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#40601 - 05/20/16 12:56 PM Rx drug prices and sourcing
grelber Offline


Registered: 08/05/09
Loc: North of 49th ||
The following may not be news to some, but it was to me:

1. I just discovered that one can use the Costco pharmacy (in both USA and Canada) without having to be a Costco member.
Apparently Costco's Rx drug prices are at the low end of the spectrum compared with many other chain pharmacies.
Of course, in Canada pharmacies follow their provinces' drug formularies vis-à-vis pricing, with any price differentials being due to dispensing fee and ancillary services offered.

2. In the USA there is also available an app called Blink from Blink Health which can determine the best pricing on Rx drugs. Apparently ca 70,000 pharmacies will honor such pricing.

3. Also in the USA one might do better to buy Rx drugs with cash rather than going through one's insurance, the co-pays on which can be exorbitant.

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#40602 - 05/20/16 01:35 PM Re: Rx drug prices and sourcing [Re: grelber]
artie505 Online


Registered: 08/04/09
I use GoodRx in NYC, but they seem to have nationwide coverage. (There's a login option, but membership isn't required, and I've got no idea what, if any, additional benefits it brings.)

They track your purchases, of course, but I've read that you can opt out.

Here's a comparison of GoodRx's and Blink's prices on my eye drops:

Prednisolone Acetate Prices - GoodRx

Prednisolone acetate – $49.43 Discount Price - Blink Health

GoodRx says that their prices may be cheaper than those of some insurances.

Their price on my skin cream is similarly low!
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#40617 - 05/21/16 06:46 AM Re: Rx drug prices and sourcing [Re: grelber]
ryck Offline


Registered: 08/04/09
Loc: Okanagan Valley
Originally Posted By: grelber
The following may not be news to some, but it was to me:

1. I just discovered that one can use the Costco pharmacy (in both USA and Canada) without having to be a Costco member..

I don't know about the U.S. but, in Canada, they are obliged by law. Anyone with a licence to dispense drugs cannot turn away any person with a doctor's prescription.
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#40618 - 05/21/16 06:56 AM Re: Rx drug prices and sourcing [Re: grelber]
ryck Offline


Registered: 08/04/09
Loc: Okanagan Valley
Originally Posted By: grelber
Of course, in Canada pharmacies follow their provinces' drug formularies vis-à-vis pricing, with any price differentials being due to dispensing fee and ancillary services offered..

I have found that pharmacists will adjust their prices downward when pressured. When my health plan only partially refunded a purchase, I asked and was told that the pharmacy was charging too much per pill.

I went to the pharmacy (a national chain) with the information and advised, "You either charge X per pill or I go to another pharmacy." They dropped the price.
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#40619 - 05/21/16 07:07 AM Re: Rx drug prices and sourcing [Re: grelber]
ryck Offline


Registered: 08/04/09
Loc: Okanagan Valley
Originally Posted By: grelber
In the USA there is also available an app called Blink from Blink Health which can determine the best pricing on Rx drugs. Apparently ca 70,000 pharmacies will honor such pricing.

If you need a drug that now has a generic equivalent, you should consider this company. They pay your pharmacist a subsidy that brings the cost of the real drug down to the cost of the generic, or even lower.
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#40620 - 05/21/16 07:13 AM Re: Rx drug prices and sourcing [Re: ryck]
Douglas Offline


Registered: 08/04/09
Loc: Seattle, WA
I checked one of my medications on Blink and it cost $108.50. On GoodRx the cost was $48.77. I think I'll stick with GoodRx.

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#40621 - 05/21/16 07:47 AM Re: Rx drug prices and sourcing [Re: grelber]
grelber Offline


Registered: 08/05/09
Loc: North of 49th ||
I was just advised that:

4. Sam's Club Pharmacy (not in Canada) is also available to non-members.

It's also worth noting (as others have intimated) that showing Blink's (or other pharmacies' lower Rx cost) may persuade your pharmacy to match the price.

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#40622 - 05/21/16 07:48 AM Re: Rx drug prices and sourcing [Re: Douglas]
grelber Offline


Registered: 08/05/09
Loc: North of 49th ||
Originally Posted By: Douglas
I checked one of my medications on Blink and it cost $108.50. On GoodRx the cost was $48.77. I think I'll stick with GoodRx.

Maybe check all your meds' pricing.

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#40624 - 05/21/16 08:46 AM Re: Rx drug prices and sourcing [Re: grelber]
artie505 Online


Registered: 08/04/09
Originally Posted By: grelber
It's also worth noting (as others have intimated) that showing Blink's (or other pharmacies' lower Rx cost) may persuade your pharmacy to match the price.

