What You Must Know About Your Medicine’s Cost

Everyone should know that the costs of pharmaceutical medicines in America are out of control. I’ve used this example several times and it is nothing special, just what millions of Americans experience every time they go to the drug store. A friend found himself suddenly facing a needed life-altering drug that runs him over $1,900 a month.

While I don’t know any of the manufacturer’s arguments for that drug costing so much I can easily assume, and likely be correct, that a degree of excessive profiteering is somewhere in the formula.

To be honest, there is often a great difference between what the manufacturer sets as the price and what an insurance company actually pays. For example, the suggested retail price for a 90-day supply of an acid reflux drug is over  $14,000. What the customer actually had to pay was $24. I don’t know how this is explained but I’ll bet the farm that somewhere between those two numbers there are lots of people and medical care providers who are charging more than $24. Someplace in this thick jungle of pricing can be found some of the answers to why American health care is the world’s most expensive.

NBC Nightly News just reported another pricing scheme that’s driving up the costs and fattening the pockets of big pharma. It’s the practice of combining two low-cost and readily available drugs, giving them a fancy-schmancy new name, and jacking the price into the stratosphere. One example provided by NBC centered on Merck’s drug Fosamax Plus D. The drug is made by combining the generic components of Alendronate and vitamin D3. The actual cost of this new pill is $1.25 but Merck is suggesting the cost be $39.05 per pill.

Another example is Zegerid, made by Bausch Health Companies. It is intended for treating acid reflux and the combined ingredients are the over the counter drug Prilosec and common baking soda. The ingredients cost .47 cents and Bausch is suggesting the new pill cost $86.29.

None of the companies involved agreed to speak with NBC and it was noted that both doctors and patients are often unaware of what big pharma is doing.

It is drastically important to know that under current law Medicare Part D, the federal government cannot negotiate drug prices with the pharmaceutical manufacturers. So when politicians want to rant about the high cost and instability of Medicare, remind them that their refusal to change the law is directly at fault.

For the complete NBC story, click HERE

One thought on “What You Must Know About Your Medicine’s Cost”

  1. How well we know about the cost of drugs. AS you pointed out the Government goes on and on about cost of Medicare but yet they and only they have the power to change the cost of medicine paid for by Medicare. My Symbicort Inhaler for 3 months cost this month almost $400. To be fair – for the month of January we pay a co-pay of $95 on each RX a Tier 3 and above. On meds Tier 1 cost us zero, but if you review your EOBs you will see what Medicare and Supplement pays!!!!! Once again the Government (Dems and Repubs) could very well change by being able to negotiate cost. Conclusion : Big Pharma pays a heck a lot of what I would call “kick backs” to the appropriate government officials. This same government does have the ability to negotiate medicine cost for Medicaid! Most time I feel like the only people that count in this country (sorry to say this) are the government and the top 1%, By the way Aref’s and my Medicare Supplement is the Advantage Medicare Supplement by UNHC. We pay one monthly payment each for our Medicare supplement. And then we pay $140.00 extra out of SS each month for Medicare. Aref has always been on Advantage because when he was SSI due to MS (filed 2007 approved 2009) and than 2011 Medicare Disability kicked in. He was diagnosed 2004 and worked until 2007. On Disability and Medicare(Medicare does not kick in for another 2 yrs after approval for SSI) before age 65 Disabled person has to have an Advantage Supplement. The regular Supplement Medicare insurance is not available. Another little thing most people do not know. Advantage Worked out fine for us, less expensive monthly. Pays out pretty much the same. My first year turned 65 and went on Medicare – BC/BS took me to the cleaners with the normal 2 supplements! Next year 2013 I went on Advantage and have not looked back. That was the year we changed from BC/BS to UNHC. Opps, better stopped my ranting and get off my soap box! Have to say, we retirees are caught between a “rock and hard place” . At this point in our life with things as they are – what would we do without Medicare? We couldn’t afford the cost of medical care or medicine.

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