AARP just released its Rx Price Watch Report and the data doesn’t do your wallet any favors. Thankfully, verified international online pharmacies offer the price relief consumers need but can’t find locally. AARP has recommended that consumers consult PharmacyChecker.com to avoid rogue online pharmacy scams.
The AARP report painted quite a grim picture concerning the lack of drug price relief in the U.S.:
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
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.
