PharmacyChecker Blog

Helping Americans Get The Truth About Prescription Drug Savings
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Nation’s Largest PBM Using Anti-Big Pharma Language in New Report Showing Brand Drug Prices Double

Pills and Money

Each week I try to come up with a new and compelling blog post to discuss issues involving drug prices and problems Americans are having affording medications. I often find myself resoundingly critical of the pharmaceutical industry and this week I was intrigued but curiously put off to be joined by a pharmacy corporation that made over $100 billion last year.

Express Scripts, the nation’s largest pharmacy benefit manager, reported that brand name drugs in the U.S. cost 98.2% (about twice) more on average today than they did in 2011. Last year, brand name drug prices were up 16%. As I read in the Chicago Tribune, Express Scripts used hostile, downright anti-big pharma (and pharmacy) language blaming “opportunistic manufacturers” and “scheming pharmacies.” Rising drug prices of this magnitude are no laughing matter as cash-strapped Americans bear the brunt of these increases, either in higher insurance premiums, co-payments, co-insurance and full cash prices for uninsured (still almost 30 million Americans), or when plans don’t cover certain drugs.

But it is a little funny to hear Express Scripts go after Big Pharma using the rhetoric of greed. After all, PBMs, particularly Express Scripts, are often criticized for their lack of drug pricing transparency and profit-seeking practices, kind of like drug companies and big pharmacies, such as Walgreens and CVS.

While the focus of Express Scripts’ ire is on brand name drug prices, most of the prescription sales it administers and profits from are generics. On that note, buying generic medication without using your insurance’s PBM is often less expensive than your co-payments. But don’t expect Express Scripts to tell you that.

So that Express Scripts doesn’t feel singled out, we’ve reported on the antics of Big Pharmacy before, including Express Scripts’ biggest competitor. PharmacyChecker CEO Tod Cooperman, MD, was on Fox and Friends not so long ago discussing an investigation of CVS Caremark in which the company was accused of price gouging. The allegation: by not informing its customers that the cash price using CVS’ own discount card program would be lower than co-payments using PBMs, such as CVS Caremark or Express Scripts, hundreds of thousands of customers were overcharged.

On that note: the nuts and bolts message is DON’T BE SHY and ask for the lowest possible price at your local pharmacy.

In defense of Express Scripts, and even CVS Caremark, PBMs and large pharmacy corporations do not yield profit margins even close to those of the biggest drug companies. Furthermore, the pharmacy corporate giant, Express Scripts, is right: the blame for ever increasing drug prices falls on opportunistic manufacturers and scheming pharmacies.

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Medication Costs The Number One Reason People Skip Meds, According to Pharmacists

A major U.S. pharmacy has finally said that high drug prices are the biggest barrier to medication adherence. A recent study from CVS Caremark revealed that 62% of pharmacists said high drug prices are the most common cause of prescription nonadherence (not taking your meds) among their patients. Ninety-one percent of pharmacists said that cost efficient alternatives to expensive therapies would improve adherence.

While previous studies from the pharmaceutical and pharmacy industries have mentioned that that cost is a barrier to medication, this is the first industry study to our knowledge that says cost is the primary barrier. Oddly enough, the pharmacy industry, including CVS and Caremark, is one of the industries profiting from high drug prices.

High drug prices are bad for public health. Medication adherence is linked to 125,000 deaths and 290 billion dollars in excess health spending per year (hospitalizations and emergency room spending, among others). High drug prices cause a large part of this – 48 million Americans did not fill a prescription due to cost in 2010.

Americans – both as patients and taxpayers – deserve access to low cost medication. As patients, our health is on the line. As taxpayers we are funding hospital stays and emergency room visits. Lower drug prices are needed in America – and the benefits go beyond simply having extra cash in your pocket.

And as far as savings go, remember to ask your pharmacist how to save. Generic medications, discount cards, and coupons offer some savings. For brand name medications without generic alternatives, you’ll find the best savings at an online pharmacy. Just make sure it’s safe and credentialed, like those listed on Whatever you do, don’t forgo needed prescription medication.

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