Millions of Americans do not have insurance that covers prescription medications. They are being hammered by rapidly rising drug costs.

What makes these skyrocketing prices so painful is that they come at a time when the economy as a whole is in the doldrums. So many people have lost their jobs and their health insurance that they can no longer afford their medicine.

A new report from the Government Accountability Office (GAO) documents the increases. In many instances, prices surged from 100 to 500 percent. That’s bad enough, but 26 brand-name prescription drugs were up more than 1000 percent.

Drug companies have been especially cruel in some of the choices they have made. With so many people out of work and worried about their finances, you might think that the pharmaceutical industry would cut them some slack when it comes to medications for symptoms of anxiety or depression. Au contraire.

Roughly one third of the big price increases were for medications to treat nervous system disorders. For example, some of the brands that made the GAO list of extraordinary price increases include Abilify, Adderall, Ambien, Lyrica and Zyprexa. Others are antibiotics such as Biaxin, Levaquin or Sumycin, or heart medications such as Inderal, Lanoxin or Lipitor.

The GAO report acknowledges that even though there are more than 400 drugs that have seen extraordinary price increases, this is a very small percentage of all the drugs on the market. Nevertheless, it has a big impact overall. Drug spending has risen roughly 10 percent a year for the last decade. This raises costs for insurers, hospitals and ultimately for patients.

Some pharmaceutical manufacturers maintain that competition and manufacturing challenges account for the increased prices. Other experts speculate that the firms may be trying to beat a health care reform deadline.

Switching to a generic drug, if it’s available, can save a lot of money. Some people find, however, that the substitute is less effective: “My husband has been taking Ambien to sleep for 15 years. We recently moved and switched pharmacies. The prescription was filled with a different generic and he went from sleeping like a log to tossing and turning all night.

“Today he called the pharmacy and the pharmacist told him that he was probably just getting used to it (after 15 years!). Then my husband called his doctor and got a prescription for name-brand Ambien. It cost $290 for a 30-day supply!

“That just seems unfair. Over the years we have taken many generic prescriptions and given them to our kids without ever suspecting a problem. I don’t think the pharmacies and the drug companies should be making all of their decisions based solely on the bottom line when dealing with the health of their patrons.”

To learn how to use generic drugs wisely, along with ten tips for economizing at the pharmacy, we offer our Guide to Saving Money on Medicines.

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  1. Marcus

    I have been taking Nuvigil for my problems falling asleep at work and have had hassles with my insurance company every time I refill. Until now after delays and paperwork they covered my prescription and I paid just over $200 for my prescription which is enough for the pharmacy to ask me if I realize the price when they refill my prescription (when a new person is working at the pharmacy).

    This time, I was refused by my insurance company. I need this drug in order to stay awake during the performance of my drug and started taking the drug because I was in danger of being fired from my employer. I asked the pharmacy how much it will be without my insurance and was told it will cost nearly $600! Unfortunately it sounds like there are no other drugs available that are cheaper.

    I looked into Provigil but from what I’ve been told it is even more expensive than Nuvigil and it is also on the pre-authorization list for my insurance company meaning I will have delays and eventually be denied refills by my insurance company. Is there any legal alternatives to Nuvigil than takining illegal drugs or taking a trip to Canada every 30 days? Unfortunately there are no generics available for either Nuvigil or Provigil which seem to be the only 2 prescriptions used to treat daytime sleepiness associated with sleep apnea. I use a CPAP machine but still have problems with daytime sleepiness.

    I wish I could completely avoid having to take these drugs but my job could be put in jeopardy if I’m caught sleeping on the job. I already had to leave work one day because I kept nodding off since I was concerned my boss will see me. I find it outrageous and it isn’t like I can vote with my wallet and refuse to take these drugs for cheaper alternatives when there isn’t cheaper alternatives. I’m wondering if drug companies purposely run generics out of business or create new drugs when their patent expires to avoid having to compete with generics. Are there any alternative treatments to Nuvigil/Provigil that will help me stay awake?

