My wife was recently prescribed a special ointment for a skin condition. At first, her insurance company would not cover this…later they relented. I found out the price-staggering!
It turns out that the ointment is made by a “compounding pharmacy”-that is, they take ingredients and mix them then package them.
The cost is so staggering ($400.00), that I am sure there is some fraud involved. How could i research this? Is there any way to know if these charges are excessive?
My mom just paid over $2,000 for an antibiotic.
Not sure why you think fraud is involved. Some drugs are expensive. If you can get it cheaper - go somewhere else. Call other compounding pharmacies and see what they charge. You probably will be able to find be cheaper, but that doesn’t mean it is fraud.
You can phone as many pharmacies as you want. Most will give a price over the phone for regular stuff, but I don’t know about compounds. Your local places might not compound it themselves, but they might give a list of where to call.
PS: I used to be on some meds that were in the $250/month range, and they were not compounded.
What’s the medicine? How much do other pharmacies want for it?
(That doesn’t sound remotely out of line to me.)
I work with veterinary compounders all the time. They are ALWAYS more expensive than retail. The reason for using them is the concentration needed is not available through regular manufacturers. Sometimes they are able to buy the raw bulk product from overseas and compound from that, and sometimes they have to purchase the wholesale/retail product and compound from that. Either way, they’re kind of doing small-scale manufacturing, to order, on the microgram level, so you’re paying for that and the expertise to do it.
You could try calling around, and possibly see if there are any Canadian compounders who can ship to the US, it could be significantly cheaper. Even if not available, I’ve seen significant price differences from one pharmacy to the next depending on the medication needed. Calling around sure wouldn’t hurt.
And, especially with compounded meds, continuing to call around every time you need a refill is a good idea. Prices change frequently with compounders. You never know when you’ll get a super price because the pharmacist has 20 milligrams of phlebotnum in his storeroom that he’d really like to get rid of before the expiration date. The same guy could be twice as expensive at a refill, if it means he needs to order more phlebotnum to fill it…or he could be “backordered” for 6 months until he gets enough orders in to make it worth it to buy the phlebotnum. We’re talking sometimes very small scale business economics here; lots of compounding pharmacies are a guy in a labcoat.
From an insider’s perspective: Seroquel XR is in the $300 range. I’ve seen claims at work for drugs costing thousands. So I’m not raising any eyebrows at a $400 drug. It’s not a $4.00 generic antidepressant at Walmart but I’ve seen a lot of drugs a lot higher.
Try www.northwestpharmacy.com. The site list products and prices.
For the OP - check with the doctor that there’s maybe not either a standard version of the cream that doesn’t require compounding, or if you can more or less compound it yourself by using a dab of X and a dab of Y. Sometimes, doctors don’t realize how expensive the stuff they prescribe can be, and usually, they’re willing to go with something else.
When my husband was dealing with radiation burns from cancer treatment, his oncologist gave him a prescription for something called silvadene and a tube of lidocaine gel, with directions to stir the two together. We could have gotten the two pre-mixed from a compounding pharmacy, but the DIY version was far cheaper.
Keep in mind the link is a Canadian pharmacy whose prices are going to be much, much cheaper than a US retail location, especially a place that compounds, which implies a smaller, more specialized, more expensive place as opposed to a pharmacy at a Big Box store that just repackages pills. I checked a few random drugs and they seem to be about half US retail prices.
In any case I’ve found it difficult if not impossible to research prescription drug costs online if you don’t have an insurance plan that covers the drug you need. As far as I know a big retail chain’s website will typically tell you how much they want for a bottle of Tylenol or a tube of Colgate toothpaste, but not for a 30-day supply of a prescription med. You can’t compare the inflated rack rates against the rates as per the agreements with the insurers.
My doctor prescribed an eardrop for me. The only ingredients were hydrocortisone and acetic acid (white vinegar).
The cost to my insurance company was $250.00 for a half ounce bottle.
I refused to fill it once I found that out, instead I made my own at a cost of about 40 cents. When I told my doctor this I half expected some crap about sterility but instead she high-fived me.
Most of it comes down to economic distortion and the fact that the person consuming the products is not the one paying for them.
I won’t fill a prescription until I know the retail price and the price my insurer is paying. My pharmacist thinks the request is strange and cringes when he sees me coming but always complies.
When I was first diagnosed with vitiligo, my dermatologist told me some people were cured by topical applications of tacrolimus ointment. She gave me a tiny sample and wrote a prescription. She warned me it was pricey, but I was still shocked when I looked into it and didn’t bother filling the script.
Auralgan, a local anesthetic ear drop my brother and SIL loved when their kids were babies, was dirt cheap at the time but has since been reformulated, and since it can’t be sold generically, the company can now charge whatever it wants. :mad:
I’m guessing that the $2,000 antibiotic was Zyvox, or maybe fidoxamicin.
To the OP: What’s the ointment’s active ingredient, and how much do you need?
The ingredients are listed as :"KETO/KETA/CLON/AMIT/ 15%/2%/0.2%/2%/2%/5%/ Cream
It was for vancomycin - for c-diff. Double the normal dose and would have been actually $3200 without any insurance.
Injectable vancomycin, which can be reconstituted and taken orally, is dirt-cheap. The capsules are frightfully expensive, and IDK why anyone would dispense them unless they lived in an area with no hospital. Yes, retail pharmacies purchase things from the local hospital all the time, and vice versa.
Ketoconazole, an anti-fungal
Ketamine and clonidine, probably. Never seen either used topically, but I suppose it’s possible. Ketamine is an anesthesia adjunct (and abused under the street name Vitamin K) and Clonidine is a blood pressure medicine sometimes also used for ADHD.
Amitriptyline, also not usually used topically, is an antidepressant with multiple other uses.
p.s. How big is the jar?
Billing compounds can be tricky, I’ll grant you that. (tearing out hair smiley)
If you’re checking prices, check Walgreens too. Most people don’t know that Walgreens will compound.