Drug Price Question

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charliec

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What the heck is going on here? I don't use a lot of prescripts, and this is a new one. So, how the heck can a script be "worth" almost $600, but because I have insurance I can buy it for under 10 bucks? Who the hell is paying the difference, or who the hell is taking it in the *** for the difference? Somethin' ain't right!
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The World of pharmaceutical pricing is very complicated. To make it simple, that retail price is false. That is just the starting point from the pharmaceutical company in negotiations between distributors, pharmacies, insurance payers, rebates, discounts etc.

The true cost if you bought out of pocket is about 30% of that price. The insurance companies get it for about 25% of that.

It’s a big convoluted game.
 
So the insurance company and Walgreens are pulling my leg for PR?
 
So the insurance company and Walgreens are pulling my leg for PR?
Not really, the numbers are correct on the first face of it and the discounts, etc follow. The pharmacy computer systems only report original non-discounted price and final price since to do the rest would be nearly impossible.

You just have to take it all with a grain of salt and be glad it only cost you less tha $10 in the end.
 
They are trying to stick it to you if they can... See who they can take advantage of...
No, it’s not a conspiracy. It is a complicated price structure driven by insurance and government regulations.

To think they are organized and intelligent enough to create a complicated scheme to take advantage of people gives them far too much credit. They are feeding off each other, not the consumer.

Trust me, I know. I have been in this game over 33 years now and they just aren’t that smart.
 
You also have to take in account is the agreed upon price that the retail pharmacy has with the insurance company, which is much lower than the retail drug price. The insurance also has large rebates with the drug manufacturers that also off sets the cost that the insurance pays. But as others have stated, your copay was only 10.00 and the insurance paid the rest.
 
try figuring out a medical procedure if you are on medicare a and b and have supplemental insurance. my knee replacement cost around 50k. i think med a/b paid 5k and supp paid 5k. who ate the rest?????
 
You also have to take in account is the agreed upon price that the retail pharmacy has with the insurance company, which is much lower than the retail drug price. The insurance also has large rebates with the drug manufacturers that also off sets the cost that the insurance pays. But as others have stated, your copay was only 10.00 and the insurance paid the rest.

This is very true. My insurance that covers my Meds..GEHA, completely pays for my Cholesterol meds...and only pays 60% of my Oxycontin, I am left with a $200@month copay. But my wife was able to get me the card that gets me a $70@month discount.
My wifes Rheumatologist bills Medicare $6300@ month for her Actemra. They only get about a third of it...assuming the rest is a write off, of which they get a chunk of it back in tax refunds?
 
i remember when my last one was born, i got about a $2500.00 bill
i told em to hold on, as soon as social security catches up and gives the little girl a number, ill ad her to the insurance and they'll cover it
sure enough, a month later, i get a new bill for the deductible, but low and behold, now the total is $3500.00

so i call the hospital to ask em what the difference is
turns out the first bill they send me had an "uninsured patient discount" on it

now there is a Whiskey Tango Foxtrot moment
 
I don't believe there's no conspiracy at all......this is a multi billion dollar industry. You rear what I'm typin? "Avarice is the root of all evil" it's right in the Bible. I believe it. So, if there's no conspiracy at all, tell me, why isn't it a standing rule for pharmacies to make sure that people get the lowest prices based on their situation? If someone doesn't have insurance, for example, they can use the "Good RX" site to get a much better price, by printing out an online coupon. Pharmacies see people come and go all day, everyday, yet they don't tell people about the Good RX site. I've seen it first hand and I spoke up about it. More than once. The people were just going to leave without the drugs they needed, because the pharmacist did not tell them about Good RX. There was even Good RX info behind the counter. I spoke up on two occasions and let customers know about it. Both times they went online on their phones and found a coupon. Both times I berated the SAME pharmacist for not telling them. You think that's isolated? My big old *** it is.
 
This is what I pay for my 5mg tablets. I pay out of pocket for every med I buy. No insurance plan no nothing. 1 of my other meds was increased to double and the price doubled. I will say when I was working and had a good plan I payed a $11.50 dispensing fee. Kim

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It's a complicated confusing scam. Some years ago, people would charter a bus, travel to Canada, see a doctor up there, get there prescription filled up there, and come back home. And still save a whole bunch of money.

