High drug costs: The other side of the coin
Monday, November 21, 2016
There are two sides to every coin. And when it comes to the price of prescription drugs, it would appear the media (and many pharma news sites) are really only interested in looking at the high-cost, scandal-ridden, skyrocketing-price side of this particular penny. It seems like a game of "heads I win, tails you lose."
Don't get me wrong. The uncontrolled inflation of some prescription prices, particularly for certain generics that have been in the market for years, is a sad story to be sure.
As someone who works on the front lines of pharmacy, I see and feel the impact of these escalating costs all the time. And there is no doubt the proliferation of specialty drugs will continue to put pressure on payers and patients, resulting in higher premiums and escalating healthcare costs.
But wait a minute. There is another side to this pharmaceutical coin. And it seems patients, the media and many pharmacists for that matter have forgotten about it.
While costs for some drugs have gone up, the price of many products has gone down. In fact, I would argue that the pharmacy industry, more than any other healthcare profession, has worked to drive down costs in numerous ways that should never be forgotten.
Consider these three factors specifically:
1. Inexpensive generics
While news outlets seem to only be able to talk about the high price of a few generics, no one seems to remember that tens of thousands of generic prescription drugs are dispensed every day for less than a fancy cup of coffee. Thousands of tablets for blood pressure, cholesterol, pain, infection and mental health are virtually given away by pharmacies for $4 or $5 for a month's supply. This is done even without insurance.
The prescription is interpreted, filled, labeled and reviewed by a pharmacist, packaged and rung up for literally pennies per pill. And this happens hundreds of times daily, leaving essentially no margin dollars to pay for things like payroll, equipment, licensing, supplies or utilities.
What other branch of our healthcare system has worked to provide so much for so little? Doctors? Hospitals? Surgeons? Labs? When is the last time you arrived at the physician's office and were handed a $4 list of services?
My point is this: While expensive medications are a concern, we shouldn't lose sight of the economic strategies that pharmacy has employed to keep costs down for patients.
There is probably no more transparent branch of our healthcare system than retail pharmacy. Yes, I understand the issues surrounding the lack of transparency with the PBM industry. But I'm talking about the patient side of business.
Any patient in the U.S. can find out the full price of his/her prescription down to the penny and easily shop around before having to open the wallet and pay. Nobody goes to the pharmacy, picks up medication and then goes home wondering what the bill will be.
This, however, happens every single day in the rest of our healthcare system. Want to shop around for the best MRI price? Good luck. How about comparing the price of a well visit, a trip to the ER or the cost of that panel of labs that the doctor just ordered?
Patients are blinded from these costs, and the system is designed to keep us in the dark. And it is this lack of transparency that plays a significant role in driving up costs. Pharmacy, once again, is the exception to this rule.
3. OTC medications
The same journalists and media pundits who are blasting away at the "high price" of medications and the "greed" of the pharmaceutical companies are doing so while popping an OTC omeprazole for their acid reflux and an aspirin for their headache — both of which they obtained without even seeing a doctor. While typing away their malicious missives against pharmacy prices, they are enjoying all of the benefits of an inexpensive OTC antihistamine that keeps them from sneezing on their work.
My point is that the pharmacy business has historically driven costs down, and then driven many prescription drugs into the OTC shelves where consumers can care for themselves. But that has become so familiar to us that we seem to forget about it while we busy lambasting the industry over the price of a cure for Hepatitis C.
Yes, folks, there are two sides to every coin. And sometimes we need to flip it and remember what is written on the other side.
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