Prescription drug costs

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dm200
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Prescription drug costs

Post by dm200 » Tue Apr 10, 2018 10:55 am

This month's (just got in mail) Consumer reports has an article on prescription drug costs, some ideas on how to save - as well as some examples of various drug cost increases.

One example was where a person encountered a higher cost for his prescription drug using Part D Medicare vs. paying "cash" (no insurance).

123
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Re: Prescription drug costs

Post by 123 » Tue Apr 10, 2018 11:10 am

I thought the price comparison for 5 sample drugs among various outlets was interesting. Costco was generally the cheapest among brick-and-mortar places. The one thing that surprised me was the CVS/Target was most expensive (of those in the sample). My brother recently had to change his prescriptions to CVS because his employer's prescription service is run/owned by CVS. Maybe his megacorp employer isn't getting such a good deal after all. Maybe the retail prices in survey were higher than insurance prices but it still suggests that CVS has higher than average prescription prices.
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gasdoc
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Re: Prescription drug costs

Post by gasdoc » Tue Apr 10, 2018 11:11 am

Try Good RX, a free online discount company, that essentially gives you all of the negotiated "cash" prices of all of the pharmacies in the area you designate. I've also used Canadian companies for asthma inhalers.

gasdoc

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gasdoc
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Re: Prescription drug costs

Post by gasdoc » Tue Apr 10, 2018 11:12 am

123 wrote:
Tue Apr 10, 2018 11:10 am
I thought the price comparison for 5 sample drugs among various outlets was interesting. Costco was generally the cheapest among brick-and-mortar places. The one thing that surprised me was the CVS/Target was most expensive (of those in the sample). My brother recently had to change his prescriptions to CVS because his employer's prescription service is run/owned by CVS. Maybe his megacorp employer isn't getting such a good deal after all. Maybe the retail prices in survey were higher than insurance prices but it still suggests that CVS has higher than average prescription prices.
Even using GoodRX, CVS is usually among the most expensive.

gasdoc

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dm200
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Re: Prescription drug costs

Post by dm200 » Tue Apr 10, 2018 11:28 am

One way my wife and I save a little on several continuing prescriptions (Kaiser) is mail order refills. We can just request the refills online (or by phone). One thing that greatly puzzles me is friends/acquaintences who absolutely refule to do mail refills. In our case, this is super convenient - even if the refills are finished, the pharmacy contacts the doctor and gets the refill authorization.

These ther folks pay more and go through more steps. I don't get it.

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Re: Prescription drug costs

Post by Pajamas » Tue Apr 10, 2018 11:36 am

123 wrote:
Tue Apr 10, 2018 11:10 am
Maybe his megacorp employer isn't getting such a good deal after all. Maybe the retail prices in survey were higher than insurance prices but it still suggests that CVS has higher than average prescription prices.
You can't assume anything about contracted prices based on the retail pharmacy prices.

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Re: Prescription drug costs

Post by jeff1949 » Tue Apr 10, 2018 11:38 am

dm200 wrote:
Tue Apr 10, 2018 11:28 am
One way my wife and I save a little on several continuing prescriptions (Kaiser) is mail order refills. We can just request the refills online (or by phone). One thing that greatly puzzles me is friends/acquaintences who absolutely refule to do mail refills. In our case, this is super convenient - even if the refills are finished, the pharmacy contacts the doctor and gets the refill authorization.

These ther folks pay more and go through more steps. I don't get it.
I have been using the Costco Mail Order for my one prescription which was VERY convenient and VERY low cost. Then my insurance company sends me a letter saying I will no longer be able to use this mail order service and still utilize the insurance. :(

This is just to say that this pharmacy and drug deal is a moving target and to get the best deals one will have to keep on top of these things as they change.

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Re: Prescription drug costs

Post by carolinaman » Tue Apr 10, 2018 11:41 am

gasdoc wrote:
Tue Apr 10, 2018 11:11 am
Try Good RX, a free online discount company, that essentially gives you all of the negotiated "cash" prices of all of the pharmacies in the area you designate. I've also used Canadian companies for asthma inhalers.

gasdoc
Good RX offers good discounts over retail prices. Also, you can use manufacturer coupons in conjunction with those for deeper discount.

