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The Drug Industry Hates Efforts to Control Drug Prices

Is it possible to control drug prices? California is trying but the pharmaceutical industry is fighting back. A new law is challenged by PhRMA lawyers.

Even if you have great health insurance you may not be protected from high drug prices. For one thing, there is the deadly co-pay problem. For another, insurance companies may not be willing to pay for the latest and greatest medicine your doctor has prescribed. If it’s not on the formulary, you may have to accept a different (cheaper) medicine. California has attempted to control drug prices by passing Senate Bill 17 (SB17). Now PhRMA is fighting back!

The California Revolt:

Most people grumble about the high costs of medicine. Legislators in California actually did something about them. Although the law won’t take effect until January 1, 2019, the lobbying group for the pharmaceutical industry is fighting back with a lawsuit. What’s got drug companies so excited?

Drug pricing is super secret. Companies have all sorts of ways of obscuring costs. Rebates and discounts are classic ways the industry has made it hard to track actual pricing.

California has tried to cut through the cotton curtain surrounding drug pricing policies. SB 17 forces drug manufacturers to inform the government and insurance companies 60 days before they raise prices over 16 percent. That’s not 16 percent in one year, but spread over two years. The companies would have to explain the reasons for the price hike.

Drug Companies Sue:

That may not sound radical to you, but the pharmaceutical industry is not at all happy about this bill. The trade group, PhRMA, has filed a lawsuit to prevent its implementation.

PhRMA has also sued the state of Nevada. In June, Nevada lawmakers enacted a bill that requires the makers of diabetes medications to disclose profits if they raise list prices too steeply.

The outcome of this litigation is unclear. We suspect that the deep pockets of the pharmaceutical industry are likely to slow down any state attempts to control drug prices. What can you do in the meantime?

How You Can Control Drug Prices:

We have been writing about out-of-control drug prices for decades. We used to think that generic drugs were the answer but there’s a problem, Houston:

1. Some generic drug prices have skyrocketed

2. We have come to doubt the FDA’s ability to approve and monitor generic drugs in a safe manner. You can read about our concerns in this regard at these links:

Why We Have Lost Confidence in Generic Drugs: New Report Casts More Doubts on Imported Medicines

Indian Generic Drug Company Spanked Again by the FDA

Why Celecoxib Is Not Working and What Can People Do?

What can you personally do to control drug prices? In our Guide to Saving Money on Medicine we offer lots of detailed suggestions. Here is is just a sample:


1. Whenever you can, make changes to your lifestyle that may help reduce the number of prescription drugs you need to take. Exercise, weight loss, real food and relaxation techniques are all very effective for helping to reduce blood pressure, cholesterol, anxiety, depression, and insomnia.

2. Consider non-drug alternatives such as home remedies and dietary supplements. You may find that vinegar and Listerine soaks or topical Vicks VapoRub are as good for fighting toenail fungus as prescription Jublia, with the added virtue of being much cheaper. Coconut water, almonds, chewing gum, fennel, yellow mustard or DGL (deglycyrrhizinated licorice) may ease heartburn without the cost or side effects of PPI drugs.

3. Talk to your doctor and pharmacist about over-the-counter drugs, which are often far less expensive than prescription medications, and frequently equally as effective. For example, there are now many effective OTC allergy medicines available.

4. Discuss your cost concerns with your doctor, and ask her to consider prescribing the most cost-effective medication for your condition. There may be several options available to you. Also talk to your doctor and pharmacist about whether or not it is safe for you to split your pills. Sometimes the difference in price between 5-milligram, 10-milligram, and 20-milligram tablets is negligible, and simply buying larger doses and splitting them at home can help save money. But not all pills can be split safely.

5. Find out if you qualify for free medicine. The pharmaceutical industry has a program for helping those in serious financial need get their prescription medications. To see if you’re eligible, visit www.helpingpatients.org or call 888-477-2669.

6. Shop around! Prices vary between pharmacies and online services. Secret shoppers for Consumer Reports surveyed over 200 pharmacies around the country. What they found was shocking: “In short, prices can vary widely from retailer to retailer, even within the same ZIP code. Drugs could cost as much as 10 times more at one retailer vs. another.”

7. Haggle! Americans negotiate the price of a new or used car. What they don’t realize is that it is also possible to negotiate with a pharmacist about the price of medicine. Consumer Reports suggests asking, “Is this your lowest price?” This is especially true if you pay out of pocket. Do not rule out independent pharmacies. They may beat the chains and are more likely to negotiate.

8. If your insurance company requires that you take a generic drug, ask your pharmacist to seek out the authorized generic, which should be identical to the brand name. It may even be made on the same production line. Though it might be a bit pricier than other generics, it will be far less than the brand name. Authorized generics are especially important if your medicine has a narrow therapeutic index (see page 11). When taking a generic drug always monitor your reactions (both lab records and subjective responses).

9. Control your quantity. See if you can try a free sample when you start a new drug to make sure that you can tolerate it and that it works for you. If you can’t get a sample, ask your pharmacist to dispense a trial dose. If you decide to go ahead with the prescription, you might save money by buying in bulk from big-box pharmacies like Costco. Consumer Reports found that Costco offered great prices and you don’t have to be a member to buy Rx drugs there. During the open enrollment time period of your insurance plan make sure your medications are covered. Plans change drug coverage from year to year.

