So my mother in law is uninsured and takes several drugs to deal with her high blood pressure.
She had been buying them at CVS for at least 10 years. Last week I went to pick them up for her and commented to the pharmacist that drugs were very expensive without insurance (I had one prescription for $150 and another for $220). The pharmacist said it might pay to shop around a bit. I didn’t think the difference would be worth schlepping all the way to Costco or WalMart after all CVS probably has at least as much bargaining power as Walmart or Costco considering how much prescription volume they have, how much could I possibly save at Costco or Walmart?
So I call Costco and the first drug (which is $150 at CVS for the generic) is $90 for the generic at Costco and I smack myself in the head and go, “jeez I should have shopped around sooner” but I was just mildly upset at myself for not shopping around.
The second drug (which costs $220 at CVS for the generic) is $28 at Costco for the generic. That’s right a $190 difference. At this point I was pissed off at CVS.
Well anyway, I was still mostly pissed off at myself at this point but then I brought the drugs back to my mother in law and she saw the difference in price and she is uncomfortable taking the drug because she is convinced that there must be something more than corporate greed behind such an enormous price difference, neither market forces nor government regulators could possibly permit such price gouging. This is despite having 2 pharmacists and a dozen doctors in the family who all assure her that the difference between the two drugs are going to be buffers that have negligible effects on the drugs potency or efficacy and has NO effect on its safety.
This price differential has convinced my mother in law that there is a difference between two generic versions of the same drug made by two different manufacturers. She is convinced that “you get what you pay for”
I know, I know. My mother in law is being irrational but she is 80 years old and health care is important to her. So I get another prescription and get the CVS version to make her feel better but she is 80 years old and the thought of my wasting $200 upsets her as well. So she is stuck either feeling uneasy taking a drug that she feels uncomfortable with because it is so much cheaper than what she has been paying for the last ten years or feeling uneasy because she is spending $200 more on a drug with chemically identical active ingredients as one that costs $200 less.
Fuck CVS and any other pharmacy that engages in this sort of price gouging.
The reason they get away with this sort of thing is because it doesn’t typically occur to most people (like you) that there would be a difference in price for prescription drugs.
Wait - this part makes it sounds like it isn’t actually the same drug? If not, it could be that CVS carries one, and it costs them more, and Costco carries the other different one, which is cheaper.
A given generic drug can be manufactured by different companies. However, the formulation must be tested so that it’s “bioequivalent”. The application process for manufacturing a generic formulation is similar to the application process of a brand new drug. Regulatory agencies like the FDA and EMA require that generic drugs perform more or less equivalently to the innovator drug.
Hahahaha, see my thread about CVS bastards. I just got price gouged by CVS on a HBP med. My husband gets the same drug under the same prescription plan and they charged me 20 times as much for 1/2 the dosage.
Why should the government in free market capitalistic USA regulate how much markup the companies can do? How much price gouging is allowed?
That’s the official line, but a doctor I know recently told me that all generic brands are not the same - for some patients of his, when the pharmacy switches from medication X to medication Y because they both have the same active ingredient, but the buffers are differently, that affects the bio-availability; or there are unexpected side effects from the buffers (although they should be inert, they are not quite) and it takes the doctors some time to figure out what’s causing the new problems when the patient was well-adjusted. (And then, when they write a prescription specifying “brand X only, no generic replacements” but brand Y is cheaper, then the health insurance punishes the doctors for using the more expensive medicine. )
There are apparently several articles in medical journals documenting that effect of real differences between purported “same” medications.
I take three different prescription meds. For two of them the generic apparently works just fine. The third, not so much. There was one generic brand that did not have a fraction of the result I needed. I researched it a bit and the original manufacturer used a different process to create the pills, as compared to the generic that didn’t work for me at all. In addition, the most unsatisfactory version (also the cheapest apparently since it was the one the drug stores always wanted to dispense) was made in a country other than the U.S. by a company that had several citations for various incidences divergence from requirements. I am able to get the non-generic version but it requires an occasional battle with the insurance company.
I’ll confess to being a moron, and assuming the price for my medication wouldn’t vary much between pharmacies. After reading this thread, I assumed I’d been overpaying CVS for my medicine for the past 15 years. So this morning I called around and was relieved that all 3 pharmacies near me charge almost the exact same.