When I got Lyme disease decades ago, my doctor gave me a script for doxycycline. It was a tier 1 drug and it was cheap [$6.00]. It is an old drug that has been around a long while. A few years ago I got Lyme again [or it resurfaced] so my doctor gave me a script for doxycycline again. Suddenly, it became a tier 3 drug???? [$45.00 with insurance]. And it was made in a foreign country! There is a number on the pill itself. You can look up the manufacturer and country of origin on one of the medical sites.
 
I don't believe there's no conspiracy at all......this is a multi billion dollar industry. You rear what I'm typin? "Avarice is the root of all evil" it's right in the Bible. I believe it. So, if there's no conspiracy at all, tell me, why isn't it a standing rule for pharmacies to make sure that people get the lowest prices based on their situation? If someone doesn't have insurance, for example, they can use the "Good RX" site to get a much better price, by printing out an online coupon. Pharmacies see people come and go all day, everyday, yet they don't tell people about the Good RX site. I've seen it first hand and I spoke up about it. More than once. The people were just going to leave without the drugs they needed, because the pharmacist did not tell them about Good RX. There was even Good RX info behind the counter. I spoke up on two occasions and let customers know about it. Both times they went online on their phones and found a coupon. Both times I berated the SAME pharmacist for not telling them. You think that's isolated? My big old *** it is.

I agree wholeheartedly , they got us over a barrel , they know people have to have it .
Ever wonder why meds are so much cheaper in other parts of the world , by the same companies ?!
 
What do you think a new Corno 19 vaccine will cost when they have one that works? It'll be so expensive most people wont be able to afford it and not get vaccinated.
 
Nobody pays MSRP for anything. Window sticker on a new vehicle is a good example. The dealer can sell it to you for less. If you were buying a fleet of 1 million of this vehicle you would get a much better deal. That's how insurance companies and drug stores buy.
Knowing MSRP is great if you're a contestant on Price Is Right.
When my cousin was dying from cancer he got a prescription that was over 1200. My mom, who is a senior and has much experience in this, called the drug mfgr. They called back after about 2 hours and told us exactly which drug store to drive to. They said it would be 19. We got the drug for only 12 and change (I drove him and paid for it). He took only 3 of these pills before he died. All of his left over drugs were returned to that particular drug store.
So if anyone does pay MSRP for a drug... they don't know there is a better way. And yes the inflated MSRP on drugs in the U.S. is a bit of a con. We might not buy insurance if we didn't see a tremendous value in it.
I'll throw this in too while in a typing mood.... back in early 80s I was chatting with my boss man. "Did you see they are tearing down the Poinsett Dry Cleaners?" His reply, "Yep, for another self serve gas station. I think there's a law requiring a gas station or burger joint on every corner by the year 2000." He/We couldn't have imagined all the drugstores we have today.
 
It's crazy. I have a blood thinner, 600/month IIRC. Got on the program with manufacturer for the first year. My insurance changed to cover it this year. Told doc, pick a different thinner... LOL

It is crazy the retail pricing in US vs rest of the world.

Reminds me of defense contractrors and cost when building equipment. Insane prices of basic items.
 
It's crazy. I have a blood thinner, 600/month IIRC. Got on the program with manufacturer for the first year. My insurance changed to cover it this year. Told doc, pick a different thinner... LOL

It is crazy the retail pricing in US vs rest of the world.

Reminds me of defense contractrors and cost when building equipment. Insane prices of basic items.

Mulcahy, Andrew W., Christopher M. Whaley, Mahlet Gizaw, Daniel Schwam, Nathaniel Edenfield, and Alejandro Uriel Becerra-Ornelas, International Prescription Drug Price Comparisons: Current Empirical Estimates and Comparisons with Previous Studies. Santa Monica, CA: RAND Corporation, 2021. U.S. Prescription Drug Prices Are 2.56 Times Those in Other Countries.
 
Everyone's dope is different .I use goodRx and the Kroger prescription club.its good for me right now but ever since some people shut the doors and decided how the will take bribes to make us pay.It hurts
 
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