from India for a more affordable $640 a month. Soon thereafter he started helping fellow Leukemia sufferers – a thousand of them – access Veenat, in effect helping save their lives. Mr. Lu was rewarded by being charged with selling counterfeit drugs and credit card fraud!
The problem was that Veenat, an entirely genuine, legally manufactured and effective medication approved in India, is designated as “counterfeit” and unapproved in China. The credit card fraud charge was brought because Mr. Lu used other patients’ credit cards to order their medicine.
So, our earlier blog post on this story was called “Low Cost Counterfeit Drugs Save Lives in China…What?!” Seem like a stretch? Not really. Medication deemed “counterfeit” was in fact saving lives. A Chinese court seemed to agree, determining that Mr. Lu’s action should not be construed as “selling counterfeit drugs” since the medication was genuine. Additionally, because his use of other people’s credit cards was to help them, it was not “criminal behavior.” For more read about it in Chinese Radio International.
Lu Yong is a prescription access hero and we applaud him rancorously. Kudos to the Chinese legal system as well.
Tagged with: China, generic gleevec, Gleevec, lu yong, veenat
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Feb 6, 2015 | Drug Prices, Generic drugs, Medicare Drug Plans
If you were to take a time machine and go back to 2006 and put a hundred bucks in a savings account with 5% annual interest, you’d have $147.50 in 2014. Not bad. But if your interest rate was tied to the annual price increases of brand name drugs you’d end up with…$202. And if for some crazy reason you just wanted to have the same purchasing power 8 years later, and tied your interest rate to inflation, you’d only end up with $125.
Clearly the increase of drug prices are out of line with the prices for everything else, and while the numbers figured above only take in to account brand name prices, generic prices are rising, too. On average, generics cost 5% more in 2014 than they did in 2013. That’s on average – some generic drug prices increased by 2,500 %!
But there’s good news on the way. Senators Sanders and Klobuchar are fighting for more affordable medication. Some more good news, at least for seniors, was released this past week. The Wall Street Journal reports that the Obama administration’s fiscal budget for 2016 calls for the government to negotiate prices for biologic and high-cost drugs for Medicare Part D. While, we’d like to see prices negotiated for all drugs, this can still represent huge savings for the government. Estimates suggest that 9.1% of national health spending could be on specialty drugs. That’s total health spending, not just drug spending.
We’re eager to see if the government will actually able to negotiate prices in 2016 – who knows how the budget will change or if Pharma will push to prevent negotiations. We’ll be keeping an eye on this and will certainly let you know.
Tagged with: Medicare Part D, Senator amy Klobuchar, Senator Bernie Sanders, Specialty Medications