One other thing on the “how do they get away with it” issue – I’m one of those people who would prefer to avoid calling a place if I can get the same information online. I can easily find the best price on a 4-slot toaster oven by Proctor Silex by typing those words into Google Shopper. Or if I have more time, by going to various merchants’ websites and seeing how much they are. I don’t have quite the same luck when I type “humalog insulin” into google shopper, or going to CVS.com and trying to find on their website how much their insulin is. If they can list the price on their Kodak Easyshare Digital Camera, and have it update automatically when the price changes or it goes on sale, why can’t they do the same thing with my insulin?
Anyhow, enough ranting, I know I’m a moron for not price shopping sooner for my medicine, but there it is.
Isn’t that always explained by the USian Dopers with the unique structure of the Health system in the US? So because each seperate insurance makes deals with the manufacturers, and because each consumer has different rates on his insurances, the price varies from one person to another, from one brand to the other.
Well sure, it would be a hell of a lengthy website to list every single combination of how much this medication costs with this insurance. But I don’t have insurance, they could at least list the “cash” cost to those of us who aren’t insured. And who knows, maybe a conscientious insured would even shop around for the benefit of their health insurance company. If their copay is $20 regardless, they could still buy from pharmacy A for $100 instead of pharmacy B for $300, if it was easier to determine prices.
But where’s the profit for the pharmacy in that? Either people go to Walmart or Costcos because of their reputation as being cheap for the uninsured; then listing higher prices won’t work for a competitor. Or they go to a specific chain because their insurer told them they have a special deal with that chain. Or they are simply going to the same name they’ve always gone (the mother-in-law of the OP).
Normal online stores list the prices because they have to because everybody else does and nobody would buy online without seeing the prices.
With pharmacies, you still have to go to a brick store to pick up medicine and show your prescription and be checked for controlled substance and warned about complications and whatnot, so you’re not really buying online.
And because it’s complicated with the insurance stuff, few consumers will probably price-compare in the first place. So it would be a huge hassle to implement all the different policies, for very limited gain.
The only reason I could see would be either consumer advocacy groups - but they have limited funding, right? They would need paying for the work involved.
or the health insurances themselves if they were interested in saving costs. But from what I hear, they aren’t interested, because they can pass on all costs by raising the rates and still make profit. So without incentive to save, why bother?
Good points, and I won’t pretend to know the ins and outs of pharmacies, marketing, and website design… but there has to be some value in being the first to offer a valuable service to possible customers? If pharmacy XYZ knows they have the lowest cash-pay price for a drug, why not put it on their website, even if you can’t buy it online? Heck, even if they don’t have the lowest price, they’d be the first company to do it, so when I do my online research they are the ONLY company showing their price online? I’d probably be inclined to shop there. And after that, wouldn’t other pharmacies have to follow suit?
Around here, where CVS started, it seems like every couple of years the state has to fine them for systematically overcharging. It sure looks like deliberate corporate policy.
I have avoided them for a long time, though they’re as common as Dunkin Donuts in this area. On the CVS wiki page, I was still surprised to see how bad they have been over the years, how many times they’ve been nailed for fraud and deceptive practices.
This stuff wouldn’t happen if consumers just got together and organized themselves. They could have groups that look at the cost of insurance, make sure that doctors are certified, verify that drugs are safe and legal, insure that pharmacies are charging reasonable rates, etc. We could do it at the neighborhood level, but it might be more efficient to do it at the county, state, or even national level. If we did a good job then we might find that costs go down and our health improves. I’m not sure what to call groups that work together to improve things, but maybe we could call it “government” .
If this was apples or butter I could see your point but we are talking about a drug that keeps you alive. If there were anything at all to the notion of competition in this arena then you would not see a 700% difference in prices between generic drugs with the same active ingredient manufactured by and sold by different folks.
Because sometimes the market does not function properly in some way or another. I’m not saying they should regulate, I’m saying that my mother in law doesn’t believe that market forces or the government would permit such price differences without a reason.
Yeah, there are different buffers that affect different people differently… so?
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