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Helping Americans Get The Truth About Prescription Drug Savings
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CEO of PharmacyChecker On People’s Pharmacy Radio Talking Safety and Savings on Narrow Therapeutic Index Drugs

Tod Cooperman, MD CEO of PharmacyChecker.com

Joe and Terry Graedon have been helping Americans make better health decisions for the last 40 years, including through their syndicated radio show on National Public Radio called The People’s Pharmacy. As you can imagine, their listeners are interested in prescription drug safety and savings. Our CEO was on their show this past Saturday and I’d like to tell you about it, especially if you want to learn how to save money on brand name drugs.

The CEO of PharmacyChecker.com, Tod Cooperman, MD, is also the founder and president of ConsumerLab.com, the leading evaluator of health and wellness products. ConsuemrLab.com has worked with The People’s Pharmacy in the past to test prescription medications. While I believe that generics sold in the U.S. are usually of the highest quality, equal to or better than generics in most other countries, ConsumerLab.com’s findings show that some generic medications in the U.S. are not always equal to the brand. Due to his expertise is drug quality and his knowledge about drug prices, The People’s Pharmacy brought Dr. Cooperman on to their show last week to talk about Narrow Therapeutic Index (NTI) drugs. Listen to the show! (See minutes 6:50-18:00).

For NTI medications, it’s even more important that the active pharmaceutical ingredient is present in the exact amount required. When NTI medications have too much of the active pharmaceutical ingredient, it can be toxic; but those that have too little may not be adequately efficacious. Most NTI drugs are available in generic form, which usually means they are low cost, even without insurance, and usually lower-priced than in Canada and other countries, too! The opposite holds true for brands.

Some providers are deciding that it’s important for their patients stick with the brand for NTI drugs for the reasons stated above.  But the prices here are often too high. In the radio show, Dr. Cooperman recommends looking internationally for those who can’t afford the brand locally. Americans can often find discounts averaging 80% internationally on Brand name NTI drugs. Last summer, when we read The Graedon’s Guide to Saving Money on Medicines, we noticed the list of NTI drugs and wanted to compare drug prices domestically and internationally. Our research from Fall 2016 is below.

Narrow Therapeutic Index (NTI) Drugs: Brand Name Price Comparison (U.S., Canada, International*)

Per Pill Cost[i] Potential Savings
Medication Name: Brand (Generic) Strength U.S[ii] Canada[iii] NZ/UK[iv] Canada Other Int’l Overall
Tegretol (Carbamazepine) 200mg $2.87 $0.77 $0.57 73% 80% 80%
Cleocin HCl (Clindamycin) [v] 300mg caps $24.00 $3.38  NA 86% NA 86%
Catapres (Clonidine HCl) 0.1mg $3.34 $0.45  NA 86% NA 86%
Sandimmune (Cyclosporine) 100mg /mL  50mL $664.84 $327.98  NA 51% NA 51%
Lanoxin (Digoxin)[vi] 0.125mg $12.54 $0.75  NA 94% NA 94%
Depakote (Divalproex)[vii] 250mg $5.73 $0.90  NA 84% NA 84%
Zarontin (Ethosuximide) 250mg $4.51 $0.66  NA 85% NA 85%
Synthroid (Levothyroxine) 100 mcg (0.1mg) $1.87 $0.35 $0.63 81% 66% 81%
Dilantin (Phenytoin) 100mg $1.45 $0.33 $0.48 77% 67% 77%
Depakene (Valproic acid) 250mg $5.76 $0.93  NA 84% NA 84%
Coumadin (Warfarin) 5mg $3.69 $0.60 NA 84% NA 84%
 Average Savings 81%

[i] Based on three month supply of medication.

[ii] Walgreens, NYC, December 2016

[iii] Prices of international online pharmacies verified by PharmacyChecker.com.

[iv] Prices of international online pharmacies verified by PharmacyChecker.com.

[v] Marketed as Dalacin C in Canad

[vi] Marketed as Toloxin in Canada

[vii] Marketed as Epival in Canada

 

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Generic Drugs Prices, Diminishing Returns?

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.

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Getting Generically Price Gouged? – Try the Brand!

Americans are used to high drug prices — at least for brand-name medications, which are often five times more expensive in the U.S. than in other countries. Conversely, Americans are used to low-cost generics, which are often cheaper here than internationally. Unfortunately, the U.S. generic pharmaceutical market is out of whack!  Generic drug prices have begun rapidly rising over the past few months…

And rapidly rising can mean a price increase of 6,000%, as reported by recent articles in the Huffington Post, Washington Times, and The People’s Pharmacy. Here’s an almost unbelievable fact: the brand-name drug is often much less expensive – if you shop at an international online pharmacy.

So, why such drastic increases? The People’s Pharmacy article attributes the increases to three factors. First, consolidation among generic manufacturers means less competition among drug makers; forty-four percent of all generic drug revenue goes to just three companies. Second, companies are discontinuing the manufacture of certain drugs leading to drug shortages. Finally, FDA enforcement actions have shut down certain manufacturers because of poor manufacturing practices. With reduced supply and competition, it’s no wonder that prices are increasing.

So if you’re finding your generic medication rising in price, how can you find it for less…much less? Try the brand! I’ve identified some generic drugs below that have significant savings when the brand is purchased from abroad.

Prices for Generic Medications

Drug Cash Price* International Online Pharmacy Price (Brand) Potential Savings (generic)
Clomipramine—75 mg, 90 pills $985 $121.50+

(Anafranil)

88%
Duloxetine – 60 mg, 100 pills $734 $100++

(Cymbalta)

86%
Doxycycline Hyclate — 100 mg, 100 pills $617 $251.21

(Vibramycin)

59%
*Cash price from local pharmacy in New York City. International Online Pharmacy Prices from lowest price on PharmacyChecker.com
+ Price calculated from 100 pills
++Price calculated from 84 pills
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