Without going into unnecessary detail… I am on a prescribed medication that used to cost $70 for 60 pills. Today, I learned that it has jumped more than six-fold, to $220 for only 30 pills.
How can this happen? What weird technological bottleneck could explain it? Is there a sudden new shortage of some raw material vital to manufacturing? Is there a sudden increase in demand, with thousands of new users clamoring for a limited supply? Or did someone just make the decision for reasons having nothing to do with technology or the free market?
As you might expect, I’m not at all happy with this development…
Nope, it’s because many wholesalers are jacking prices up to levels beyond anything we could ever have imagined. There are also “shortages” too, often of critically necessary things.
Makes me all the more happy I decided to retire as a pharmacist in 2012.
It’s also possible that it is something that is available in generic, but is still somewhat expensive, for some reason (this is true of a lot of the stimulants prescribed for ADHD and narcolepsy), and varies from supplier to supplier, and your pharmacy changed suppliers, or just used a different supplier this month, because the old one ran out. If you don’t have insurance, your insurance doesn’t cover this particular drug, or your co-pay is a percentage of the drug, then you could get hit with a bigger charge than usual.
Another possibility is that you usually get generic, and the pharmacy was out of generic, so they filled it with brand name, and charged you for brand name. When this happens, the pharmacy should say something to you at the very least, or if they are my pharmacy, they would charge you the generic price for the brand name. I suspect what most pharmacies would do is give you a couple of days worth of the brand name, and ask you to come back when they have new stock of the generic. But there is always dropped communication between employees.
You should examine the drug to make sure it is the same thing you usually get. If not, call the pharmacy. If they cannot tell you why the charge was different, then call your insurance company.
If you are in the donut hole, when you need more medication at the end of December, just fill a couple of days worth, because in January, you’ll be out of the hole.
I ran into the same issue a few weeks ago - I needed a tube of steroid cream for a case of ringworm. Everywhere else in the industrialized world, it cost $20-some, but here it was almost $300. It’s INSANE.
Further information: yeah, this is for the generic version.
And, no, I’ve got no insurance, so this is the full cost.
Weird, and damn scary, as this is something I pretty much need to live…
(It makes me think of the Poul Anderson SF story “A Plague of Masters,” where human life is only possible on a particular planet if everyone takes a daily antidote for the biotoxins natural to that world. No pill, you die. The result wasn’t just high prices, but slavery.)
I’ve been running into this quite a bit on the veterinary side, too. One recent short supply was 1-liter bags of electrolyte-enriched fluids such as Plasmalyte, Normosol, and Lactated Ringer’s. Any drugs that are having supply issues, go to the human side first, and the price gets jacked up for people’s pets. My latest run-in with this was with cyproheptadine, a generic that’s been around a long time. If I order it from my only supplier that still has it, it’s $132.02 for a bottle of 100 tablets. I called it in to a Walgreens for a client where they could get the same thing for $57. I get it yet cheaper for the shelter by using a compounded liquid from Wedgewood Pharmacy. But still not as cheap as I used to get the tablets less than 6 months ago from any of my regular suppliers.
I hope that’s not what your situation is. Steroids will make most topical fungal infections worse. Sometimes a mix of anti-fungal and steroid is used together to treat things like ringworm, to reduce symptoms faster. But that can go awry if the fungus is resistant to the antifungal.
As for the OP, the rising cost of generics is playing holy hell with the budget of our system’s pharmacy. Colchicine went from $0.09/tab to $4.85, a 10 day course of doxycycline went from $8 to $270, etc. etc. Shortages, manufacturing problems, and outright opportunistic pricing by the handful of generic firms still making those drugs are a part of the problem.
