Why are drugs so expensive?
Drugs can be extremely expensive so much so that patients find them unaffordable. Many a times, patients have experienced going to their local pharmacy to pick up their prescription only to be confronted with an astounding price tag.
Sometimes, it could be a new treatment prescribed by your doctor without mentioning how pricey it is. Other times, patients find that a medication they have been taking for a while, which was once affordable is now being marketed at an extraordinary price, due to a change in market conditions or insurance coverage.
The cost of medicines in the U.S is so outrageous sometimes that it becomes unaffordable, for example, in 2015, the price of Daraprim, which is used by AIDS and transplant patients soared from $13.50 per pill to $750. Raviciti, used for urea cycle disorders cost about $794,000 for an annual treatment while Glybera, a drug for treating familial lipoprotein lipase deficiency (LPDL) cost about $1 million per year.
According to a January data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics, ‘nearly 1 in 10 of American adults do not take their medications as prescribed because they cannot afford to.’
Over 40 million Americans have no health insurance, and millions more have limited health insurance coverage, which means that many Americans just can't afford healthcare.
A lot of reasons contribute to why drugs are expensive and patients don’t understand why; these include; no price controls, market exclusivity (patent rights), product shortage, increasing research and development costs, insufficient competition, small markets, change in your insurance coverage, availability of fewer new generics, etc.Lack of Price control
The US government doesn't regulate prices, unlike many countries where their government agencies negotiate prices for every medicine, the manufacturers set wholesale prices based on what competing brand-name medicines cost and whether their new medicine is better.
Market exclusivity (patent rights).
According to the Journal of the American Medical Association, it was found that market exclusivity is the reason why manufacturers charge so much for prescription medicines. The Intellectual property rights are strongly protected by patent laws, and the exclusivity of these rights lasts for years. Some delay the entrance of generic substitutes to the market.
Patents last longer in the U.S than in any other country, usually giving a medicine's maker exclusivity that prevents competition for 20 years from when the patent is issued. Patents however, are filed while the medicines are still in testing, that clock starts ticking long before the medicine goes on sale.
The manufacturers generally increase their prices every year, by about 5% or more which adds up and become bigger as the expiration of the patent approaches.
Medicine shortages are caused by many factors which include difficulties in acquiring raw materials, manufacturing problems, regulatory issues, business decisions and irregular supply chain. Though, most product shortages occur when the manufacturing facilities run into a quality control problem and may be forced to slow down on production or even stop production briefly. The only option may be the more expensive brand-name medicines.
There isn't enough competition to hold down prices for many medicines, so, many older generic medicines were priced too low to be profitable which cause some manufacturers to stop making them. Once only one company or two companies are making a medicine, the price usually shoots up, while some manufacturers have de facto monopoly on some brands, because the brand-name medicines that treat conditions are too rare to attract multiple manufacturers.An uptick in development and production costs.
Research is becoming increasingly expensive. Industry groups say it can take about a decade and well over $1 billion to get a new medicine approved, though that includes developmental costs for the many medicines that don't work out.
The most-exorbitant new medicines are biologics, produced by living cells under precise conditions, which costs far more than mixing chemicals to make pills. Therefore, this can lead to an outrageous hike in the prices of drugs.
Medicine manufacturers set high prices for many new medicines that are for rare conditions, or cancer sub-types involving a particular genetic mutation, because they are not common. So, they help just thousands or hundreds of patients, in order to recoup the research and development costs of such medicines in no time.
Availability of fewer new generics.
Because of the cost incurred in development of new medicines, fewer generics have been made available, and brands that are available are more expensive.
Not being able to afford your medications has many health consequences, ranging from health deterioration, illness, resistance especially for antibiotics, etc.
About 40 percent of patients say they cut corners with their medications to make ends meet, they split their pills without their doctor’s consent, skipped doses, or didn’t fill their prescriptions. Some even avoid seeing their doctor or go for medical procedures. All these can be disastrous and ultimately more costly than the medicines themselves.It’s time to figure out how to save the most possible from your wallets: Here are the best deals and steals you can get from your local pharmacy:
It sounds crazy that you may have to approach buying of your prescription drugs like you would a house—by shopping around and horse-trading, but that’s how it is now in the pharmaceutical market. This is because prices can vary widely from store to store that are even in the same town or locality. Shopping around helps to find out what various retailers, big-box retailers and chain drugstores are charging. For example, a shopper quoted a coupon price of $41.33 forAugmentin at Walgreens, while, Kroger pharmacy said it would sell the same medicine for just $18.97.
