Talked to my Pharmacist today about drug company pricing.

[Savannahmann]

I was getting a refill for the Wife, and we talked about the ACA. The Pharmacist (Private family run local shop) said that the ACA is killing them already. The drug companies are as of January 1st of next year are limited to how much they can increase their prices on the meds. So the painfully obvious happened, the Drug Companies have basically quadrupled the prices of nearly all the drugs.

So the cost to the Pharmacy to buy that which they are issuing is four times higher according to this story. The Insurance Companies have 90 days to pay the bills, and they are taking every minute of those 90 days to cut the checks, which means the pharmacist (independent owner of the small town family pharmacy) is out of pocket an enormous amount until the checks come in, so he's in the red, and has payroll and other costs that won't wait. The workers won't agree to go 90 days without a paycheck to keep the drugs running across the counter, nobody can, or would.

Of course, those who don't have a drug plan or insurance are screwed too. I could type the words you all realize, but why? The purpose of this was to inform you of the drug companies actions to guarantee profits for the next decade or more. Their argument will be painfully obvious, and it is that the limits on price increases are not adjustable to factors like inflation, increased costs, or whatever. There might be some slight truth to that, but not to the extent of increasing the prices 400%. That is nothing but outright greed at an unfathomable level.

[JaneyVee]

1. The ACA is killing them? How about the greedy drug companies who

Are doing the gouging, they don't deserve the blame?

[Savannahmann]

4. I did not say I agreed

I reported what he said. I concluded the post with a comment that said I put the blame where it belonged on the drug companies.

Public perception is part of what I've been talking about for a while. Now, I could have gone off on a rant about the evils of the drug companies, and done little to nothing to change his mind. I would probably harden his beliefs, people when shouted at or ranted at tend to harden their beliefs. Or I could be sympathetic, concerned, and informed of another person's opinion. I choose the latter, because that way I get the next round of information, and the round after that. In the meantime I can also gently nudge him around to the right (as opposed to wrong not conservative) frame of mind. Changing a mind is not something done quickly, it is something done over long a patient efforts.

[yeoman6987]

28. Small pharmacies

Small pharmacies will go away and Walmart and national drug stores will survive. That is the breaks but that is what will happen.

[Humanist_Activist]

2. The ACA should have included price controls for prescriptions, even setting prices in many cases...

same goes for medical equipment and the running of it, this limiting the profit margin of insurance companies is a good first step, but it certainly isn't enough to rein in the rising costs of health care.

[Savannahmann]

5. The ACA (according to the same pharmacist)

Limits price increases as of January 1 2013 to 5%. So as of January 1 the price can only increase 5% a year. According to my friend they are getting ahead of that by really jacking the prices up now.

[Humanist_Activist]

13. Negotated group prices have always varied widely, I don't know how...

pharmacies are reimbursed compared to wholesale or retail price of the medication. Its not unusual for me to see the uninsured price for a medication to be 500 dollars, but the price that the insurance company actually pays in 50 and the patient 10.

Not sure if that screws the pharmacy that has to get the medication wholesale, or if they are reimbursed by the manufacturer, or how that works, its not my department, and I never really asked before, now I'm curious about it.

[Control-Z]

3. Funny, because all my Rx's

have gone down in price. All of them. From 65 to 44 for one. From 38 to 10 for another. 10 to 8 and 10 to 5 for two more. Go figure.

[Humanist_Activist]

7. Is that the price negotiated by your group plan, or the (uninsured)market price?

Or are you talking about copays?

The Market price is what an uninsured person would pay, its the most expensive, usually.

Group prices vary by plan, but are almost always less than market price, this is the price the insurance company pays, minus your copay.

Copay is your share of the group price.

So which of these three went down, also, bear in mind, if its a percentage based copay, its calculated as a percentage of the Group price.

[Savannahmann]

9. Our plan covers prescriptions

Our co-pay is the same as it has been, but I don't know about the full price. I know when new producers put generics out that the price often drops, but I am truthfully ignorant of the actual cost. Again, I am just reporting as accurately as possible the gist of the conversation I had with the small town family owned/operated pharmacy.

[Kelvin Mace]

6. Weird

As my wife has MS and takes some VERY expensive drugs. I haven't noticed any prices that have "quadrupled". By shopping around recently, I cut the cost of my blood pressure meds by half by buying them outright at Costco for $10, instead of paying a $20 copay at my regular pharmacy.

Someone was exaggerating.

[Humanist_Activist]

12. You may not see these price increases, only the pharmacy and your plan might see them...

the OP is unclear as to precisely what prices are being increased, market prices, group negotiated prices, etc.

Copay are, unless percentage based, removed from these prices, a policy change with a specific insurance company can radically change your copays, the only exception are percentage based copays, which are calculated as a percentage of the negotiated group price for a particular drug. That can lead to some radical price increases and decreases over the course of a year. I've taken calls from patients who had their copays double or triple in a single month because of this.

[Kelvin Mace]

15. I check the retail price

on all my drugs, even though this is not what I pay. I have seen no 300% increase on any of the meds my wife or I take.

