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Have Prescription Drugs Always Cost an Arm and a Leg?

My company started a new insurance plan last year, which uses a combination PPO with a Health Savings Account.

With this new plan, I have a very high deductible ($2000 idividual or $5000 per family). Once this deductible is reached in a calendar year, the insurance kicks in and there are no additional out of pocket expenses.

As part of the plan, my company “funds” our HSA for us as one of our benefits. So, every quarter, my company puts an additional $1250 into my HSA. All money in this account roles over from year-to-year, and anything that I haven’t don’t spend, when I leave the company, it is mine. I can simply cash it out (or transfer it to another HSA).

I have a separate Master Card from the insurance provider, and I simply use this card to pay for doctors visits or other medical expenses (until the $5K deductible has been reached).

It’s a good plan — last year, I only went to the doctor once ($239 visit). So, I rolled $4, 761 over into this year. If I didn’t spend any money on the doctor this year, I would have nearly $10K in that account.

______

I explained all of that to get to this — HOLY SHIT, have prescriptions always cost this damned much money? On insurance plans I’ve had in the past, I usually had to pay a $20 co-pay or deductible at the pharmacy, and the insurance picked up the rest.

Today, I had to go pick up an prescription for my wife who was diagnosed with pneumonia this morning. Since we haven’t reached our $5K deductible yet this year, we paid the full price (using the HSA credit card).

The doctor prescribed her 10 ea antibiotics (moxifloxacin) and a small bottle of cough suppressant ( Tussionex — which is chlorpheniramine/hydrocodone extended-release suspension).

The small bottle of cough suppressant was “only” $58. However, her antibiotics were $112. For 10 pills. When the guy said, “That’ll be $170.”, I was floored.

She needed some prescription allergy medication last week (Allegra) — that prescription was $128 dollars (60 pills).

Seriously — I had no idea that prescriptions were so expensive.

Posted by Robbie Cooper on Sunday, February 3rd, 2008 | Trackback |

11 Responses to “Have Prescription Drugs Always Cost an Arm and a Leg?”

Yeah, it’s rough. One way to (sometimes) knock a good bit of cash off the price is to buy generic instead of brand name scrips (usually the doc will tell you if you absolutely MUST get the brand he prescribes).

Left by John Jarzemsky on February 3rd, 2008 at 6:38 pm

there is no generic for moxifloxin yet. it’s a super antibiotic still under patent. it gets both gram negative and gram positive bacteria. did your wife’s doc do a culture? no, i’m sure he/she didn’t. they just reached for the antibiotic that gets it all. pneumonia is serious stuff. people die of it. want the best? want something that might work? i know the answer. you want the best that works the quickest.

think about this when you think about universal health care. I support universal health care, by the way, but i’m real warry of the details.

Left by Dianne on February 3rd, 2008 at 7:41 pm

Stop bitching. Mexican pharmacies are great.

Left by Anonymous on February 3rd, 2008 at 7:50 pm

Dianne — she had blood work done to determine what was wrong with her and what to give her.

She caught pneumonia about 4 years ago while she was at a real estate convention in Las Vegas. When she woke me up at 4:00 a.m. this morning, she said she felt the same as she did then…she was certain it was pneumonia again.

She’s feeling a bit better. Her fever was 105 when we got her to the Emergency care facility this morning. She was down to 100 a few hours later, but spiked for a short time this evening at 103.

The syrup (liquid Vicodin is really what it is) has helped her get some rest.

Left by Robbie Cooper on February 3rd, 2008 at 10:36 pm

Best of health to your wife.

Left by Preston on February 3rd, 2008 at 10:46 pm

I would have to say that it all started with HMOs. Before that, in the 80s, it wasn’t so bad. I don’t know why there is a connection, but that is what happened.

I have MS and take an injection of copaxone every day to hold off the damage. The cost? $998 a month. Not $9.98. $998.00! If I didn’t have insurance, I wouldn’t have my medicine.

I don’t think government health care is the option. I have already had one doctor tell me that he will retire if we go to that. I do, however, think that there is something rotten that needs to be dug up and purged in the medical industry.

Left by Terr on February 4th, 2008 at 7:49 am

Robbie…glad to hear she’s on the mend.

