by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Jun 13, 2014 | Drug Importation, Drug Prices
A few weeks back we wrote about drug affordability problems related to high deductible Obamacare silver plans. A new report finds problems across all four tiers for patients requiring expensive specialty drugs. Many plans have co-insurance rather than a fixed co-pay for these medications, which means patients pay a percentage of a drug’s price rather than a flat fee. In fact, over 50% of bronze, silver, and gold plans studied had co-insurance rather than fixed co-pays for specialty drugs. That compares to only 38% for platinum plans.
According to Wellmark, “Specialty drugs are prescription medications that require special handling, administration or monitoring. These drugs are used to treat complex, chronic and often costly conditions, such as multiple sclerosis, rheumatoid arthritis, hepatitis C, and hemophilia.”
Pamela Morris, of Zitter Health Insights, said “A lot of times, if someone has coinsurance their first exposure to OOP [out of pocket costs] is at the pharmacy, where they may be unsure if they’ve met their deductible or if the costs are purely coinsurance.”
So how big could this price shock be? Let’s look at Tecfidera, a sample oral Multiple Sclerosis drug. The cash price is around $6,000 for 60 capsules of the 120 mg dose. Even if your co-insurance is 25%, that’s $1,500. You can purchase the same amount for $1,200 from an international online pharmacy. Still expensive, but a $300 savings is nothing to scoff at. And it’s likely that the co-pay would be even more than 25% in which case the international savings could be much higher.
Gleevec, a medication used to treat certain types of leukemia, is around $29,000 for 90 pills. That will cost you $7,500 if your co-insurance is only 25%. Using an international online pharmacy, you can purchase 90 pills of generic Gleevec for $725 from a Canadian pharmacy. This may even be cheaper than using Novartis’s patient assistance program for brand name Gleevec. The program has strict eligibility requirements but is worth pursuing if you believe you’re eligible.
We’re sorry to report that many specialty meds may not be safe to order from an international online pharmacy. Some might be extremely temperature sensitive, others are administered in a clinical setting, only sold by specialty pharmacies, and some aren’t even approved for sale outside the U.S. For some specialty drugs, the savings might not even be that great, as prices are high globally!
We promise to research all avenues of savings for these medications and report back to you soon…
Tagged with: Gleevec, Obamacare, specialty drugs, tecfidera
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Jun 6, 2014 | Drug Importation, Drug Prices, Generic drugs
Americans who take Celebrex to fight arthritis may be pleased to know that a generic version has been approved by the FDA. The New York Times’ coverage reports, in a somewhat predictive fashion, that generic drugs “can cost 30 to 80 percent less than the branded products.” While that’s true, don’t expect generic Celebrex to be so cheap. What’s most likely is that its price will initially be around 80%, and then creep downwards.
Millions of Americans have seen this pricing trend over the past few years, as many popular medications have recently gone generic. A patent’s expiry does not necessarily mean cheaper drugs, at least immediately. That’s because the FDA grants marketing exclusivity for a generic to a single drug company for six months, so only two drug companies – the brand name manufacturer and the first generic manufacturer – are competing. As more drug companies enter the market the price will eventually cost a fraction of the brand name counterpart. But that first generic to market will usually only be about 20% cheaper than the brand.
When atorvastatin (generic Lipitor) first came out you could actually save a lot of money by purchasing the brand from an international online pharmacy instead of the generic from a U.S. pharmacy. Now, with many companies manufacturing atorvastatin, generic Lipitor in the U.S. can be found for about $15 per month if you use a discount card. International online pharmacies that once had a leg up on U.S. pharmacies lose big once competition drives U.S. generic drug prices down.
A perfect example is the popular antidepressant Cymbalta. Currently, the cash price of a 90 day supply of duloxetine (generic Cymbalta, 60 mg) is around $250 – and that’s after using a discount card at the pharmacy. A 90 day supply of brand name Cymbalta is only $90 when ordered from an international online pharmacy – a 64% discount!
We expect this pricing pattern for Abilify, Gleevec, Crestor, and many other drugs coming off patent down the pipeline. In the initial phase of a new generic’s release, the brand version from an international online pharmacy will probably be much cheaper, but eventually your neighborhood pharmacy will be your best bet. So if you take Celebrex expect to celebrate a low cost U.S. generic in early 2015!
Tagged with: Atorvastatin, Celebrex, Cymbalta, Patent Cliff
by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | May 24, 2013 | Advocacy, Drug Prices, Pharmaceutical Industry
A group of over 100 doctors recently banded together to declare that “lower drug prices [are] a necessity to save the lives of patients who cannot afford them,” as written in their article in Blood, the medical journal published by the American Society of Hematology. We couldn’t agree with them more.
The doctors, experts in chronic myeloid leukemia, focused particularly on the drug Gleevec (imatinib), which costs around $100,000 annually per patient in the United States. Gleevec costs around $35,000 internationally.
There is nothing politically or economically radical about their position. In fact, they acknowledge the societal and political pressures that affect drug pricing, as well as the necessity of profits by drug companies to fund future research. They simply seek fair pricing.
Unfortunately, cancer medication prices are dramatically increasing and are not “fair.” To quote the Blood article: “imatinib may have set the pace for the rising cost of cancer drugs. Initially priced at nearly $30,000 per year when it was released in 2001, its price has now increased to $92,000 in 2012 (1), despite the fact that all research costs were accounted for in the original proposed price….”
Such protests can work; last year doctors at Sloan-Kettering Memorial Hospital pressured Sanofi into effectively halving Zaltrap’s initial market price of $11,000 by offering discounts. We hope that these precedents mobilize more doctors to hop on the bandwagon to further publicize that high drug prices in the U.S. are a serious threat to the public health.
Tagged with: cancer, Gleevec, Sanofi
