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.
The article “Taming Drug Prices by Pulling Back the Curtain Online” in the New York Times (February 10, 2016) features a new website, Blink Health, which shows reduced drug prices available through local U.S. pharmacies. Its limitation is that savings are mostly on generic drugs, which, for the most part, are already fairly inexpensive. Describing Blink and a similar site, GoodRx, the article notes that, “The sites cannot help much with brand-name drugs, which are made by a single manufacturer and carry prices that can be as high as hundreds of thousands of dollars.”
The article fails to mention that the largest pharmacy savings on the Internet are from international online pharmacies which can offer you the lowest prices worldwide. These prices can be found on PharmacyChecker.com, which “pulls back the curtain” even further than Blink Health and GoodRx by exposing the huge gap (often more than 80%) between drug prices in the U.S. and those in other countries — such as Australia, Canada, India, New Zealand, Turkey, and the UK. You can also find discounted local U.S. pharmacy prices on PharmacyChecker.com.
The table below shows the lowest prices on popular brand name drugs found on PharmacyChecker.com, BlinkHealth.com, and GoodRx.com in comparison to regular U.S. pharmacy pricing.
Lowest Prices and Greatest Savings on Brand Name Drugs Using PharmacyChecker, Blink Health, and GoodRx
The media rage these days when it comes to prescription drug prices is three-fold: 1) generic drug price spikes of literally thousands of percent, 2) specialty medications that cost $1.000/pill, and 3) cancer treatment costs in the hundreds of thousands of dollars per year! We’re glad the media is loudly covering the public health crisis of high drug prices, but its focus of late seems to take the heat off of never ending brand name drug price increases and the pharmaceutical companies that charge those prices. We haven’t forgotten. For us the heat is on: including a loud reminder that these brand drugs are sold much more affordably outside the U.S., and can be found and safely purchased online.
To help us, I looked to the research of David Belk, MD. Dr. Belk, who is concerned with, and voraciously researches the insanity of healthcare costs, publishes a website called True Cost of Healthcare. His research shows that brand namedrug prices increased by 13 times the rate of inflation over the past two and a half years. These are medications for which there is no available generic in the U.S. He looked at 335 drugs, their wholesale prices and tracked their increases from the October 2012 to the beginning of 2015. Only one drug, Norvir, actually came down in price. Dr. Belk writes: “All other brand name prescription drugs on my list went up a minimum of 9% and an average of just over 40% in price in only 2 1/2 years.”
While these brand drugs aren’t $1,000 per pill like Sovaldi, many Americans really can’t afford them. Below are two examples of brand name drugs that if purchased outside the U.S., would potentially save an American $4,000 a year and/or prevent that American from going without a prescribed, essential medicine for Diabetes or Asthma.
Januvia 100mg (siptagliptin), a drug that treats type-2 diabetes could cost you $1,149 for a three month supply at a local U.S. pharmacy. With a prescription discount coupon, you might get it for $963. If that’s too much, then brand name Januvia, marketed by MSD (a subsidiary of Merck), can be purchased online for $103.50 from an international online pharmacy– a percentage savings of 91% and a cost savings exceeding $1,000 over 3 months. Over a year, the cost savings is about $4,000.
Another example is Advair Diskus (fluticasone propionate/salmeterol), a popular asthma medication that is out of reach for many Americans due to cost. A three month supply of the 250/50mcg inhaler can run you $1,050 in a local U.S. pharmacy. With a discount card the price might be reduced to $874. At a verified international online pharmacy, the drug called Seretide Accuhaler, the name brand used by GlaxoSmithKline to market fluticasone propionate/salmeterol in several countries, is only $105: another three-month savings of $1,000 and annual savings of $4,000.
This summer at PharmacyChecker.com we’re going to keep the heat on the pharmaceutical industry with lots of examples of the crazy costs of normal brand name drugs in the U.S., and cooling things down for consumers with lots of savings you can find online.