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Helping Americans Get The Truth About Prescription Drug Savings
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Ending Big Pharma’s Co-pay Cards as Deductibles Hurts Consumers

I’m on a roll here, agreeing with drug companies on an issue related to affordable medicines access. Last week, I wrote about Gilead’s messaging about remdesivir, the new Covid-19 treatment permitted via FDA’s emergency use authorization: namely that you can’t buy remdesivir online: if you try, you’ll be scammed. Often drug companies lie or pay others to lie about buying drugs online from other countries, but not in that case. This week, I’m agreeing with the Pharmaceutical Researchers and Manufacturers of America (PhRMA) that the Trump administration’s new rule on drug manufacturer co-payment cards is not good for consumers because it will prevent the co-payment from counting toward deductibles, which means higher costs for patients.

If you didn’t know, drug manufacturers blanket medical offices throughout the country with their co-pay cards. These cards are sometimes immensely helpful to patients going to fill a prescription for a brand name drug, particularly when there is no generic substitute. How? Simple: the drug company picks up the tab!

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Higher Medication Costs Lead to Fastest Prescription Drug Spending Growth Rate in a Decade; PBMs Play Hardball

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…)

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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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