Left by Dianne on February 4th, 2008 at 8:53 am

After I left my government job, I paid the same premiums for my HMO that they did. When Cobra ended, my premiums shot up 50% and so did my Rx bills. What meds once cost $10, now was $400. In other words, the self-employed are stuck subsidizing medical care for government workers and illegal aliens. It sucks. However, I don’t think these government plans are the solution.

Left by Anonymous on February 4th, 2008 at 8:58 am

I’m no expert but based upon all the things I’ve read about it over the years,. there are many factors that impact the costs of medicine. I can outline a few.

Most pharmaceutical development occurs in this country. That is because most of the socialist countries in europe that have robust enough economies to support it, also have socialized medicine and the attendant price controls. That means that if pharma companies there invest in R&D, they’d go bankrupt because they wouldn’t be able to charge enough to offset the costs.

Because companies can’t sell their drugs in countries that have price controls at high enough prices to pay for R&D, they have to charge more where they AREN’T contending with those controls to make up the difference. That would be right here in the good old USA.

Many people note that drugs in Canada are cheaper than here and suggest that we stop buying from the domestic companies and import our drugs from Canada. What they don’t realize is that those low prices are mandated by the Canadian government. If we did what they suggested and the drug companies lost the ability to make enough profit to fund the R&D, guess what happens? No more R&D. No more better, faster, stronger drugs…no more miracle cures.

Another reason for the high costs of drugs is because there is a significant number of people who are provided drugs at reduced prices because of g0vernment subsidies (medicare, medicaid, etc) and the attendant government price controls. The companies are required by law to provide the drugs but at government mandated prices. Those lost profits must be made up from somewhere. They are made up from private insurance companies and those who can afford to pay for their own medications.

Another place that the companies have to make up for is most Pharma companies have programs whereby qualifying people (poor, elderly, disabled) get their medications provided to them free. It’s a great PR move for the Pharma companies, but they don’t just magnanimously decrease their bottom line to pay for it. They make it up by averaging those expenses into the price of all the drugs purchased at full price.

Those are just some of the considerations…the fact that untold millions and billions of R&D money is spent on drugs that never pan out or are not approved by the FDA. The FDA process itself which delays the release of new drugs for (sometimes) years, etc. etc. etc.

If there were no price controls anywhere in the world, if there were no government mandated price caps, no charitable freebie drugs, the FDA was streamlined and the market was allowed to work drugs would get much cheaper very quickly. It would happen even faster if there was no influence by insurance companies. If EVERYONE had to face the reality of what their prescriptions cost, perhaps we would have the dual benefit of a less medicated populace and lower drug costs…the industry would be forced to find ways to lower the prices charged.

Anyway, I’m rambling. The point is that there is no simple solution and there are no free lunches. Everything has a cost and every policy has unintended consequences.

Left by Sailorcurt on February 4th, 2008 at 9:07 pm

“Seriously — I had no idea that prescriptions were so expensive.”

And that’s the sunny side (and a direct consequence) of the US health care system which is all about the money and has nothing to do with ‘care’.

US Health Money System..

Left by Jacques on February 7th, 2008 at 1:38 am

Anyone Tried those PPA Programs?

My scripts cost me about $480 a month, and I have no prescription coverage. Has anyone ever tried to get on those drug companies PPA plans? Well, it is a nightmare…seems like they are there for the PR, so they can say they have ways of helping people that can’t afford their scripts. I have 4 scripts, all from different manufacturers, of course…so I applied to the PPA’s for all four…after taking about 2 weeks to track them down and get the forms. I finally gave up after about 2 months of constantly having to re-submit every single application I made, to all 4 manufacturers, due to various “problems” with the forms I submitted. My doctors office even tried, but they gave up, as well.

I was refered to a website by a registered nurse I know to see if I could get on the PPA’s for the drugs I have…if she had not refered me I would not have even tried, but she had good results with these people. It is a great site and I found out why I had been unsucessful in my attempts. Well, after about an hour I got my scripts for $80 a month, and I get 90-days worth at a time. I am not affiliated with this site, and I rarely recommend anything like this, but if you want to find out about PPA’s and actually get on the PPA’s this is the website to visit first. http://www.medwisehealthcare.info ALWAYS take anything you read on the web with a grain of salt, but do look at this site if you need help with your scripts.

Good (and affordable) health to all!

Kelly

Left by Kelly Garrett on February 28th, 2008 at 3:24 pm

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