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zakruti.com » Blogs and People » Philip DeFranco
Why You Should Care About This Massive Change To Prescription Drugs.

Why You Should Care About This Massive Change To Prescription Drugs.

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Why You Should Care About This Massive Change To Prescription Drugs. Lisa Jacobs: At a glance, this package of changes actually seems like it could ignite some serious improvements to our current high-cost healthcare system. The overwhelming majority of people in the US have moderate to low health literacy and nothing frustrates me more than how Big Pharma (aka most of the members of PhRMA) and insurance companies take advantage of the lack of health literacy by over-using medical jargon throughout important documents and pricing transparency statements. As someone who works in the healthcare field, I feel I have a very high health literacy and STILL cannot figure out how much a medication is supposed to cost me at any point in the spending on my plan; its incredibly frustrating because I genuinely try to take the time to explain to people why something costs them out of pocket what it does, but just when I figure out that recipe things change again and suddenly the insurance customer service is giving me a completely different answer to the SAME question. I would rather people come to the pharmacy with a higher price in mind (from a television ad) and then be surprised when I tell them a lower cost, then vice versa. Before you even brought up the comparison to auto advertising, I was drawing comparisons to that throughout the initial explanation; except auto ads usually advertise a much lower price than what youre told at the dealership, since taxes, etc. arent factored into advertised financing and lease rates. With prescriptions there are similar additions to the acquisition costs (what the drug company sells the medication to the distributor for + distributor costs/mark-up) but they can vary from one drug to another, from one pharmacy to another, and from one insurance plan to another; different states have different laws (search prescription price transparency laws + state) around disclosing versus not disclosing this information. If a state allows it, then anyone can go to (or call) the pharmacy theyve filled a prescription at and ask for a detailed printout of the costs and fees of what they paid for their prescription. If the pharmacist has time, they may even be willing to print out a similar detail for a therapeutically alternative medication to show you the cost benefits of one treatment over another. For example, my out-of-pocket cost of propranolol (immediate release) tablets is higher than propranolol (extended release) capsules, but my doctor prescribed me the tablets because they are typically cheaper; the printout showed that the insurance companys negotiated cost (with the pharmacy) of the capsules was lower. So I called my insurance company to ask why that was and to make a long story short, I got an answer I wasnt thrilled with but accepted it. I called my doctors office and asked them to change my prescription from tablets to capsules. Through some extra leg-work I was able to lower the cost of my prescription from 15 a month to 0.
Date: 2019-11-01