Only very few patients understand pharmacy economics well enough to be able to negotiate prices of their prescriptions with their pharmacist, and that is the reason some local pharmacies earn much higher profits on those patients that are uninsured or under-insured.
Shoppers sometimes found that they could get a discount on their prescription, but only after they asked. Asking can prompt the seller to reduce the price considerably, or to provide information on any available discount programs or coupons. “Retail pharmacies don’t really expect anyone to pay those high prices, the list price is just a fantasy number,” says Adam Fein, Ph.D., president of Pembroke Consulting.
As frustrating as sudden price hikes can be, a recent Consumer Reports poll showed that just 1 in 4 patients talked to their doctors about cost. Your doctor probably would not broach the topic of price. Let your doctor know if the cost of your treatment is important to you. You can negotiate a lower price with your doctor. Make him aware of your financial limitations, he may be willing to negotiate an affordable payment plan for you so that you can get the best affordable form of the medications for your treatment.
Patients should always check back on their local pharmacies often because prices and offers may change, you should never assume that one pharmacy’s “discounted” price is lower than another’s regular price, because ‘prices are not always set in stone.’
Why getting a brand-name drug for $30 when you can actually get the generics that will do same work for $5?
According to the FDA, generic drugs are required by law to have the same active pharmacological ingredients and activity as the brand-name medicines, but most brand–name medicines are really expensive. Whereas, generics could cost up to 90 percent less than brand-name medicines. This infer that you will be getting the same medicine, same active ingredients, and same effects at a fraction of the cost.
Regardless of which drugstore or local pharmacy you use, choosing generic over brand-name medicines can save you some costs, tell your doctor if your health insurance does not have coverage over your prescription drug, in this way he may be able to prescribe lower-cost alternatives in the same class of drugs. There are numerous medications out there that your doctor can make wise choices on which will save you a ton.
Every year during “open-enrollment” season, health insurance plans often change the medications they cover for, you should compare enough insurance plans to know which one would be covering for your prescriptions.
You don’t have to stay fixed with an insurance company that is not covering your medications. Depending on your insurer's formulary (a list of medications that are covered), the co-payments for two similar drugs, may be wildly different. Check for options to avoid paying for the pricier drug. Choose the best option and let your doctor know the drug you prefer.
Check online or flip through magazines and see if you can find a coupon or discount for your prescriptions. You can google the brand name and you will find lots of discounts. You can check GoodRx.com to learn its “fair price” and use this to determine if your seller quotes you a higher price. Find coupons online at sites such as Optimizerx.com and InternetDrugCoupons.com.
A lot of pharmacies post to their websites lists of drugs that are always discounted, see which store may offer the best price. In cases where your medication is on the list then it’s perfect. But if not, you can call to ask them how much it would cost you to fill your prescriptions in their pharmacy. Doing this can save you a ton over the course of a year in procuring your medications. Check around local pharmacies for offers, such as transferred prescriptions on your long-term prescriptions, where you can get gift cards.
Also, always ask for the lowest prices and any available discount on your over the counter (OTC) medications. Many local pharmacies offer amazing discounts on OTC medications. Take for example, dexamethasone that goes for $64.19 cash can be takenat a discounted price of just $19.42 at Walgreens pharmacy, using an Easy Drug Card. Also, update yourself often about OTC medicationpromos, because many of them work with a time frame. You can register for aPharmacy Drug Card as well.
Many a times, you will find that local pharmacies actually have better prices on brand name drugs than the big box stores.
Another thing to consider when comparing different deals and stores is their loyalty reward for filling your prescriptions, some pharmacies give rewards for every prescription you fill. For example, in Kroger, for a $10 medication you buy from a pharmacy, they can give 10¢ off a gallon of gas for every 2 prescriptions you fill, which means that you have $1.75 saved for each prescription. You can earn 500 balance rewards for every prescription in Walgreens.