I prefer to buy from an independent pharmacy (I've lost count, but I think there are 17 plus Walgreens and Rite Aid within 1/2 mile of my home.), but when I tell the pharmacists how much Walgreens charges me with my GoodRx coupons they just shake their heads and tell me to go there.

I don't know how they do it, but GoodRx's prices are simply waaay to low for others to match.

Edit: The independents will match Walgreens regular prices, but not the GoodRx prices.


Edited by artie505 (05/21/16 09:08 AM)
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#40625 - 05/21/16 09:05 AM Re: Rx drug prices and sourcing [Re: grelber]
artie505 Online


Registered: 08/04/09
Originally Posted By: grelber
Originally Posted By: Douglas
I checked one of my medications on Blink and it cost $108.50. On GoodRx the cost was $48.77. I think I'll stick with GoodRx.

Maybe check all your meds' pricing.

Counting my two meds, GodRx is three for three, and by significant margins in all three instances.

I haven't got any others to check, so it'll be up to somebody else to find an instance in which they fail to deliver.
_________________________
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#40628 - 05/21/16 02:33 PM Re: Rx drug prices and sourcing [Re: artie505]
honestone Offline
Banned

Registered: 11/13/15
Loc: Seattle, WA (up in God's Count...
With the Medicare Advantage plan that both my wife and I have, the copays do vary somewhat, but we get the lowest ones by using Safeway. And, the one we use is less than 3 miles from where we live. The nearest Costco is further away.
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#40629 - 05/21/16 02:54 PM Re: Rx drug prices and sourcing [Re: honestone]
artie505 Online


Registered: 08/04/09
I've never gone for Medicare Part D; the last time I looked, the lowest annual premium I could find was $310, and my annual Rxpenditure with GoodRx is about $20.
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#40636 - 05/22/16 08:41 AM Re: Rx drug prices and sourcing [Re: artie505]
honestone Offline
Banned

Registered: 11/13/15
Loc: Seattle, WA (up in God's Count...
The Medicare Advantage Plan my wife and I each have includes parts C and D, and the premium each month is $0. Of course, to qualify for such plans, one needs to have "basic" Medicare Parts A & B.
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#40641 - 05/23/16 06:05 AM Re: Rx drug prices and sourcing [Re: grelber]
grelber Offline


Registered: 08/05/09
Loc: North of 49th ||
From the feedback I've been getting via this forum and beyond it seems clear that, especially with respect to the situation in the USA, much depends on:
• where you're located
• how many and what sorts of pharmaceutical outlets are available (including legitimate/reliable online outlets)
• what types of insurance plan are in place

In Canada the variability is far less obvious. And down the pike, if and when the healthcare system gets its act together, pan-provincial/-territorial group buying may even the playing field even more and make Rx drugs much less expensive.

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#40646 - 05/23/16 08:05 AM Re: Rx drug prices and sourcing [Re: grelber]
joemikeb Online
Moderator

Registered: 08/04/09
Loc: Fort Worth, Texas
Originally Posted By: grelber
From the feedback I've been getting via this forum and beyond it seems clear that, especially with respect to the situation in the USA, much depends on:
• where you're located
• how many and what sorts of pharmaceutical outlets are available (including legitimate/reliable online outlets)
• what types of insurance plan are in place

Spot on Grelber! It gets even more convoluted if you are taking off-formulary or high value medications that are only available through specialty pharmacies. There is a growing number of medications the low cost and mass market outlets such as Costco, Walgreens, CVS, etc. refuse to carry because the inventory and special handling cost is simply not worth the risk.

Before anyone complains about the cost being the result of drug company profiteering, that is often not the case. Rather these are medications that cannot be "manufactured" per se because they are living proteins that must be hand cultured on an almost dose for dose basis. But these medications are by far the most, if not only, effective treatments for painfully crippling diseases such as Rheumatoid Arthritis, Psoriasis, Psoriatic Arthritis, and a number of other auto-immune conditions. Ask me how I know and I will show you my pharmacy bills.


Edited by joemikeb (05/23/16 08:07 AM)
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#40647 - 05/23/16 08:13 AM Re: Rx drug prices and sourcing [Re: ryck]
Virtual1 Offline


Registered: 08/04/09
Loc: Iowa
Originally Posted By: ryck
I have found that pharmacists will adjust their prices downward when pressured. When my health plan only partially refunded a purchase, I asked and was told that the pharmacy was charging too much per pill.

I went to the pharmacy (a national chain) with the information and advised, "You either charge X per pill or I go to another pharmacy." They dropped the price.

Most medical insurance handlers will charge the maximum that the insurance company is willing to pay, because they CAN. This doesn't affect your copay or deductible usually so most people don't care.

