Medication Prices Often Lower Without Insurance

The cost of prescription drugs — in particular, generics — is increasingly lower when patients purchase the medications directly from online suppliers and leave their insurance cards out of the equation, according to a collaborative effort by the New York Times and ProPublica. The story, linked below, takes a closer look at the whys and implications.

https://www.propublica.org/article/when-buying-prescription-drugs-some-pay-more-with-insurance-than-without-it

 

Response: Call them what you want, but it is all just brand or generics.

by Dr. Franco Mueller
Partner/Medical Director, TFG Partners

We remain a bit skeptical of the studies mentioned in our previous post from KHN. Please look at the study dates, the data is from  between 2007 and 2013. Many Pharma companies have boosted the price in the last two years and we are just seeing costs continue to skyrocket. There are more problems facing employers then just orphan drugs in the industry pipeline. The issues go much deeper into the pharmaceutical industry and orphan drugs are just one part of the horizon.  more

Study Says Concerns About Orphan Drug Spending Are Unjustified

 | September 7

Rising concerns about spending on prescription drugs that treat rare diseases are not justified, according to a new analysis in the journal Health Affairs.

“We wanted to focus on the true impact of orphan drugs,” said Victoria Divino, a senior consultant at IMS Health and an author of the study. Researchers at IMS Health and drug maker Celgene analyzed U.S. pharmaceutical spending from 2007 to 2013 on more than 300 drugs that had orphan approval under the 1983 Orphan Drug Act. more

Point/Counterpoint – The Firestorm Over Drug Prices

by Ryan Jerico
Senior Consultant, TFG Partners
We all need to sit down together and talk this one out.

When it comes to the current media storm surrounding the EpiPen and other drugs with rising prices, their are two points of view when it comes to laying blame. In the media, we see fault being assigned to either the drug companies or the insurers. Here are two articles illustrating the opposing viewpoints.   more

Conspiracy Theory: A Secret Group Controls What Drugs You Can Take

This no conspiracy, it is completely true. As this article in the St.Louis Post-Dispatch explains,  A secretive board controls access to prescription drugs for millions of Americans. As an employer, you contract with a PBM to make these difficult decisions in the interest of balancing necessity, efficacy, and savings. Unfortunately, you’re employees may not always see it that way. more

We Call Them ‘Zero Balance Claims’

by Ryan Jerico
Senior Consultant, TFG Partners

With my Prescription Benefit, I pay a $20 copay for all generic medications. So when I go to the doctor for my yearly sinus infection each spring, things are pretty routine. She writes me a prescription for Amoxicillin.  I walk across the street into a large chain grocery store who advertises $4 for a 30 day supply of 40 different generic drugs. more

Comparing Costs Around the Globe

The International Federation of Health Plans has released its 2015 Comparative Price Report, detailing its annual survey of medical prices per unit for medication and procedures around the world. As you might expect, the United States’ pricing is highest in most cases.

Prices examined in the study included those from Australia, New Zealand, South Africa, Spain, Switzerland, United Kingdom and United States. More than 540 million medical/Rx claims were analyzed from the US alone.

Checkout the breakdown for yourself in Becker’s Hospital Review.