It can be more convenient and even cheaper if you get your medications in large quantities, especially when you are on a long-term medication. For example, the average cost of a bottle of Ibuprofen (Advil) with 24 pills was $3.92, at a rate of 16¢ per pill, which was about double the amount per pill for a 200-pill bottle. If you use a health insurance plan, you will pay one co-pay when you buy once for three months medications rather than three co-pays for three different months.
For example, a co-pay for a 30-day supply of a specific drug might be $15 compared to $30 for a 90-day supply, which save you $75 over the course of a year. All you need do is to check if such discount is available for the specific prescription you are filling.
You can ask your doctors for free samples as this can act as good substitutes, although this is not an effective long-term solution to saving cost. Sample packs of medications are usually provided to the pharmacies by pharmaceutical sales reps in order to allow their patients to evaluate the effectiveness and the side effects of the drug before they buy it.
Free samples could be a smart way out when no other volition exist.
Study says that, ‘Pill Splitting Can Save You Up to 56%,’ it has been observed that higher-dose pills are only a little more expensive than the lower-dose pills. So, to save cost, splitting pills can be a way out, which means that pills that are double your usual dose can be split into two and half taken per time. For example, getting metformin 1000mg for $6 rather than two metformin 500mg which cost $4 each will save $2.
Ask your doctor for a double-strength prescription and then they take half a pill. This method may not be appropriate for all medications especially drugs which are not easy to break or too small. Most medicines that can be split are generally scored, to ensure accurate and easy splitting. However, consult your doctor first to ask if any of your prescription can be split, that way, you can save money and still get the benefit from the drug.
Help is available for patients who are uninsured or earn low, and cannot afford their medications. These programs are frequently called Patient Assistance Programs (PAPs) which are designed by many pharmaceutical companies, (although, not all) to help low-income seniors, (patients above 65 years of age) pay for gaps in coverage, so as to obtain their medications at no cost or very low cost. If a pharmaceutical company decide to have a PAP, they decide on the drugs to include in their PAP. Some include most of all the medicines they manufacture while others may include only a few. For example, there are a few programs that sell their generic drugs at a fixed price, currently $15 for a three month supply and $25 for a six month supply. Sometimes, some drugs will be on a pharmaceutical company PAPs and others may not.
Check on the Internet to get more information about the different PAPs to find that which cover your prescriptions. Some of these websites which offer information to patients without charges are NeedyMeds (www.needymeds.com), RxAssist (www.rxassist.org), and HelpingPatients.org (www.helpingpatients.org).
Also, Medicare beneficiaries with limited income and resources may qualify for assistance. Medicare is a government program that helps people of age 65 and older with costs of a Medicare prescription-drug plan, including monthly premiums, annual deductibles, and prescription co-payments, and this could worth roughly $4,000 per year. Check what is available in your state on Medicare website.
You can speed up on some things that could make your health improve greatly, for example, in some chronic conditions such as high blood pressure, obesity and diabetes. A modest weight loss, exercises, cutting down on carbs, reducing too much salt intake will cause great improvement on your blood pressure, blood sugar, and cholesterol. As your health improves, you may be able to cut back on drugs, saving you some costs.
Also, with Affordable Care Act, almost every patient can take advantage of some preventive services such as mammograms, vaccines andcolonoscopies. The aged people can also avail themselves of the one-time Welcome to Medicare visit, yearly wellness visits, and free health screenings where they can get medical conditions discovered early, and when they are most treatable. This may help reduce the chance that you will need to take multiple prescription drugs down the road.
Storage conditions such as light, humidity and temperature could greatly affect your medications, don't store medicines in the bathroom where it's hot, or on your windows directed to sunlight, as these can reduce the potency or even lead to total spoilage. You don't want to open up an expensive bottle of medicine and see it all clumped together because it's full of moisture.
Lastly, find a pharmacy that you like and that offers a good price, fill your prescriptions there and ask them for a cross check whenever you get your prescriptions filled so as to keep all of the medications you take in one system. This helps to avoid duplications and dangerous interactions.
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