When I was between jobs I had to have a wisdom tooth removed. I'd been there before for several others and had been covered by insurance then, but not this time. When it came time to pay, I got the bill at the desk and then let them know I'd have to be paying for it myself since I didn't have insurance anymore. They more than cut the bill in half. They basically have a "insured" and an "uninsured" rate.

From one point of view you could consider this a bit of "socialism on the sly", as the insurers are somewhat indirectly helping me - they can charge the insured a little more, and charge me a little less
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#40654 - 05/23/16 09:15 AM Re: Rx drug prices and sourcing [Re: Virtual1]
honestone Offline
Banned

Registered: 11/13/15
Loc: Seattle, WA (up in God's Count...
Originally Posted By: Virtual1

Most medical insurance handlers will charge the maximum that the insurance company is willing to pay, because they CAN. This doesn't affect your copay or deductible usually so most people don't care.


Almost correct, at least in the US. For the Medicare Advantage Plan my wife and I had last year, going to a "preferred" pharmacy would result in a lower co-pay (fortunately, we have no deductible for any of our benefits, including our current plan). For that plan, the closest preferred pharmacy was Safeway.

One other thing is that while we do not have a deductible for drugs, there are "Coverage Stages" with associated maximum tiers. For the "Initial Coverage Stage", that amount is $3,310 for each of us (there is also such stages for our medical benefits, but again, neither of us gets nowhere close to that amount). Fortunately, both my wife and I do not take many medications, and almost all the ones we take are generic equivalents, and thus we never come close to that amount (for each of us). My wife does take a brand name drug for her diabetes, but again, we are fortunate that our doctor gives us so many samples of it that we do not need to spend anything at all on that one.


Edited by honestone (05/23/16 09:18 AM)
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#40656 - 05/23/16 09:53 AM Re: Rx drug prices and sourcing [Re: Virtual1]
joemikeb Online
Moderator

Registered: 08/04/09
Loc: Fort Worth, Texas
Originally Posted By: Virtual1
From one point of view you could consider this a bit of "socialism on the sly", as the insurers are somewhat indirectly helping me - they can charge the insured a little more, and charge me a little less
  1. a substantial part of medical cost is incurred by the highly trained clerical support staff necessary to process all of the government and insurance company paperwork.
  2. Providers often incur long delays in receiving compensation from third party payers and therefore end up with substantial interest charges from their bankers.
  3. There is a definite risk that in the end the healthcare provider will be unable to collect part or all of their costs. Insurance companies and Medicare can and do change their mind about whether a given procedure is covered or at what rate even if the procedure was pre-approved, patients walk-away from their deductible, etc
THE POINT IS: If a patient pays their bill in cash the health care provider avoids those costs and risk, so they can legitimately offer, if not a special rate per. se., a discount for cash. It is just good business.
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#40662 - 05/23/16 02:08 PM Re: Rx drug prices and sourcing [Re: joemikeb]
honestone Offline
Banned

Registered: 11/13/15
Loc: Seattle, WA (up in God's Count...
Originally Posted By: joemikeb
THE POINT IS: If a patient pays their bill in cash the health care provider avoids those costs and risk, so they can legitimately offer, if not a special rate per. se., a discount for cash. It is just good business.


I suspect the discount will not be that "great". Along similar lines, dental insurance for retirees, in the US, s**ks big time! So, when we go to the dentist and pay cash (actually use our credit card to build up reward points), the discount is only 10%.


Edited by honestone (05/23/16 02:10 PM)
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#40667 - 05/23/16 06:55 PM Re: Rx drug prices and sourcing [Re: honestone]
ryck Offline


Registered: 08/04/09
Loc: Okanagan Valley
Originally Posted By: honestone
Fortunately, both my wife and I do not take many medications, and almost all the ones we take are generic equivalents, and thus we never come close to that amount (for each of us). My wife does take a brand name drug for her diabetes, but again, we are fortunate that our doctor gives us so many samples of it that we do not need to spend anything at all on that one.

Originally Posted By: ryck
If you need a drug that now has a generic equivalent, you should consider this company. They pay your pharmacist a subsidy that brings the cost of the real drug down to the cost of the generic, or even lower.

Or, in the case of the U.S., it may be at this address.


Edited by ryck (05/23/16 06:55 PM)
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#40668 - 05/23/16 07:10 PM Re: Rx drug prices and sourcing [Re: honestone]
joemikeb Online
Moderator

Registered: 08/04/09
Loc: Fort Worth, Texas
As pointed out by V1 the cash discount can approach 50% for medical procedures. Dental economics are vastly different from medical for a number of reasons, not least of which is because with the exception of dental surgery, which is covered under medical not dental insurance, the contribution of third party payers (insurance) is a relatively small portion of the practice's income.
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#40669 - 05/23/16 09:39 PM Re: Rx drug prices and sourcing [Re: ryck]
honestone Offline
Banned

Registered: 11/13/15
Loc: Seattle, WA (up in God's Count...
Originally Posted By: ryck
Originally Posted By: honestone
Fortunately, both my wife and I do not take many medications, and almost all the ones we take are generic equivalents, and thus we never come close to that amount (for each of us). My wife does take a brand name drug for her diabetes, but again, we are fortunate that our doctor gives us so many samples of it that we do not need to spend anything at all on that one.