There have been a lot of noticeable price increases lately, most of them on long time generics, where there is no “logical” reason. I’ve been seeing prices jump on a multiple of drugs, and it causes havok on everyone. The patient who pays cash, and the pharmacies that fill it. One big issues lately is the sudden price increases, while Pharmacy Benefit Managers (the people your insurance company hires to handle prescription benefits) only update their AWP (average wholesale price, the price they use to reimburse pharmacies) once every few months.*
One example, the price of Doxycycline, an antibiotic used for many things. In late 2012, the drug was cheap as dirt (actually cheaper). It was on most pharmacies $4 lists, and some supermarkets even gave it away for free. It cost the pharmacy, on average, about $60 for a bottle of 1000 (since it was cheap, and popular, that’s how most pharmacies ordered it). In late 2012, to early 2013, the drug was on manufacturer back order, started getting hard to get in mid to late November, and most pharmacies stock ran out by end of December. The drug finally came back on the market in mid to late Febuary of 2013. When it came out, that same 1000 count bottle (which used to cost $60), now only sold by one company, now cost the pharmacy a little over $3,500. However, it took most insurance companies over 3 months to update their price lists. The normal, 20 capsule prescription, which now costs the pharmacy about $100 to fill in drug costs alone, was still being reimbursed at a rate less then $10, leading to a $90+ loss on every Rx filled… How many people do you think would eat a $90 loss for EVERY script filled?
Your two examples are for two different reasons, the doxycycline as above, (mainly opportunistic pricing by the ONE generic firm that still made it), but Colchicine price went because it went from generic to brand only. That one can be blamed on the FDA who under President Bush II, required drugs that were grandfathered in at the time of the FDA’s creation in the 60’s and 70’s, (when they only had to prove safety), to comply with current requirements to prove safety AND effectiveness. This required going back to clinical trials, and the first company to complete them got a new period of exclusivity, so was able to sell colchicine as the brand name Colcrys.
But, as QtM said, “Shortages, manufacturing problems, and outright opportunistic pricing by the handful of generic firms still making those drugs are a part of the problem”, and it sucks for everyone when the prices jump multiple thousands of a percent in a few months time.
Only thing I can suggest is to shop around, different pharmacies update their prices at different times. One pharmacy might have increased right away, while another one is still selling the drug at the old price, and some pharmacies end up lowering prices faster then others. As for my favorite example, Doxycycline (first drug I experienced this price roller coaster since I became a pharmacist, so followed it closely), a typical 10 day course, at a local supermarket that used to give it away, costs about $150; my employer, $40.
*One thing I’ve heard rumors of was that the PBM’s update the price they charge the plan sponsors much more often, pocketing that price differential as profit. So as the price skyrockets, the two big winners are the manufacturer and the PBM, the big losers are the pharmacies and the cash paying customers.
I know all day release Ritalin quintupled, so I switched to the ‘instant kind’. Something about the all day kind being more readily abused? I don’t remember exactly.
Last time I was in the donut hole, my insulin cost over $500 for 30 days. And that’s my copay, not the entire cost. Then it came down to $20-something.
The donut hole is an insurance thing, not a medical thing. So my insurance company is paying the same amount every month, right? So on what basis can they justify such an increase?
Riddle me this one - when I got pregnant my allergist changed me to the only nasal spray steroid that’s category B for pregnancy. For some reason which was never explained to me instead of $35 with insurance, which is what most nongenerics are, it was $55. Which was not a negligible sum to us.
Then they came out with a generic several months ago. Yay! $8!
Now, for some reason nobody can explain to me, it’s free. It doesn’t work quite as well as my old Dymista did but that’s $35 and this is now, oddly, free!
I take Spririva, Xopenex, and an albuterol inhaler. I buy all my meds from a pharmacy in India. I have Medicare part D, but I never use it. If I bought my meds in the US and had a copay, they would still cost more than the Indian pharmacy. The quality is the same. Even the packaging is the same or similar. I can buy three month’s supply from overseas and pay less than one month’s supply here.
Canada, Mexico & India are a good sources of overseas medications on the cheap. I’m going to assume Canada has the highest quality control, but that could just be bias.