As announced by HHS Secretary Alex Azar, the Trump administration is planning to force drug companies to include prices in their advertising. That means that, along with the long list of drug side effects that you hear during a TV ad, you’ll see the list prices. That list price is referred to as the wholesale acquisition cost, which is around the cash price you’d pay without insurance. Prices would have to be included in all ads for drugs covered by Medicare and Medicaid (i.e. pretty much all drugs).
The goal of this policy is to control drug prices by making them more transparent. Sound unlikely? It has a noble free market, pro-consumer ring to it, which I kind of like. It will be fun to see how this plays out, but it’s a minuscule policy move that won’t bring the kind of drug price relief that Americans want and need. In the proposed rule, Azar, or whichever of his staff wrote it, is all high and mighty about transparency and market efficiency:
“Markets operate more efficiently when consumers have relevant information about a product, including its price, as well as alternative products and their prices, before making an informed decision whether to buy that product or, instead, a competing one.”
At PharmacyChecker, we know a lot about the importance of drug price transparency. That happens to be one of the things we’re best at (along with verifying pharmacy practice standards). Our recognized forte is international pharmacy drug price transparency.
Here’s a scenario for you:
In this future world of Azarian drug price transparency, Jorge from Brooklyn will be watching the baseball game (maybe the Yankees in the World Series next year), and he’ll see an ad by Merck for the drug, Januvia. Jorge has just learned he has Type 2 diabetes and has a prescription. He’ll hear that Januvia can help lower his blood sugar, which is good. Then, he’ll hear that the side effects could include joint pain, a skin reaction requiring treatment in a hospital, and even death from pancreatitis. He gets that all these ads have to list those side effects.
Then he hears: it’s $550 for a one-month supply; but, wait, it will likely cost much less with insurance! That doesn’t exactly help. Jorge is one of 30 million uninsured Americans, and $550 is more than he can afford after paying his rent, groceries, gas bill, his daughter’s ballet classes, and his son’s asthma inhaler. Yes, he’ll hear there are Januvia patient assistance programs that might be able to help. Let’s hope so…because people often don’t qualify.
There’s no generic competition for this drug in Brooklyn. Unlike generic drugs, you can’t pharmacy hop for the best price or find a significantly lower U.S. price on the web. So what good is that transparency other than a minor slap on the hand to Big Pharma?
45 million Americans didn’t fill a script in 2016 because they faced similar situations to Jorge.
But there’s hope! When my fellow Americans visit www.pharmacychecker.com, they are blown away that the price of a drug is almost nine times higher in the U.S. than in Canada – and, yes, I mean Canada (not India or Turkey, where drug prices are even lower, and for the same drug).
On our website, Jorge learns that brand-name Januvia is $270 for a three-month supply if he orders it from Canada. Now that’s Drug Price Transparency! It’s a massive punch to the Big Pharma gut.
Canadian pharmacy prices among verified international online pharmacies in the PharmacyChecker Verification Program are ones he can afford. If he cannot, then those same online pharmacies may also refer orders to pharmacies outside of Canada, which may have even lower prices.
Azar’s proposal shows just how vulnerable Americans are
To the credit of Azar’s proposed rule, it at least identifies how incredibly vulnerable Americans are to drug prices.
Uninsured paying cash prices
Insured finding that PBM formularies don’t cover all drugs
Insured finding they must pay co-insurance of 30-60% (not just copays) on really expensive drugs (in the many thousands per month)
These coverage gaps affect tens of millions of people each year, which is why we have a crisis. Making drug companies note the price in TV ads while leaving the patient powerless to do anything stinks.
Interestingly, one drug company, Johnson & Johnson, warns that this is a bad idea because people might end up not taking their prescribed medications. The Onion couldn’t do better than this. It’s not The Onion, though. It’s Bloomberg: J&J Says Putting Drug Prices in Ads May Scare Away Patients.
Senator Claire McCaskill (D-MO) requested an investigation into drug price increases among the Medicare Part D program’s 20 most widely-prescribed medications over a five-year period. The investigation, conducted by the Senate Committee on Homeland Security and Government Affairs, found that average annual drug price increases were 12%, about 10 times higher than the rate of inflation. One drug, Nitrostat, increased by 477% during the five-year period. PharmacyChecker decided to find out what the savings would be from international online pharmacies for cash payers on these medications. The average potential prescription savings is 80%, further evidence that seniors can benefit from lower drug prices outside the U.S. when their pharmacy benefits are inadequate.
Adding a little spice to this research, we found that 70% of these 20 medications, the ones sold in U.S. pharmacies, are foreign-made, imported drugs. This shows that importation is legal for drug companies that make medications overseas. The countries where they are made get the manufacturing jobs; we get the higher prices!
And what about those drugs made in the U.S., often in Puerto Rico? You can buy those drugs cheaper in Canada. Synthroid is a perfect example. Synthroid, sold in Canada, is made in Puerto Rico and can be purchased for 15 cents a pill, compared to $1.68 a pill in the U.S.: a 93% savings for the same drug.
Here’s a crazy one: The medication Premarin is made in Canada. It’s $6.93 a pill at a U.S. pharmacy, but can be bought online and filled from a U.K. pharmacy for 17 cents: a 98% savings. In this case, the drug made in Canada is cheaper in the U.K. than in Canada.
And what about Nitrostat, the drug that increased by 477% over the past five years? It’s 80 cents a pill in the U.S. and only 28 cents in Canada. The drug is made in Puerto Rico.