Originally Posted By: ryck
If you need a drug that now has a generic equivalent, you should consider this company. They pay your pharmacist a subsidy that brings the cost of the real drug down to the cost of the generic, or even lower.

Or, in the case of the U.S., it may be at this address.


For folks that have Medicare Parts A & B (like my wife and I), there are a number of Medicare supplement plans that we can choose from during Open Enrollment, which occurs from October through December. THe 3 types of plans we can choose from are:

Plan C - better coverage for Medical "procedures".

Plan D - Prescription Drug Coverage

Plan C & D - Combines the benefits of Plans C and D above.

My wife and I have always had Plan C & D (called a Medicare Advantage Plan).

Of course, each plan that we can choose from has different "features", and one should choose a plan that fits their needs. For my wife and I, given that we are in very good health, and have no major issues, we always choose an "HMO TYpe"plan, with no monthly premium. And, as I mentioned above, we can change our plan during the Open Enrollment period for the following year. We have done that each time, and it has worked out well.

For prescriptions, in just about all cases (except when a preferred pharmacy can be used, or one uses mail order), the copays for drugs are the same.
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Using Macs since 1984
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#40671 - 05/24/16 07:07 AM Re: Rx drug prices and sourcing [Re: honestone]
ryck Offline


Registered: 08/04/09
Loc: Okanagan Valley
You don't understand. InnoviCares is not a drug plan and does not have any interaction with your drug plan. If only interacts with your pharmacist at the time you are filling a prescription. It is simply a way to ensure you get the original drug, not the generic.

It works like this:

1. Your pharmacist has both the real drug and the generic available.

2. For "Drug X" 100 pills cost 200.00 but 100 generic pills cost only 60.00

3. Your health plan is only willing to pay the generic cost.

4. If you are registered with InnoviCares, you get the real drug even though It costs 200.00.

5. While you are filling your prescription, InnoviCares remits the difference to the pharmacist.

6. The pharmacist then charges you only for the cost of the generic.

7. You submit your claim for the cost of the generic, but you got the real drug.

I have been enrolled with InnoviCares for about four years and, as a person who remains leery of generics (no, I do not wish to have the debate), InnoviCares is the answer. There are no fees or costs of any kind to be a member.

The links provided both point to the Canadian scene (my error) but I have to assume there is an equivalent American program at InnoviCares. It's worth a search.


Edited by ryck (05/24/16 07:31 AM)
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#40674 - 05/24/16 08:27 AM Re: Rx drug prices and sourcing [Re: ryck]
artie505 Online


Registered: 08/04/09
Quote:
...I have to assume there is an equivalent American program at InnoviCares. It's worth a search.

Well, it's not goodrx.com; their "break" on the generic equivalent of my drops is only $10 off the $137 price. frown

innoviCares doesn't seem to have a US presence.
_________________________
The new Great Equalizer is the SEND button.

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#40676 - 05/24/16 09:42 AM Re: Rx drug prices and sourcing [Re: honestone]
Ira L Online


Registered: 08/13/09
Loc: California
Originally Posted By: honestone
For folks that have Medicare Parts A & B (like my wife and I), there are a number of Medicare supplement plans that we can choose from during Open Enrollment, which occurs from October through December. THe 3 types of plans we can choose from are:

Plan C - better coverage for Medical "procedures".

Plan D - Prescription Drug Coverage

Plan C & D - Combines the benefits of Plans C and D above.

My wife and I have always had Plan C & D (called a Medicare Advantage Plan).


There are actually more than three choices if you opt for a MediGap plan (these use letters F through N and are non-HMO). The coverages vary in co-pays, deductibles and what is covered. Under the Affordable Care Act each plan must be the same across all providers. That is, any insurance company's Plan N will cover exactly the same things with the same co-pays, etc. as any other company's Plan N. The only difference will be the monthly premium charged and the level of service provided.

None of these Plans F-N include drug coverage, which is where buying a Plan D would come in. Plan D's can have varying levels of co-pays and deductibles, based on the provider.

What is available to any individual will definitely vary by geography.

Interestingly, when looking at out-of-pocket costs for drugs under different plans, the insurance company will use the retail price of the drug even if you paid less. Just one more way of moving the consumer faster into the Medicare Drug Plan "doughnut hole" (where the individual must cover full costs for a period).
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