Published October 6th, 2016 by Stephanie
Drug prices are, to be perfectly frank, a complicated mess. Pharmaceutical companies set prices as high as they can, not just for the sake of funding new research but because they are for-profit businesses that want to make the best profit possible. They also set prices high to they have room to negotiate with pharmacy benefit managers, companies that do most of the bargaining and that take an unknown cut of the lower price thanks to the secret nature of the negotiating process.
Finally, there are three groups that have to pay out the final price based on where the pharmacy benefit managers set the lower price. Large employers and insurance companies traditionally eat most of the cost, leaving a much more reasonable number for the person with the prescription. But as prices continue to go up across the board, things are starting to shift around in this payment scheme.
For instance, while it hasn’t gotten as much publicity as other drugs, the most expensive class of drug right now in terms of total yearly costs is anti-inflammatory medications. These drugs help keep the exceptional pain of arthritis at bay, and according to the pharmacy benefit manager Express Scripts, the one percent of its members who use anti-inflammatories are incurring ten percent of the members’ overall drug spending.
As a result of this and other price increases, Express Scripts is creating a list of preferred and not preferred medications, and for the second category they won’t provide any coverage or discounts. Apparently, this only applies to new prescriptions going forward and the idea is to get drug companies to lower prices to get on the preferred list. However, even if this hardball negotiation tactic works, it’s still going to leave a lot of people out in the cold and in tremendous pain.
But in some ways, this may be just what needs to happen for the system to change. An Epipen today costs six times what it did ten years ago despite being the exact same product, and the only reason people sat up and took notice recently is because a pharmacy benefit manager shifted more of the cost onto the public instead of the insurer. So if this trend continues, so might the public outcry and the political response.
And in the meantime, one guaranteed way of getting relief from high drug prices is with a USA Rx pharmacy discount card. Whether a drug is brand name or generic, preferred or not preferred, we can get you up to 75 percent off the list price of prescription medications in over 60,000 US pharmacies. All we need in exchange is your name and an email account where we can send your card. If you’d like to discover more, you can send us an email at [email protected] or call us at 888-277-3911.