Canadian pharmacies are an option but you need to vet which pharmacy you use carefully as these prescriptions are often filled offshore.

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Re: Prescription drug costs

Post by sport » Tue Apr 10, 2018 11:50 am

dm200 wrote:
Tue Apr 10, 2018 11:28 am
One way my wife and I save a little on several continuing prescriptions (Kaiser) is mail order refills. We can just request the refills online (or by phone). One thing that greatly puzzles me is friends/acquaintences who absolutely refule to do mail refills. In our case, this is super convenient - even if the refills are finished, the pharmacy contacts the doctor and gets the refill authorization.

These ther folks pay more and go through more steps. I don't get it.
I could use mail order Rx's at a lower cost and I don't. Here's why:
I received a mail order Rx for a nasal spray. It was a something I use all the time. That one time, it seemed different. It did not feel the same. I asked my Dr. and he said not to use it. I contacted the mail order pharmacy and they said since there had been no recall on the drug, it must be OK and they would only send a replacement if I paid another copay. That drug has a narrow storage temperature and I believe it was "cooked" in the mail. The pharmacy did give me the phone number of the manufacturer. I called and explained the situation and they said they would replace the drug. However, they did not have a license to dispense and they would provide a replacement to the pharmacy to send to me. The pharmacy refused. So, the manufacturer refunded my copay on the condition I send the damaged/defective drug to them, which I did, after paying the second copay to the pharmacy.

This also got me to think about other mail order Rx's. In the summer, the mail trucks can get very hot, they are not air conditioned. Similarly, in the winter, they can get very cold. If the Rx is a pill or capsule, there would be no way for me to tell whether or not the drug was damaged by the temperature excursion. So, my conclusion is that using a mail order pharmacy is not a good idea, even if I could save some money by using this service. I would rather pay more than used compromised medications.

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dm200
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Re: Prescription drug costs

Post by dm200 » Tue Apr 10, 2018 12:11 pm

I don't know how many other drugs have the same (or similar) issues, but if you take "Synthroid" or the equivalent - be aware that (according to what I read and have been told for 30+ years) there are not 100% equivalent generics. The alternatives, Levoxyl, Levothroid, generic levothyroxine, etc. are just as good BUT you should take the same brand/manufacturer all the time unless and until you have the required tests for the proper dosage. I have taken "generic" levothroid (Kaiser) for about 7 years now and last year the refill had a large and conspicuous notice enclosed that the manufacturer Kaiser used had changed and to consult with the prescribing Physician to verify proper dosage. Good communication (both ways) with both Pharmacists and your prescribing physicians is important - in many ways.

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Re: Prescription drug costs

Post by TN_Boy » Tue Apr 10, 2018 12:16 pm

dm200 wrote:
Tue Apr 10, 2018 11:28 am
One way my wife and I save a little on several continuing prescriptions (Kaiser) is mail order refills. We can just request the refills online (or by phone). One thing that greatly puzzles me is friends/acquaintences who absolutely refule to do mail refills. In our case, this is super convenient - even if the refills are finished, the pharmacy contacts the doctor and gets the refill authorization.

These ther folks pay more and go through more steps. I don't get it.
I am one of those folks. One reason is that we have a good local pharmacy about three miles away. If we have a question about a prescription, or a concern, they will answer any questions. I think if the doctor accidentally prescribed something strange, they would note it and possibly double-check with the doctor.

I can request refills by phone with my brick and mortar pharmacy, so that's not an issue. If I tell them to, they will contact the Dr office to get a refill authorization.

But the main reason I don't like mail-order refills is that during the summer it can be 95 in the shade where I live, and I'm not wild about prescription meds sitting for a long time in high heat.

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Re: Prescription drug costs

Post by bberris » Tue Apr 10, 2018 12:19 pm

123 wrote:
Tue Apr 10, 2018 11:10 am
I thought the price comparison for 5 sample drugs among various outlets was interesting. Costco was generally the cheapest among brick-and-mortar places. The one thing that surprised me was the CVS/Target was most expensive (of those in the sample). My brother recently had to change his prescriptions to CVS because his employer's prescription service is run/owned by CVS. Maybe his megacorp employer isn't getting such a good deal after all. Maybe the retail prices in survey were higher than insurance prices but it still suggests that CVS has higher than average prescription prices.
Or, maybe the employer is getting a really good deal by getting rebates from CVS.