10. Shop online. Consumer Reports suggests GoodRx.com to “learn a drug’s ‘fair price.’” Visit PharmacyChecker.com and CIPA.com to find verified Canadian pharmacies (see page 16 of this guide). This may be especially important if you need to take a brand name medicine that is prohibitively expensive in the U.S. and is a narrow therapeutic index drug.

To get much more information about how to control your personal drug costs, check out our Guide to Saving Money on Medicine. You will learn about authorized generics and much more information about Canadian pharmacies. Here is a link to the Guide.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Many of us give to charitable research for medical conditions, (cancer, Alzheimer’s etc)…..is this just so that drug companies can fund their research on our dime and then charge exorbitant prices that we can never afford? Only the wealthy will get the benefits?!?

There are some drawbacks to having your prescriptions scattered over multiple sources (Canada, retail pharmacies, mail order, etc). Although all use computers, there is no link between different businesses (each particular chain may have your profiles linked, but not between 2 different drugstore chains). Therefore, other than your doctor (and only if he is your only doctor), no one has your complete profile of the medications you take and possible serious interactions, unless you provide each with a complete medication list. (If you have insurance they may show interactions when the claim is processed, even if you bought it at a different corporate entity). Many doctors aren’t aware of all the interactions either.
If you pay cash, you might be able to haggle, but if you are on insurance forget it. Most third party insurances do not allow copay discounting, nor will most chains do it. I suggest avoiding peak hours (Mondays, Fridays before holiday weekends, Tuesday after long holiday weekends, etc) if you decide to have this kind of discussion with your pharmacy. And don’t do it at the drive up window.

The PHarmacy Sector is THE MOST PROFITABLE in the US. This is on the backs of sick people who need their wares, and the taxpayer for Medicare and Medicaid. The VA can negotiate prices, as do most other countries, including Canada. And their oversight of the manufacturers is far better than our FDA. This is criminal! HOoray to Nevada and California!

I have saved money and had fewer side effects by switching to more natural products. I do follow my doctors orders and discuss with him what I am doing but in many cases things like turmeric, cherry and blueberry concentrates and some supplements solve sleep and arthritis pain problems.

I have on more than one occasion seen drug company reps on TV explaining that they “have to” charge Americans so very much more because other countries dictate to them what they may charge and “someone” (Americans) has to make up the difference. Sorry, I don’t agree that Americans should have to foot the bill for the rest of the world. Other countries have become used to relying on Americans for whatever the rest of the world wants but doesn’t want to pay for.

For the past ten years I have ordered my prescription medicines from UniversalDrugstore.com It is a very well regulated store in Canada. They will not ship unless they receive a doctor’s prescription. Costs vary but generally I save about half. For example have your doctor write your script for mail order. Then fax it to them. The local price of my medicine is $200 my Canadian pharmacy charges $100 for same thing. Same manufacturer.
George M.

George, I went on line to your Canadian pharmacy and found the following, and I wonder how they have a physician review a new customer’s complete medical history as they state? TIA

I am a customer with a local physician; can I have my prescription filled through your international prescription service?

Yes, you can. We require that you complete and sign our patient questionnaire/order form, and mail or fax it to us along with your valid prescription. For orders filled by our contracted Canadian pharmacy, they have a licensed Canadian physician who will review your entire medical history against your written prescription and once satisfied will issue a new prescription under his/her Canadian license so we can fill your order. Please note that this is solely the case with orders filled from Canada and may be different in other countries.

Bringing down drug prices should be a primary thrust of the government with regard to reducing Medicaid and Medicare costs, not reducing benefits to those who have earned them or to the needy. I live near the campus of a Big Pharma company and I can tell you that they vastly overpay their employees; high school graduates are receiving big paychecks and half million dollar retirement funds for doing secretarial work, and I’ve heard this directly from employees. Some years ago the company polluted local bodies of water to the extent that they were court ordered to install residential water systems to replace wells that had been poisoned. They continue to dump their waste illegally and were caught destroying a pond where children used to play within the past few years. They’re fat and rich and arrogant. Those big paychecks and huge retirement funds come from the pockets of everyone who takes prescription drugs and everyone who pays taxes.

It isn’t just the elderly who are being drugged up to the gills (on average, eleven prescriptions per senior, I’ve read), many Medicaid recipients are formerly institutionalized mental patients who are heavily medicated, often to their detriment.

We, the general population, have to start thinking for ourselves and taking responsibility for our own health, not looking to doctors and prescription drugs to fix what we ourselves break with junk food and mental and physical inertia. As many learn too late, prescription drugs and surgery can’t reverse the damage already done and often leave us even worse off.

In some instances they may be doing us a favor by price gouging. If we don’t have $$$$, we will tend to look for a different option.
That might include getting a price reduction from the pharmaceutical company itself.

Like all big business, pharmaceutical companies control the government instead of the other way around. America will never truly be great again until we take all the money out of politics!

Membership retailers, e.g., Costco, are not obliged to provide pharmacy services to non-members in all states. From the Costco web site: “Costco’s pharmacies are open to non-members where required by state law. The Costco Member Prescription Program is a value added benefit of a Costco membership. However, you do not have to become a Costco member or join CMPP to continue buying prescriptions at the pharmacy. “

AMEN. Thank you for saying it!

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