I had an upper endoscopy in August and was diagnosed with H. pylori (bacteria that can survive in stomach acid) gastritis.
Most common therapy can include 1 or 2 of 4 antibiotic classes, an acid reducing medication, and bismuth (think Pepto Bismol) Well, one antibiotic class has severe interactions with one of my heart medications, and another class has severe interactions with one of my antidepressants. That leaves me with 2 antibiotic options.
So I get prescribed Metronidazole and Tetracycline. With my insurance, the Metronidazole is $3.00. The pharmacy called me and said the Tetracycline prescription would be $500.00 for a 2 week supply. FIVE HUNDRED DOLLARS for a generic antibiotic that has been on the market for 63 years.
I’m wondering WTF ?!?!?! I do a search and find peoplespharmacy.com. “We cannot say for sure that tetracycline has been caught up in the price fixing scandal.” Well, I CAN SAY FOR SURE THAT IT HAS BEEN INVOLVED IN A PRICE FIXING SCANDAL.
This goes far beyond what I think is a “reasonable profit”.
This is obviously not rated for human consumption, it’s for laboratory cell culture. But the purity and freedom from toxic contaminants required for cell culture is stringent, so the cost of production here would be similar to what would be required for human consumption.
The cost via that link is about $5 per gram. From a quick Google, I think the highest dose is 500mg per day? So the cost for a 2-week course at 500mg per day should be something like $35.
I was curious about the price in Canada, where prescription drug prices are regulated. For comparison purposes only, I found this site where tetracycline is $27.99 for 100 250-mg capsules, or 28 cents each. I cannot attest to the quality of this particular product or vendor, but that’s probably in the ballpark of prices at regular pharmacies. I do know that the blood thinner Brilinta, which is still under patent and only available by brand name, is (IIRC) somewhere around one-tenth the price in Canada compared to the US. I don’t remember the exact price differential but it was something like that. I remember looking into it because it was quite expensive even here, and was astounded at the difference.
In my area the default suggestion by GoodRx is for 56 capsules (500mg each) is about $94 at Costco or local grocery store pharmacies. Still FAR too expensive for such an old generic drug, but far short of $500.
Do treat your H. pylori, though. Don’t let it go. I had this infection as a kid, before people knew about it, and got diagnosed with stress-related gastritis, and was treated in all the wrong ways while the infection did a lot of damage.
I had to take a pair of antibiotics, one long term for a serious bladder infection several years later, which probably is what finally knocked out the H. pylori, but I went through years of gastric symptoms, and ultimately needed gastric surgery due to tissue changes, and it is also probably the reason I have symptoms of IBS even though I don’t have a full set of blood markers for it.
The surgery left me with a tendency toward reflux, heartburn, and random acts of puking. No fun whatsoever.
The years I had what they thought was “stress gastritis” were full of pain.
I’m sorry you are being jerked around by the insurance companies, but don’t decide not to treat this.
It’s not even that. While in the UK the Pharmaceutical Price Regulation Scheme (PPRS) seeks to regulate prices on behalf of the NHS, in Canada prescription drug costs are not (yet) socialized, except for the poor and those over 65. But they are regulated on behalf of everyone by the Patented Medicine Prices Review Board.
In short, the UK has the PPRS to regulate drug prices, Canada has the PMPRB, the US has Martin Shkreli and a corporate-toadying Congress. There is no effective oversight of prescription drug profiteering.
Here’s a good reference for what it should cost. This is not rated for human consumption,but it is the exact same product, with a potentially less careful logistics chain.
If those drugs will do the job, it strikes me as something bordering on malpractice* for the doctor to prescribe the massively overpriced one. Do you have any sense of what his/her reasoning might be?
*Yes, I know that wouldn’t actually be malpractice.
I presume that’s why Obamacare didn’t include a measure to regulate drug prices, despite the fact it would so obviously benefit both insured and uninsured Americans. Has one ever even been proposed?
Huh we were always able to get the veterinary grade stuff (in bulk powder) for peanuts. But we haven’t needed any recently.
I see there was a capsule recall back in April, which may be messing with supply.
I’ll nitpick here – it thrives and reproduces. Plenty of bacteria survive, else it would be hard to get an intestinal infection. Which is why the notion of ceviche being “cooked” by acid and thus made safe is incorrect.
Ignorance of the price. TCN used to be cheap as dirt. If his particular organization’s formulary hasn’t been adjusted for cost constraints to automatically suggest a substitute, then the doc may be blissfully unaware, or assume your insurance covers it save for a minimal co-pay. These days so many old drugs are horrendously pricey for those without insurance, but may run $5/script for those who have good health coverage. Yeah, what a system, huh?
Here’s the update: I sent a message to my Veteran’s Administration primary doctor to see if I could get the prescription through the VA. He said: “Get a written prescription from your doctor and bring it to me and I will prescribe it for you through the VA system and will have it mailed to you.” So, I called the gastroenterologist office, he wrote the prescription, I drove to his office and picked it up and then drove to the VA clinic and dropped it off. The Tetracycline prescription was filled yesterday and, amazingly (thank you US Postal Service), I got the prescription today.
Discussing medication prices with the gastroenterology receptionist, she mentioned a $2,100 cost for another patient’s antibiotic where the patient said: "Hmm, my house payment or my antibiotic?’’
The Republicans hate the Affordable Care Act, and want to repeal it. I say: "What’s your alternative? You have had 10!! (Ten!!) fucking years to come up with a “better system”. (sound of crickets)