Should there be intervention on just the meds you are taking?
Prescription Costs
- Thread starter Passport1
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That's a drastic oversimplification of GoodRx's business model. They have their paws in so many different pockets of the supply chain that gets rolled into a money saving (or profit to the company) bucket to consumers.
Here's one of many reads from Adam Fein, that breaks down some of the ways they make money and how they price/pass along pricing.
https://www.drugchannels.net/2020/08/how-goodrx-profits-from-our-broken.html
My wife takes Humira injections every three weeks.
So far this year our first out of pocket was $2250.00.
Second Humira prescription that I picked up on Friday was $800.00 co pay.
As a further note last year her total out of pocket was $6500.00
And now she just started medication for Diabetes.
Thats just out needs, I know that there are others out there that have expenses of a higher magnitude, but it can be an unrealistic what drug's cost, but we adapt and do the best we can.
Don't worry the Government is working on Prescription price caps. Right?
CONVERT
So far this year our first out of pocket was $2250.00.
Second Humira prescription that I picked up on Friday was $800.00 co pay.
As a further note last year her total out of pocket was $6500.00
And now she just started medication for Diabetes.
Thats just out needs, I know that there are others out there that have expenses of a higher magnitude, but it can be an unrealistic what drug's cost, but we adapt and do the best we can.
Don't worry the Government is working on Prescription price caps. Right?
CONVERT
In one respect, hard to have a pure free market in an area where post successful commercialization of a product, it could be reverse engineered and produced on the cheap immediately driving down the price, forget about looking for treatments for any orphan diseases. In another respect, whats stopping the patient from stopping after their free trail runs out. Presumably the quality of life they are getting from the product is why they keep up use.
I can't help but wonder how free of a free market we really want in the US. Not saying elsewhere has it right either but it is easy to say, everyone should have access to medical coverage or healthcare, saying someone has to have access to [insert correct descriptor] (affordable, good, quality, appropriate, etc.) all means something different and like anything else has cost/quality implications that we have trouble aligning on (and for understandable reasons).
We could be put on the same plan that the Congressmen or Senators get (free?) or put them on what we have to go through $$$$$$$.
CONVERT
CONVERT
My company, Case New Holland in New Holland Pennsylvania has excellent insurance. Have not paid over $2.50 for any prescription for a 90 day supply. Lots of times its less than a dollar. Extremely happy with our benefits. Before I was getting the Walmart 3 dollars a month -- which I think is now 4 dollars a month.
I’m not looking to start a war with our Canadien neighbors but I once read that the low cost of prescription drugs in Canada is subsidized by Big Pharma charging Americans more for said drug. In other words, Canada tells Pfizer (or whichever drug company) how much they are willing to pay for said drug...Pfizer says OK...and passes the cost on to Americans. IDK if this is 100% accurate but knowing our bought and paid for politicians I wouldn’t doubt it.
PS: I just saw Lubener’s post above mine and that’s what I had read.
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You aren't addressing what I stated. You've altered my statements to fit a narrative. EDIT: I meant to add you neglected (and that seems to be the right word) to include the out-of-state mail order fact in there. And in a condescending manner. I wrote about local CVS and local indy pharmacy and compared them to an out-of-state pharmacy that does mail orders as well. The out-of-state is an indy in Stamford, CT and I am in NY. My reply was stating your brush was incorrectly broad as you stated:
"Nope, everyone pays the same as it's dictated by insurance companies in most cases, at least when it's a medication they cover."
Overreaching statement as I've shown one way where we are not all paying the same costs. A 90 day supply from out of state for $30 is not paying the same when in-state 90 day supply is $90 at best from a local Indy and local CVS is $180.
I can add to it when my oldest son was 12 he needed an implant in his arm for a year and then it was taken out and a new one added for another year. The med implanted was $25k per dose. Had to be ordered as it isn't something stocked for obvious reasons. Original was CVS with a $150 co-pay. Doctors office called me and let me know if I ordered from (can't remember their name but was in Texas) the co-pay would be $50 and I was assured it was legitimate and there was no generic version of this tincture.