Now, that is not to say that Big Pharma might not be jacking up drugs I don't see, but a four-fold increase in drug prices would be causing a lot more than just grumbling by an independent pharmacist. I would think it would be a story trumpeted 24x7 by the corporate media, especially Fox.

[dixiegrrrrl]

24. So smart of you.

My 86 year old neighbor is pretty smart, on most things, but a total wuss when it comes to medical stuff.
She has good insurance on top of Medicare, but was highly resistant to paying 10.00 for 90 days of generic drugs,
preferring "to let the insurance company handle it, like always"
which costs her not only the premiums, but 25.00 copay.
All of her current meds can be had for generic prices.

Me...no drug insurance.
I get them cheap on the 10.00 x 90 day generic plan.

[Kelvin Mace]

36. I am also fortunate in that my sister is VERY

wired into the whole issue. She used to write claims software for insurance companies, has done medical record coding for hospitals, has a nursing assistant certificate, has spent the last 11 years with a chronically ill child, and just completed her training as an ACA navigator.

I am trying to get her to post here and help answer people's questions.

[dixiegrrrrl]

40. She would have helpful info, I do think.

Tell her to come on down, the water's fine!

[Hoyt]

8. I'd sure like to see some corroboration of 400% increases.

While I don't doubt there is some gouging going on, I really don't believe it is anywhere near that. It would tank Medicare, Medicaid, and dramatically inflate private insurance premiums above current levels.

[Savannahmann]

10. I did a quick search, and found numerous stories from 2010 and 2009

But nothing recent. The report I am giving is single sourced, and unconfirmed. I didn't state that because I figured it was obvious. However, I am accurately reporting what I was told, not stating it as fact, but a report of a conversation. My opinion is at the end, that if true, it is unimaginable greed on the part of the drug companies.

[Hoyt]

18. Your pharmacist would not be the first to use Obamacare as an excuse to raise prices or gripe.

I don't doubt he said that., but I do not believe drug prices have gone up 400% or anywhere near that in the past few years.

CMS -- the federal agency that oversees Medicare -- maintains Average Wholesale Prices of all drugs, and there is no 400% increase.

I don't doubt that drug prices have increased more than inflation, maybe as much as 10 - 15% per year according to some sources. But that is not anywhere near 400% in 5 years.

[dixiegrrrrl]

25. .Your pharmacist would not be the first to use Obamacare as an excuse to raise prices

My Dr. clinic raised Office visits from 50.00 to 70 to 109 in 9 month cycle.
Obamacare, they said, which "made " them get a computerized system.

( the screw ups from them using a computer would fill a book)

Plus they changed labs, so the annual blood work is now 135.00 instead of 60.00.
I don't have to pay it all, thanks to Medicare B
but I do see the bills that Medicare paid.
The deductible is easier to meet now, tho.

People are starting to realize the new law is a boon to insurance compnies.

[Kelvin Mace]

17. Pedantic math nitpicking

A quadrupling of prices means a 300% increase, not 400%.

[Hoyt]

21. OK, you got me. Well unless the pharmacist meant prices are 400% of base period.

Doesn't change the fact that they haven't increased 300%, four fold, quadrupled, or that prices are 400% compared to base year.

[Kelvin Mace]

34. I agree

I also am skeptical of the claim. But I have a touch of the Sheldon/Moss OCD.

[dixiegrrrrl]

30. look at that!

you just fought inflation by 100%!

[Skidmore]

11. Perhaps explains the sudden push to get

a whole bunch of people to take statins recently. Pill pushin'.

[gvstn]

14. I will say that I started buying insulin for my mom

At the end of 2003. It was $27 for a 10ml vial. Last week it was $98 (up from $87 the previous month). So in 10 years it has gone up to about 4 times the price. This is not a new drug with any associated R&D costs. It is the same medicine it was then. A combination of the Medicare part D which allowed higher prices because more people were covered and now the ACA has given drug companies a lot of leeway to take advantage and raise prices. Perhaps okay if you have a prescription plan but paying retail is a killer. One more example of the "poor tax". I will be very grateful if prices hold at 5% increase per year--that will be comforting--as it is now I never know what the increase will be month to month.

[busterbrown]

16. So you are telling us that this only applies to increases..

The drug companies can keep the prices at their current levels but this is only about amount they can increase.??

What are the limitations of their increases imposed by the ACA..

Sounds like your Pharmacists is pissed off and is making stuff up..
If this was a national situation...We certainly would be hearing it all over..

“Obamacare Forces Drug Companies to up prices by 4 times" Local Pharmacists have to wait 90 days.......and so on.

Nope, Somethings Fishy..

[Savannahmann]

19. Perhaps. But his emotion was genuine.

It wasn't just the anger, but the fear, the dread that you see in the mirror when you are in a situation with limited income and it seems unlimited expenses. I've seen that same look in the mirror myself when times were tough, the how do I pay this and how do I pay that fear.

As for news stories, right now, they are all chasing the sign up problems and numbers. The republicans probably can't figure out a way to pin this on Obama, so the RWM isn't reporting it yet. Give them time to come up with a spin.

