Knowledge is Power for Saving on Prescription Drugs
Two weeks ago, we had the opportunity to help a member (we’ll call him Joe) with a tough choice on his hands. It was a situation many of us can relate to – Joe was deciding whether or not to buy an expensive medication for his child that would force a choice about which other life essential his family would then have to choose to go without.
After visiting a dermatologist with his daughter, Joe walked out of the office with a prescription to treat his daughter’s rosacea (caused by acne), for Noritate Cream. Noritate has an active ingredient in it called metronidazole, a drug that was first made commercially available 55 years ago, in 1960. Brand name Noritate is produced by Valeant Pharmaceuticals. The metronidazole concentration in the product is at a level of 1%. And the price tag – over $1650 for a 60 gram tube, or about $27.50 a gram.
After two days of calling pharmacies to try and locate lower pricing, calling the insurance company to see if an override was available or another product could be used, and looking for coupons online, their search yielded no helpful results.
Luckily we were able to intervene, identify another product (generic metronidazole cream, 0.75%), work with the doctor to change the prescription and find the product for under $60, or about $1.33 per gram. Essentially, we provided information (both clinical and pricing) that was otherwise not available for the patient and prescriber to use as they evaluated options.
For me, this interaction had a couple of important takeaways.
First, the majority of drug manufacturers don’t participate in the type of above mentioned activity. There are, unfortunately, a few like Valeant and Turing that are consistently bringing negative press to the industry as a whole as they look to maximize profits on “me too” drugs - a drug that is structurally very similar to (or in this case the same as) already known drugs, with only minor differences.
Second, while the pharmaceutical industry as a whole faces mounting pressure to produce new drugs with lower price tags, I believe that ultimately free market economics will prevail and the simple rules of supply and demand will win. And while politicians are talking tough about new regulations with the looming elections just under a year away, based on past performance, I’m not convinced new legislation even on universally supported issues, is possible.
Information is power, and accessing it at the right time can mean all the difference. This is true for consumers and medical providers alike who are often times left in the dark about options and associated costs as they evaluate care decisions. As the healthcare landscape changes, the demand for more information throughout the continuum of care will continue to soar.
Voluntary Benefits and Supplemental Health Leader
9 年It's cases like this one that makes coming to work a rewarding experience.
Health care consumerism in action -- got to love it...
I love reading articles like these. I can save my patients up to 90% on meds in my practice. Do the same with imaging, labs, and path. Cost of care will be deflated in the next decade with practices like ours.
Medical Director at Equity Health
9 年The problem is that for most, there is simply a $10 or $20 copay and the patient has no real skin in the game. It is because of this type of pricing that the PBMs and health plans must pay attention and restrict access to the over priced products through preferred formularies and prior auth. But physicians also have to become more of a steward of this money. I have a hard time with a physician who hands out a $1600 prescription for basically a rash... and one that can be (and has been) treated with something at a small fraction of the price of the drug form prescribed. There is no way that physicians can keep up with all prices, but via EHRs they certainly can try. Must also ask the question...did this MD prescribe it because he is personally incented to do so? High likelihood. Until physicians start to pay attention, we will continue to have this type of story.... and by the way, thank you for finding an alternative!
Army CBRN Officer | HAZMAT Technician
9 年Interested in this field. Specially the interaction of patient, provider, and insurer.