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Re: Prescription drug costs

Post by ResearchMed » Tue Apr 10, 2018 12:23 pm

We already get far too much of our neighbors' mail, and we also get some of their packages (from all of the delivery services, FedEx, UPS, USPS). We don't have a clue why this is such a problem in our area.
In some cases, the "incorrect item" isn't even for someone nearby.

So... the *last* thing we want is to deal with meds that are required daily... and what would likely be recurring "missing deliveries".

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Re: Prescription drug costs

Post by sport » Tue Apr 10, 2018 12:33 pm

dm200 wrote:
Tue Apr 10, 2018 12:11 pm
I don't know how many other drugs have the same (or similar) issues, but if you take "Synthroid" or the equivalent - be aware that (according to what I read and have been told for 30+ years) there are not 100% equivalent generics. The alternatives, Levoxyl, Levothroid, generic levothyroxine, etc. are just as good BUT you should take the same brand/manufacturer all the time unless and until you have the required tests for the proper dosage. I have taken "generic" levothroid (Kaiser) for about 7 years now and last year the refill had a large and conspicuous notice enclosed that the manufacturer Kaiser used had changed and to consult with the prescribing Physician to verify proper dosage. Good communication (both ways) with both Pharmacists and your prescribing physicians is important - in many ways.
It seems you misunderstood me. The situation I described was not that of a different generic. It was the same medication I had been using. The drug was apparently damaged in the mail due to temperature exposure outside the specified range.

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Re: Prescription drug costs

Post by RetiredAL » Tue Apr 10, 2018 4:49 pm

jeff1949 wrote:
Tue Apr 10, 2018 11:38 am
dm200 wrote:
Tue Apr 10, 2018 11:28 am
One way my wife and I save a little on several continuing prescriptions (Kaiser) is mail order refills. We can just request the refills online (or by phone). One thing that greatly puzzles me is friends/acquaintences who absolutely refule to do mail refills. In our case, this is super convenient - even if the refills are finished, the pharmacy contacts the doctor and gets the refill authorization.

These ther folks pay more and go through more steps. I don't get it.
I have been using the Costco Mail Order for my one prescription which was VERY convenient and VERY low cost. Then my insurance company sends me a letter saying I will no longer be able to use this mail order service and still utilize the insurance. :(

This is just to say that this pharmacy and drug deal is a moving target and to get the best deals one will have to keep on top of these things as they change.
+1 for Costco, especially for generics. I've personally used them for years via their local warehouse. I found their street prices on the common generics I was taking were less than the insurance contract rate other pharmacies were charging me.

As an example, I recently had my wife move her RX for a very common generic, which Target was charging her $12.80, to Costco which charged $1.80. Her yearly drug expenses do not reach the Medicare deductible amount.

Costco has on-line pricing lookup in their "warehouse pickup" section.

The negative to Costco Warehouse Pickup is you likely can't walk in get your RX today. You get it the next afternoon. That's fine for your ongoing drugs, but not for that antibiotic you need/want today.

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Re: Prescription drug costs

Post by samsoes » Tue Apr 10, 2018 6:47 pm

TN_Boy wrote:
Tue Apr 10, 2018 12:16 pm
But the main reason I don't like mail-order refills is that during the summer it can be 95 in the shade where I live, and I'm not wild about prescription meds sitting for a long time in high heat.
I had a mail order Rx delivered in the summertime and spent hours inside the sweltering curbside mailbox. These particular pills were melted by the heat and stuck together in a clump. :shock:

Good thing they were generic and not life-critical. No more mail order drugs for me.
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Re: Prescription drug costs

Post by vested1 » Wed Apr 11, 2018 8:26 am

My wife takes a medication once a week, that even with Medicare Part D would have a co-pay of $4,500 a year, which is a fraction of the retail price. Without the drug she would be crippled in about a year.