When it comes to getting your prescription medication for an affordable price, nothing compares to comparing prices. We talk about online, international options for prescription drug savings a lot. Americans use our site, PharmacyChecker.com, to find much lower prices available abroad for their prescribed medications. They also use us to find discount coupons for their local pharmacy.
After a disappointing visit to Walgreens, Garrick Feldman, editor in chief of the Arkansas Leader, did it the old-fashioned way by calling around his town. In doing so, he discovered how people are price-gouged by not only Big Pharma—but by their local pharmacies. His story is awesome. (more…)
There are not many issues you can hear both Republicans and Democrats clapping about in unison, but high drug prices is definitely one of them. Echoing his 2016 campaign, President Trump again proclaimed during his State of the Union address Tuesday night that his administration is determined “to make fixing the injustice of high drug prices one of our top priorities.”
Speeding up the approval of lower-cost generics was noted by Trump as “exciting progress,” but nothing substantial has been done by the Trump administration on drug prices. The appointment of Alex Azar to head the Department of Health and Human Services department was a major disappointment. As president of Eli Lilly USA, Azar oversaw major price hikes on lifeline medications, such as insulin.
Appealing to both his base and popular opinion, President Trump could use his executive authority immediately to more expressly permit Americans to buy medication from international pharmacies.
AARP just released its Rx Price Watch Report and the data doesn’t do your wallet any favors. Thankfully, verified international online pharmacies offer the price relief consumers need but can’t find locally. AARP has recommended that consumers consult PharmacyChecker.com to avoid rogue online pharmacy scams.
The AARP report painted quite a grim picture concerning the lack of drug price relief in the U.S.:
Yesterday, President Trump declared the opioid crisis a public health emergency, which hopefully will jumpstart the nation’s response to get more treatment to addicts, including medications that can save them from overdose, and empower law enforcement to more successfully pursue and stop illegal (and even legal) distribution of opioids that have killed hundreds of thousands. This is NOT the time to ease up on the administration or Congress regarding the public health crisis of high drug prices or to let Big Pharma use it as a pretext to curtail access to more affordable, imported (non-opioid) medication. Just last week we wrote about Trump saying for a second time that drug companies were getting away with murder because of drug prices. He should have added for drug dealing as well.
As I wrote in The Hill back in June, Big Pharma is not only responsible for high drug prices but also for causing opioid abuse and death in America. They want to use a crackdown on illegal opioid imports to stop safe drug importation, which is a lifeline for millions of Americans who cannot afford the outrageous prices the drug industry controls here at home.
The drug companies’ front groups are supporting legislation called the Synthetics Trafficking Opioid Prevent Act (STOP). STOP’s goal is to cease illegal imports of fentanyl, a drug sold lawfully in the U.S., which is often used as an ingredient to make opioid-based street drugs and even counterfeit versions of prescription narcotics. Well, I support that idea, too! Who wouldn’t? Here’s the problem with the bill: That same legislation could also impede Americans who import real, non-opioid, non-controlled medication for their own use because they can’t afford it here!
Pharma’s death machine has no boundaries. Op-eds continue to infest the Internet and daily newspapers warning that legalizing imports of lower-cost medication from Canada will worsen the opioid crisis. Most that I’ve read are written by paid lobbyists, consultants, or employees of drug companies.
This would all be funny if it wasn’t so horribly sad.
Is Mary Bono a lobbyist for Pharma? According to Open Secrets, ASOP has spent $420,000 this year lobbying on importation and online pharmacies alone. I believe that Ms. Bono genuinely wants to stop dangerous illegal sales of prescription narcotics and even regular drugs – but to mix it all in with a narrative that perpetuates that ALL international online pharmacies are dangerous is wrong. You’ll notice on the Open Secrets page that the executive director of ASOP, Libby Baney, is a principal at Faegre Baker Daniels and a lobbyist.
Safe international online pharmacies help Americans afford medication to treat high blood pressure, diabetes, asthma, depression, heart disease and many other conditions. They require valid prescriptions, meet high standards of pharmacy practice, and have nothing to do with the opioid crisis. PharmacyChecker explicitly bans any websitefrom our Verification Program that sells prescription opioids to patients in the U.S., or any controlled medication, as defined by the U.S. Drug Enforcement Agency.
The tragedy of hundreds of thousands of deaths by opioid abuse and overdose in America is nothing short of disgraceful. It’s well-known that the pharmaceutical industry’s commercial greed bears much responsibility. One example is that the pharmaceutical industry pushed for looser prescribing rules to expand opioid sales to people who don’t really need them. More recently, investigative reporting showed that Pharma lobbied for the successful passage of legislation to prevent the DEA from going after companies violating opioid drug distribution laws. This has led to unnecessary deaths, and yet we continue to let Big Pharma sweep the truth under the rug.
The FDA has never reported a death due to ordering medication from an international online pharmacy that required valid prescription. Never. Juxtapose that with the 200,000 who have died from opioids. Also, the FDA notes that 125,000 Americans have died because they have not taken prescribed medication. Why haven’t they? Often because they can’t afford it. Based on Commonwealth Fund surveys, we’ve estimated about 45 million didn’t fill a prescription because of cost in 2016.
I’ve been saying for years now that the pharmaceutical industry is misleading the public and Congress on prescription drug importation in a major way. So, I’ll say it again: the opioid crisis should not be a pretext to make it harder for Americans to afford non-opioid drugs internationally.