I do agree with you we need gov't but I am a less gov't is better person overall. Where we diverge is the thinking that gov't has done well with medical care and RX pricing. The politics of big pharma and ins have been a historic negative for all Americans. The inability to shop Ins from state other than I live is an epic failure to me, the consumer. Such a fail at basic level of competition shows the underbelly of politics in this big business matter.
Can you look up the cost of various medicines through your insurance ? Plenty of plans offer very inexpensive medications but it very much depends on the drug, especially if a generic is available. Very curious what you would pay for something like Vyvanse or Trulicity and others.
To those that assume that USA does the vast majority of R&D on drugs, well you need to realize that Europe, Israel, Japan, and Canada do this too.
To clarify on the Canadian situation, not everyone has a benefit package so they pay for their own meds ~ albeit at far lower prices than USA levels.
Canadian benefit packages often require that generic drugs are used to keep costs lower. I have benefits via my wife's employer, but the pharmacy is an online site that mails my meds as needed. It doesn't really shine for service compared to the old bricks & mortar Rx places.
To clarify on the Canadian situation, not everyone has a benefit package so they pay for their own meds ~ albeit at far lower prices than USA levels.
Canadian benefit packages often require that generic drugs are used to keep costs lower. I have benefits via my wife's employer, but the pharmacy is an online site that mails my meds as needed. It doesn't really shine for service compared to the old bricks & mortar Rx places.
I had my spleen removed about a year and a half ago. I had to take a couple injections and it cost me $700 out of my own pocket each time. I found out after the second injection that if I had it done at a pharmacy instead of the hospital clinic it would have cost half the price. I have one more to take in July and then I am finished. The injection is supposed to prevent some kind of meningitis. Other than these 3 injections my insurance pays for almost everything. If I can give any advice to anyone it would be to find out how much things cost before just doing it.
We have a HDHP with a reasonably low deductible ($6,000 family, my employer chips in for a good chunk of it). My sons focalin, for his ADHD, costs us $20 every month until we hit the deductible. He’s the only one with an ongoing prescription.
The only other one I can think of was Meijer pharmacy wanting $500 for some oddball antibiotic my wife needed because she’s allergic to one of the families of antibiotics and insurance didn’t cover it. We switched pharmacies when we heard that (they were also having problems filling my sons Rx, this was in 2019-2020 before the ADD/ADHD med shortages), it was still $150 but they’re way nicer at this pharmacy.
The only other one I can think of was Meijer pharmacy wanting $500 for some oddball antibiotic my wife needed because she’s allergic to one of the families of antibiotics and insurance didn’t cover it. We switched pharmacies when we heard that (they were also having problems filling my sons Rx, this was in 2019-2020 before the ADD/ADHD med shortages), it was still $150 but they’re way nicer at this pharmacy.
Mine are all free
My most expensive prescription was for a blood thinner, Zarelto. Even with insurance, it was over $500 every three months. But some drugs still under patent here can be licensed or off patent in other countries. I am now getting the equivalent, not labelled Xarelto, from a Canadian pharmacy. The actual medicine is made and packaged in India, and mailed to me from Germany. Under $150 every three months.
Medicare should be able to negotiate prices, and that price should be the average price charged in other first world nations as negotiated by the drug companies themselves. It is ridiculous that we pay more than anyone and negotiation is forbidden.
Medicare should be able to negotiate prices, and that price should be the average price charged in other first world nations as negotiated by the drug companies themselves. It is ridiculous that we pay more than anyone and negotiation is forbidden.
The Inflation Reduction Act was passed last year (2022) and has provisions requiring price negotiations for top spend drugs in Medicare.
My Rx prescription co-pays range anywhere between $8-$60, depending on the daily dose. My wife has no Rx co-pay.
A few days ago, we went to pick up her 200-pill Rx (100 days). The pharmacy mistakenly ran it thru, sans insurance and it rang up as $2768.00
A few days ago, we went to pick up her 200-pill Rx (100 days). The pharmacy mistakenly ran it thru, sans insurance and it rang up as $2768.00
That's crazy that we now consider a $6000 deductible as "low"