It is hand delivered to our door every 88 days in a Styrofoam container with ice packs surrounding it. We are extremely fortunate that her insurance makes it unnecessary for either of us to have Part D or supplemental insurance, and that her co-pay is $10 every 88 days for the drug, subsidized by her retiree insurance and a discount card from the manufacturer, even past Medicare age. The cost without insurance is $1,200 a week.

The drug manufacturer supplies a free nurse who will come to your house if requested, a concierge service when ordering or if you have questions, as well as other free materials to store used sure-click injectors.

This drug has been on the market for 20 years and has no generic equivalent, due to efforts in court to keep it that way by the manufacturer. It makes me wonder what the price of the drug would be if offered generically, or without the 1 day delivery to your door, or the free nurse and concierge service. It makes me wonder how much is enough for the drug companies. It makes me wonder how long it takes to pay back the costs of R&D. It makes me wonder how many crippled people are out there because they can't afford to pay for the drug, and can't afford adequate insurance.

It makes me wonder how much this drug costs in other countries which have a tighter control over drug prices. Someone has to make up the difference in the cost of the drug, and in the case of this drug it appears to be the insurance companies and Medicare, which drives up the cost for everyone.

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Re: Prescription drug costs

Post by dm200 » Wed Apr 11, 2018 11:41 am

An acquaintence of mine is in the business of doing statistical analysis for, among others, drug companies.

He does not have medical credentials, but certainly knows how to read and understand the (alleged) effectiveness of various drugs. Of course, the newer drugs and those pushed by drug companies are much more expensive. It is his opinion that few new drugs, where there are already effective drugs for the condiiton, are any better than the older,cheaper ones.

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Re: Prescription drug costs

Post by schachtw » Wed Apr 11, 2018 12:05 pm

gasdoc wrote:
Tue Apr 10, 2018 11:11 am
Try Good RX, a free online discount company, that essentially gives you all of the negotiated "cash" prices of all of the pharmacies in the area you designate. I've also used Canadian companies for asthma inhalers.

gasdoc
+1 for using Canadian pharmacies. I’m always amazed as to what Part D drug plans won’t cover.
I’ve got asthma, and anyone who may have to pay retail knows how exorbitantly priced inhalers are.

It’s gotten to the point that my wife and I use Canada for most of our maintenance drugs. We only use local pharmacies for antibiotics and other one time medications. Thus far, our Part D premium payments are pretty much money down the drain.

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dm200
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Re: Prescription drug costs

Post by dm200 » Wed Apr 11, 2018 12:17 pm

Thus far, our Part D premium payments are pretty much money down the drain.
Note that most, but not all, Medicare Advantage plans include prescription drug coverage.

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Re: Prescription drug costs

Post by ResearchMed » Wed Apr 11, 2018 3:57 pm

dm200 wrote:
Wed Apr 11, 2018 11:41 am
An acquaintence of mine is in the business of doing statistical analysis for, among others, drug companies.

He does not have medical credentials, but certainly knows how to read and understand the (alleged) effectiveness of various drugs. Of course, the newer drugs and those pushed by drug companies are much more expensive. It is his opinion that few new drugs, where there are already effective drugs for the condiiton, are any better than the older,cheaper ones.
I did a lot of work in this area.

There can be patients who do not respond to Drug A, but do respond to Drug B, so even if the "percentage responding positively" (however measured, which is non-trivial at times) is similar, it doesn't mean there aren't patients who are genuinely helped more by B than by A.
Same situation with side effects. Some may not be able to tolerate A's side effects, but don't have a similar problem with B.
Or there can be drug interaction problems such that some patients "can't take" A, but could take B...

It's a very complicated - and fascinating - research area, and it gets even more interesting when one specifically studies placebos as well.

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Re: Prescription drug costs

Post by mouses » Wed Apr 11, 2018 5:57 pm

gasdoc wrote:
Tue Apr 10, 2018 11:11 am
I've also used Canadian companies for asthma inhalers.

gasdoc
An asthma inhaler for two months: $400 in the US, $100 via Canada.

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Re: Prescription drug costs

Post by goodenyou » Wed Apr 11, 2018 6:40 pm

If someone could crack the Ivermectin for dogs racket, that would be great. A "required" vet visit per year for a one year supply of Heartgard is getting ridiculous! And, I have 2 dogs!
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