Comments and reviews: 9


I agree in medical industry which includes pharmaceutical there is a problem. The problem is getting upfront prices for any goods or services. Try asking cost for any surgery from multiple places. Almost all of them will avoid giving you a cost and just ask what insurance you have and that they do or do not accept that insurance. If you have insurance, they often try to tell you not to worry about the insurance will cover it (even if it won't cover all of it. I personally think adverts are not the problem nor do I think it should be required to place prices in adverts. To me the solution is insurance to go back to what it used to be 'in case of emergency' and not for every day care. That every day care should be a different sort of payment, whether you want to pay every time you visit or get a deal (like around here I see dentist advertise something like this and a FastMed, or membership that gives you free visits and discounts for extra visits you may need for a set fee. Now I know many of you think this is crazy, but all insurance does is hide the prices and give doctor offices and other medical groups an excuse not to give you prices upfront-which makes it impossible to shop around. I work with an elderly man as my boss who gets all sorts of medical bills MONTHS after whatever he went in for. The bill seldom has a clear reference of what it is for, or even when the event took place so he is always unsure whether it's been paid for already or if he should question it. The totals are always large, with another large number for insurance then finally what the remainder is. He also ends up getting refund checks sent to him for small amounts since billing is such a mess that often times they sent the same bill twice so he paid twice. Really medical needs to be like other forms of business, get prices upfront or clear estimates of what to expect (aka ranges based on possible complications or needs. Another thing not uncommon in America is two get multiple bills for the same visit because one part usually the anesthetist is billed separately adding more confusion. Final note: Many doctors get affliation with drug companies for deals, that makes the doctor encourage the use of that drug for benefits. Also people in American culture prefer to pop a pill to solve a problem because it is easy and gets to be not there problem. I think if most pills were sugar pills we still have most people feeling better because they just felt the need for something outside to fix their life.
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As someone who has relied on the help of daily medications to survive my daily live for years, I say that this move is a good first step for the government. I think the pharmaceutical industry is ridiculous when it comes to name brands when the off brand is cheaper for the exact same medicine. I don't want to have to pay 20%-30% more just because the drug has a easier to say name than the rival company that keeps the actual chemical compound name. Of course they might have other factors that I am unaware about that makes the brand Bane required but the basic form of the medicine is the same. That being said, I don't think this will pass in it's current form but at least to opens the door for further discussion and alterations to the subject. Thank you for reading my little soap box rant. Have a great day.
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Easy solution. Require listing the full price of the drug and adding Cost per individual will vary depending on insurance coverage. I love this idea. Big pharma is already beyond ridiculously shady in almost every aspect of their very existence and practices, let alone their secretive pricing tactics. Without a listed price before hand, they can effectively manipulate the cost based on insurance coverage. Someone who has 50% coverage might be charged 400 and someone with 90% coverage could be charged 2, 000 for the same medication. Each customer is paying 200 out of pocket, but big pharma isnt treating them equally. They can do this because nobody ever actually looks at their receipts AND nobody ever really compares pricing with each other for this stuff.
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The only reason I can afford my life saving medications is because my meds are subsidized. I absolutely would have died by now if I didn't have them. I'm already kinda bitter about the pay us or die situation I'm in, but pharmaceutical companies saying pay us MORE or die genuinely pisses me off. The fact that the Trump admission is taking this on makes me respect them, at least a little bit, which is pretty unusual cause most internet folks would consider me a libtard snowflake. But yknow, props where props are due, this is a good move. Especially for elderly folks who those ads a typically directed at. They often don't have the tech knowledge they need to find cheaper alternatives, so this transparency will likely make their lives a whole lot easier.
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Was VERY surprised that something like this happened/ is starting with this administration. I do believe prices will come down but I doubt in any largely meaningful way - at least not across the board or even close to it. But I do see it being impactful in specific cases. Even if this had no effect on prices I think this is a HUGE step in the correct direction. Medical expenses and services are about the only thing an American citizen buys while being clueless to the cost. To the misleading claim about not being an accurate depiction of what the end customer pays, well I positive they have market research that has fairly accurate idea of the end cost to consumers narrowed via many factors including coverage levels.
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I don't think it will do much. It's a step in the correct direction, but as stated in video, list price isn't customer price. The problem that really needs addressed with healthcare is that insurance companies hide the actual price. No insurance company pays the list-price for a procedure/med, they pay a totally different price which they agreed on during negotiations. Basically, insurance companies are rich in large part because we don't know the market value of anything. If you apply business law to healthcare, it's actually totally illegal (the standard payment industry compliance training about rubber ducks or metal widgets. Really not sure how it got this way.
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I'm definitely a fan of the extra videos. As far as advertising drug prices, I think it's a good idea in theory but as mentioned, it can get confusing with different insurance coverages. I think that they should be made to provide a week's worth of their product because of the side effects. Having to pay out up to 60 (using that # because it's the most i've paid with my insurance) and finding out you can't take it is beyond infuriating. I was given a new medication yesterday that came with a card for a two week trial and I really think that's the way to go. At least a week. Or provide the dr with enough samples to make it happen.
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I hate trump but the fact that he is actually trying to do something about this issue is awesome. Don't know if it will work but it doesn't hurt to try. I take inhalers for asthma and one of them cost me over 200 My insurance doesn't pay for medications. There is no less expensive one either. We have a discount card for it but it's still over 100 which we could use to eat or pay bills. I need the inhaler to breath and these drug companies take advantage of people like me who need certain meds in order to stay alive. Once they make their money back, they need to make it less expensive and come up with a generic one.
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After living outside of the U. S. and then coming back, I was hyper aware of the commercials and am really bothered by them. I would prefer that we didn't have ANY commercials so that doctors are provided us with an RX based on the medical need and not a medical want. Example: I should go to the doctor because I have a medical need - such as a skin disorder that I want to care for, and the doctor prescribe something to me and we can have a conversation on whether or not I can afford it. RATHER THAN, I saw a drug commercial that said it could help my skin and I should go to the doctor to discuss the drug.
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