Big Pharma is in the mood to share! A new report commissioned by the Pharmaceutical Researchers and Manufacturers of America (PhRMA), the trade association representing the world’s largest global pharmaceutical companies, seems to assert that the blame for high drug prices should be shared with pharmacy benefit managers, retail pharmacies, wholesalers, and, I think, even hospitals – and more. It appears that PhRMA’s main target is the pharmaceutical benefit managers.
Noting that President Donald Trump recently said drug companies are “getting away with murder” – I view this report as pharma’s attempt to communicate, “hey, prez, we’re not alone here in being greedy.” The report has merit, which I’ll explain below when looking at the dollar numbers. But as far as the American consumer is concerned: murder is murder. Hey, I’m just using the president’s words. Due to the killing made by pharma and friends (because they’re all friends), 10s of millions of Americans are leaving their scripts unfilled because the prices, one way or the other, are out of reach.
How would you feel if the cost for your brand name drug went up from a copayment of $44 to a cash price of $614 for a three-month supply ($6.82 a pill) when you went in to fill your script in 2017? If you take brand name Crestor 10mg then that may happen to you if you’re signed up with CVS Caremark, which is dropping that drug in 2017. In fact, large PBMs, such as CVS Caremark and Express Scripts are dropping lots of medications from their formularies in 2017. What’s insane is that brand name Crestor 10mg from the lowest cost international online pharmacy verified by PharmacyChecker is 29 cents a pill or $26 for a 90 day supply, dispensed from Turkey. If you prefer to buy it from Canada, it will cost a low of about $2.85 per pill, much more than Turkey but still almost 60% less than in the U.S.
We looked at 15 brand name medications that will no longer be available on some PBM formularies in 2017 and found that the maximum savings average is 74% if you purchase the medication from a PharmacyChecker-verified international online pharmacy compared to the lowest cost U.S. pharmacy options. For more on this price analysis check out today’s news release.
Most Americans have insurance, about 90%, which is a record high. No, I’m not getting into a discussion about the successes and failures of Obamacare, but you should know that just because you’re insured doesn’t mean you can afford medication. Looking at Kaiser Family Foundation data, about 41% of underinsured Americans between 18-64 don’t fill a prescription because of cost. That’s about 16.5 million (too many) people.
Lest you forget, for many of these dropped drugs, the generic is often available in the U.S. at lower cost than the brand name from an international online pharmacy. But not with Crestor. The generic of Crestor, Rosuvastatin, can be purchased at your local pharmacy, with the lowest prices ranging from $35-50 for a 3-month supply, which is more (but still comparable) to the lowest international, online cost of brand name Crestor.
Each week I try to come up with a new and compelling blog post to discuss issues involving drug prices and problems Americans are having affording medications. I often find myself resoundingly critical of the pharmaceutical industry and this week I was intrigued but curiously put off to be joined by a pharmacy corporation that made over $100 billion last year.
Express Scripts, the nation’s largest pharmacy benefit manager, reported that brand name drugs in the U.S. cost 98.2% (about twice) more on average today than they did in 2011. Last year, brand name drug prices were up 16%. As I read in the Chicago Tribune, Express Scripts used hostile, downright anti-big pharma (and pharmacy) language blaming “opportunistic manufacturers” and “scheming pharmacies.” Rising drug prices of this magnitude are no laughing matter as cash-strapped Americans bear the brunt of these increases, either in higher insurance premiums, co-payments, co-insurance and full cash prices for uninsured (still almost 30 million Americans), or when plans don’t cover certain drugs.
But it is a little funny to hear Express Scripts go after Big Pharma using the rhetoric of greed. After all, PBMs, particularly Express Scripts, are often criticized for their lack of drug pricing transparency and profit-seeking practices, kind of like drug companies and big pharmacies, such as Walgreens and CVS.
While the focus of Express Scripts’ ire is on brand name drug prices, most of the prescription sales it administers and profits from are generics. On that note, buying generic medication without using your insurance’s PBM is often less expensive than your co-payments. But don’t expect Express Scripts to tell you that.
So that Express Scripts doesn’t feel singled out, we’ve reported on the antics of Big Pharmacy before, including Express Scripts’ biggest competitor. PharmacyChecker CEO Tod Cooperman, MD, was on Fox and Friends not so long ago discussing an investigation of CVS Caremark in which the company was accused of price gouging. The allegation: by not informing its customers that the cash price using CVS’ own discount card program would be lower than co-payments using PBMs, such as CVS Caremark or Express Scripts, hundreds of thousands of customers were overcharged.
On that note: the nuts and bolts message is DON’T BE SHY and ask for the lowest possible price at your local pharmacy.
In defense of Express Scripts, and even CVS Caremark, PBMs and large pharmacy corporations do not yield profit margins even close to those of the biggest drug companies. Furthermore, the pharmacy corporate giant, Express Scripts, is right: the blame for ever increasing drug prices falls on opportunistic manufacturers and scheming pharmacies.