01 April 2013

Pill Pushers

Like lots of people, I spend a good deal of time scratching my head about health care costs. I'm particularly sensitive on a personal level, because the health insurance that I have has a very high deductible - $10,000 a year for me and my daughter. We get a handful of things "for nothing", that is, outside of the deductible - like well visits, flu shots and mammograms - but we pay the "contracted" rate for everything else. That's things like sonograms, sick visits, lab work, prescriptions, casts, colonoscopies and all those other things one might need.

I recently had to refill two prescriptions for maintenance medications. I usually just get them at CVS, but I thought I'd check out the mail order website offered by the insurance company. Back in the day when I had an insurance plan with co-pays, you could get mail order drugs for less. One co-pay would get you 30 days at a retail drugstore, but two co-pays (double, that is) would get you 90 days worth of meds by mail order. Since there was a decent savings, it was worth the hassle of doing it by mail order.

Alas - it's not like that anymore, at least not through my insurance. While the pricing on the brand name versions of the two drugs was more or less comparable between retail and mail order, with mail order coming in slightly lower on the price per pill, I was a bit dumbfounded to find that the generic versions of the mail order drugs weren't less, they were actually A LOT more.

SourceQuantityPatient’s CostCost Per Day
DRUG AMail-order pharmacy90$58.94 $0.65
GenericRetail31$9.22 $0.30
DRUG AMail-order pharmacy90$400.49 $4.45
Brand NameRetail31$151.31 $4.88
DRUG BMail-order pharmacy90$101.85 $1.13
GenericRetail31$2.52 $0.08
DRUG BMail-order pharmacy90$474.12 $5.27
Brand NameRetail31$178.90 $5.77

In fact, it's so much more that I can't see how anyone would actually want to buy their (generic) drugs that way. Besides, even though CVS isn't exactly a local company, buying my drugs at the CVS that's down the road apiece keeps some of my money local, in the form of employee salaries and rent paid.

What is going on here?


RuthWells said...

Are you not able to get the generics through mail order? Because that should save you money over the 30-day supply at CVS. Unless it's another carrier altogether, I have never heard of the mail order costing more per day/dose than a local 30-day supply. I'm scratching my head.

RuthWells said...

Reread. Those prices are for GENERICS from mail order? This makes no sense.

S said...

I don't know the answer, but I'm impressed that you took the time to investigate this.

Anonymous said...

What is your opinion on generic vs other? Now I am reading that generics could be bad or not the drug that has the desired effect?!!!

V-Grrrl @ Compost Studios said...

My son has cystic acne that is kept in check with a Retin A ointment. Two years ago, it cost us about $60 (with insurance) for a tube. Last fall it went up to more than $80. When I had it filled in February it was $120! I asked the pharmacist if the manufacturer or formula had changed: nope. Then she told me that without my insurance, it would cost $400. Seriously? For Retin A, a product that is neither new nor revolutionary? UGH.

Did you read the recent Time Magazine article on health care costs? It was a widely circulated link about a month ago. I think the article was titled Bitter Pill. Read that and your eyes will be opened to the sheer randomness of health care costs and the huge impact they have not just on individuals but on our economy.

Heide Estes said...

Weird. Mail order is such a pain in the neck, but the economics of it pretty much forces us to do it.

the queen said...

Why would we WANT to go through mail order? We don't. They make us. My current insurance will permit you to fill a script twice at the CVS, then after that you have it get it through mail order if you want them to pay anything at all.

And my company calls my plan a "high deductible" plan. Yeesh! They haven't heard about yours.

Mayberry said...

Whoa! Crazy. One of my generics used to cost 68 CENTS. A MONTH. After January 1 it jumped past $1. Obviously, still great, but what made it almost double?

Anonymous said...

Buy it at DrugMart. They are very local and live in town.

Jody said...

I do not KNOW, but I think that most of the walk-in pharmacies now sell generics at rock-bottom prices as a promotional policy. Remember when Wal-Mart started selling $4 generic prescriptions? It was a loss-leader type situation to get people to buy their expensive prescriptions at Wal-Mart (I think, I am not 100% sure). That drove all the other chains to do the same.

Meanwhile, the mail-in folks get most of their business from mandated purchases (we MUST buy most prescriptions via mail or pay a massive penalty), plus they don't have the same level of comparative competition (quick, name more than one mail-in company and tell me how to buy drugs there), so they haven't been forced to lower their generic prices as much.

This is theory, though. Maybe something else is going on.

Retin-A probably keeps going up because demand keeps going up. It's not the teen-acne users but the middle-aged wrinkle-fighters that allow the manufacturer to drive up prices.