  2. L

    It’s insanely unfair. This, to me, signals the end of civilization more than most other horrible things happening. They just don’t care about the daily needs of people… so people who need Provigil can’t afford it from July to December? Should I stay off the roads from July to December because people are asleep behind the wheel because they need to use their money to EAT and pay utility bills instead of spending 1000 on a drug they need? What a world.
    To think, as little as 6 years ago I got my ambien, brand, 20mg’s a day (can you believe it) for like 20 bux. Now, it’s dang me, you need to pay 95 a month and from June to December 202 a month?? Am I eating gold nuggets?

  3. BH

    Does anything really matter anymore? We are at the mercy of the insurance and pharmaceutical companies, none of which seem to be suffering the same loss of income the rest of the population is seeing. I, too, need Provigil, but have to fight with my PDP insurer about it and pay over $1,000 for a 30 day supply when I hit the gap. It is insane, but how can we fight it?
    We are paying for all the expensive advertising and “sales expense” for the pharmaceutical companies.

  4. LB

    I was sent to have a sleep study done after experiencing serious symptoms, such as extreme sleepiness in the afternoon; I literally was falling asleep at the wheel. The study showed severe sleep apnea and other bad things. I started using a breathing device at night but, unfortunately, this does not take care of my daytime sleepiness. Then the doctor added Provigil to my treatment. This is literally a live-saver for me. My insurance made a lot of objections but eventually agreed to cover it. Even so, the deductible is $180 per month and caused my benefits to run out about three months before the end of the year. Then the cost went to $560/month. I made do without the medication until the new year started.
    In a few weeks I am losing my current insurance which was through a former employer and became a sort of supplement to Medicare after I joined the latter. I will have to use the “Part D” supplement for my medications. Several companies I looked into do not have Provigil (or Nuvigil) in their formulary. I chose one that does but charges $860 for a month’s supply. Between this and my other prescriptions, I would exhaust my benefits in two months!
    I have been rationing the medication by taking only one on days when I do not plan to do much in the afternoon. (I am supposed to take two pills a day.) At the new rate I simply cannot afford this medication. Yet, without it, I am a total zombie.
    I tried buying generic Provigil from a Canadian pharmacy which obtains it from India. I cannot be sure, of course, but it did not seem to be the real thing – it had no effect on me. The alacrity with which they took it back and refunded my cost reinforced my suspicions. Incidentally, I have a Ph.D. in Chemistry and am a great proponent of generics, so my objection did not come out of ignorance.
    Why is this particular drug so ridiculously expensive? Sleep problems are not a rare disease requiring a rare drug, the reason usually given for high cost of certain medications. Does anyone have a suggestion for a difference source with which they had good experience?

  5. isaac

    Keep in mind that the pharmaceutical industry has laid off 20-30% of its workforce in the past few years. Couple that with some very large and expensive clinical trial busts (torcetrapib failed in Phase III after Pfizer dropped nearly $800 million in it, yes nearly a Billion dollars). And then countries collectively bargain for lower prices or they threaten to break patents and infringe upon their discovery. Like any business, they’re going to try to make up the difference somewhere.
    If we could import drugs from Canada, the US costs would go down and the Canadian costs would go up. Unfortunately, it’s the American public that foots the bill due to lawmakers. It’s not simply a case of the evil and greedy pharmaceutical company. Most people don’t realize that you’re not paying for the cost of that pill. You’re paying for the 9 other experimental drugs that failed in clinical trials (only 1 out 10 compounds that start in Phase I actually make it through to be successful in the clinic).
    Rest assured, though, that if pharma is not allowed to profit, new drugs WILL stop. It’s simple economics. No investor will invest nearly a billion dollars on such a risky venture that takes over a decade to realize. High risk/high reward. The lion’s share of medical research, development and new therapies are commercialized in the US for a reason.

  6. danna

    I ordered People’s Pharmacy brochure re: drugs and picked one of the Canadian pharmacies listed. I take Provigil and it was costing me $300 when I went into the drug “gap”. I got a 60 day supply from my pharmacy in Canada (I live in TX) for $135. After Jan 1, 2010, I had run out so I just went to my local pharmacy which I use and a 30 day supply was $88. BUT, it will go back up when I hit the “gap” again. I have nothing but good things to say about the one pharmacy I used in Canada and will order from them again. We also ordered my husband’s Plavix from them when he went into the gap last year and the savings were also substantial.

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