[busterbrown]

23. Yea, its tough all over.

Middle class as they sink lower and lower down economic ladder are no longer patronizing their local pharmacists as they use to. Several are closing down because their prices on all their over the counter stuff is being compromised by the prices of the Corporate Pharmacies.

Your guy is pissed off and believe me his sales have been going down since the recession.
He like most, is looking for some simple answers..Obamacare is such an easy target.

Why isn’t he saying.. Gee these Drug companies are killing us?

[TheKentuckian]

20. I don't know about this story. I deal closely with several high dollar biotech drugs and pricing has

been remarkably stable (granting a lot less room than other drugs to go up so my picture maybe distorted).

I can imagine that his drug cost could have quadrupled while individual drug cost are stable or even drop in some cases because of stuff staying on patent longer, better diagnosis and the accompanying on patent therapies, plans allowing certain medications to even be filled locally rather than coming from a large specialty pharmacy and then having to stock stuff they never did before.

Really, I think it is mostly the latter factor. I bet if he went drug by drug comparing apples to apples he would see that costs aren't going up so much as he is in the position carrying more expensive stock and fewer things go generic to balance that out some.

[FarCenter]

22. Local pharmacist can't negotiate prices like CVS, Walgreen's, Rite-Aid, Walmart, Target, supermarket

Competition heating up between CVS, Walgreens and Rite Aid

Read more: http://medcitynews.com/2013/09/competition-heating-cvs-walgreens-rite-aid/

If he has a good client list, and a good location, maybe one of the chains would buy his business while he still has something to sell.

2012 Market Share of Top Pharmacies

•The top five dispensing pharmacies—CVS Caremark, Walgreens, Express Scripts, Rite Aid, and Walmart—accounted for about 63% of U.S. prescription dispensing revenues in 2012.

http://www.drugchannels.net/2013/01/2012-market-share-of-top-pharmacies.html

[dixiegrrrrl]

32. Walgreens moved into town and immediately bought out our local pharmacy.

Last edited Fri Nov 29, 2013, 05:09 PM - Edit history (1)

We have supported local buying here for decades.

The local pharmacy sent us letters AFTER the fact that they were now CLOSED,
our presciptions had been sent over to Walgreens.
Walgreens promptly filled our prescriptioins, sans refill order from us, and notified us by
mail that we could come in and pick up the meds.
They had filled ALL my scripts, even the ones I was not planning on re-filling.

Guess what?
the prices were 3x higher.

Not many people seemed aware that they could switch their pharmacies from Walgreens.

I naturally went to the other local pharmacy, they cheerfully got the scripts from Walgreens
( it took a week, even tho they are just a few blocks apart)
and I enjoyed my "normal" prices.
Have no idea what Walgreen's did with my filled bottles.

I was pissed that all my prescription info. was now in Walgreen's puters, without my permission.

So, we are down to 1 local pharmacy in town, plus Walgreens, Rite-Aid and Wal-Mart pharmacies.

[font style=color:#FF0000;]There is something very wrong about this country.[/font]

[alc]

26. maybe there's more to the Obama & pharma negotiations that did/didn't/did/didn't happen

If those did happen in a bad way, this is pharma's payoff (4x drug prices) and they probably have enough documentation that Obama can't go after them.

If those meetings were no big deal then the IPAB will fix things (e.g. cap prices) soon enough.

If the drug increase is real, it's a good early test of the IPAB. Are they going to

* work for consumer protection (balance price and availability),
* be portrayed as a "death panel" (screw availability it has to be cheap - i.e. pharma will use the media to sell this message),
* give into industry (available and expensive but avoid a media war with pharma).

[libodem]

27. Personally

I hit the donut hole this month and one prescription cost me $366.00 for 90 Lyrica. I have to pay out of pocket for 3 more, too. It wiped me out. I about fainted.

[gopiscrap]

37. welcome to du

[tridim]

29. Top-notch FUD Mann-y! nt

[Laelth]

31. If they keep this up, we will have to nationalize them all.

Some price-gouging was expected following the passage of the ACA on the theory that the "free market" would eliminate the price-gougers. The problem is that the market isn't really free. These businesses are a cabal. They set prices, and they eliminate competitors who dare to offer lower prices (or they just buy them out to maintain their monopoly). Nationalization may become our only option. Let us hope it doesn't come to that.

-Laelth

[jberryhill]

33. Never heard of an inventory loan, this feller, eh?

My word, how do other merchants manage to run stores and dealerships, with all that capital tied up in inventory? Deep mysteries of the universe...

[TeeYiYi]

39. One of my prescriptions...

...went from $25/mo. to $147/mo. at my local pharmacy. I used to fill it at Walmart for $8/mo. but it went up to $75/mo. This price increase happened basically overnight, about 3 or 4 months ago.

That is more than quadrupling the price. I can no longer afford to buy it.

TYY

Edit to add: These price increases are for the generics.

[CFLDem]

41. I knew it Rx is a scam

when my commonly available generic drugs are priced at $250 a month.