Hope this doesn't become a rant

[oldtrap59]

Was reading YCC's " tied the knot" thread earlier today and his comment on drug prices set me off abit. Again is probably some closer. With retirement not to far off we will be without our drug coverage.(either pay for coverage or go without as I understand the system) Anyway, we been checking around for prices as the wife takes several meds on a daily basis.(I take bayer when I have a headache sometimes) Now I'm sure yall have heard of the four dollar plan at Wally world and other places. So first place we checked was there. Total came to $89.44 per month with some of the items not on the plan. Next we went to CVS for a check. They do not have the four dollar plan and quoted us $269.03 per month. Wife talked to the doctor the other day and he suggested checking with a Texas based grocery chain we have here. We did and found that most of what she takes falls under their four dollar plan.(Brookshire bros) Total there will be $40.99 per month. I'll save you some time and tell you that's $228.04 less then CVS. Now knowing that none of these places are in business to loose money will someone tell me how this makes sense? I guess you could say the grocery store just sells these pills as a come on buttttttttttttttttt come on now. I ain't buying that line. Well I'll just add CVS to my list of,"ain't spending a dime there places".

Oldtrap

[Rick]

OT - Sometimes it's called a loss leader. The reasoning goes something like this. CVS will run a sale on milk, sometimes at or below their cost to get you in the door. AND WHILE YOU ARE THERE you might as well get some scripts filled and pick up some toothpaste since it's right there and handy. On the other hand, Brookshires might offer a generic antibiotic at or below cost to get you in the door. AND WHILE YOU ARE THERE you might as well pick up some bread and milk and some toothpaste since it's right there and handy. Walmart is the absolute king in loss leaders. Especially in electronics. I've seen cordless phones on sale for $12. That's below their cost but you'll spend more than what they loose as long as they can get you in the door. Besides, the loss is a write-off. They do the same thing with some scripts.

You did the right thing and something most folks don't do and that's comparison shopping for scripts. You can comparison shop for surgical procedures just as easily. You'd be surprised the differences that exist between local hospitals on something like, say, a gall bladder removal or just an MRI or CAT scan. It can be of equal quality but very different prices. Ask your doctor if that procedure they just prescribed will change the way they treat your (plug in problem here). If not, then what's the need?

Talk to your doctor as well about any samples he/she can give you. AND, ask them if an alternative drug can do the same thing. You may or may not tolerate a different drug but if it does the same thing and is cheaper then it might be worth looking at. Certainly worth talking about.

[randyt]

when it comes to loss leaders a consumer needs to learn to "cherry pick"

[Rick]

You bet!!! Go for that item and go home. But that's not what retailer's count on. Marketing 101 you know. That's why bread and milk are in the back of the store. And the items at the end of the isle are almost always being sold at full price. We assume if they are stacked up at the end of the isle they must be on sale. But check the price!!!!

[BENESSE]

Also, if applicable, get a prescription for a larger mg content and split the pill especially if you can do it accurately. For example, if you take 10mg of Lipitor daily, get a prescription for 20mg and use a pill splitter to split it. Etc.
I know people who are doing it and saving substantially.

[Rick]

As long as it's not timed release or has an enteric coating to protect your stomach. Some meds are meant to be released further down the digestive tract so talk to your doctor. I'm sure that's what the "if applicable" part was. Just wanted to clarify.

[LowKey]

I have the new BCBS policy that actually forces you to shop around. They've rated facilities on a 3 tier system and base your out of pocket on what tier the facility is in. My PCP just happens to be top tier. I can go to see him with a $50 co-pay or I can 'shop around' for a new doctor on tier 3 and pay $15. No joke. What does appear to be the joke is my doctor is in a medical group with a lab, ekg, MRI and X-ray facilities and I can do what's necessary in one trip by maybe changing floors. The doctors on the lower tier are most often private practice with all the extra running around that entails. I save that $35 in gas and aggravation.

They have hospitals, independent labs and other medical facilities graded the same way. It isn't so much that I get to shop around, I have to choose whether to pay more or select from those they have graded at lower cost. We could not get the BCBS rep who came to our company to explain the policy to explain adequately what their grading system was.

I get monthly letters telling me I should be more aware of my health care costs and that my current PCP is in a higher tier. Like I want to change my doctor on a yearly basis just cuz the insurance company thinks I'm paying too much. What happened to continuity of care?

[BENESSE]

Xactly, Rick. A friend is doing it with Lipitor with his Dr.'s blessing.

[Rick]

Lowkey - I'd keep after them. Write them a nice letter and ask them to explain, in detail, what criteria they use to create the tier system. Then ask them why your doctor costs so much more. I'll bet they don't answer the first letter but by the time the fourth or fifth rolled around and a copy to their CEO was included I bet they answer you. That's how I'd do it. There is no reason for a company not to explain their criteria process.

I'm also with you on the continuity of care issue. There is little more important than a patient/physician team that works together. I'm fortunate to have been with the same PCP for the last 7 or 8 years and we know each other pretty well. It's one thing when a new patient comes in and says the pain is terrible. It's another thing entirely if a well known patient that doesn't complain comes in and says the pain is terrible. Maybe a bad example but hopefully it gets the point across.

If anyone is trying to compare doctors from PCPs to specialists just be careful. Some doctors see high risk patients and some won't so their win/loss ratio (if you'll pardon the pun) may be vastly different. The doctor with the highest loss could well be the better doctor but doesn't appear so because he/she treats high risk and the other doctor doesn't.

[LowKey]

They keep referring me to this on their website.
Bear in mind that Basic tier is the most expensive. Doctors who apparently charge higher rates (and therefore don't meet their cost benchmark, but from what I understand, those rates are based on former negotiated contracts with BCBS) are lumped in with doctors who don't meet their quality benchmark. Is there something I'm not getting or does that seem wrong?


Within Massachusetts, each time members seek care from a PCP or hospital, their cost sharing is based on which of the three tiers* the provider is assigned to. This helps encourage members to consider the cost and quality of their PCP or hospital each time they get care and rewards them for choosing providers in enhanced or standard benefits tiers.

* Enhanced Benefits Tier—Lowest member cost sharing—Includes Massachusetts PCPs and hospitals that met our quality benchmark and our benchmark for lowest cost.
* Standard Benefits Tier—Mid-level member cost sharing—Includes Massachusetts PCPs and hospitals that met our quality benchmark and our benchmark for moderate cost. Also includes providers without sufficient data for measurement on one or both benchmarks. In limited circumstances, the Standard Benefits Tier includes certain providers whose scores would put them in the Basic Benefits Tier to provide geographic access for members.
* Basic Benefits Tier—Highest member cost sharing—Includes Massachusetts PCPs and hospitals that scored below our quality benchmark and/or our benchmark for moderate cost.

*Note: For the cost benchmark, hospitals were measured on their individual facility's performance and PCPs were measured according to the costs their group's HMO patients incurred. Physician groups can be composed of an individual provider, or a number of providers who practice together. Tier placement is based on benchmarks where measurable data is available; those without sufficient data were defaulted to the Standard Benefits Tier. Specialty hospitals were measured on cost alone for their overall tier rating. Hospitals with nonstandard reimbursement were placed in the Basic Benefits Tier.

[your_comforting_company]

Many drug companies are working to keep their prices down (Astra zeneca). Found out yesterday that my cost at the hospital pharmacy is only 150% of cost.
That means that if the hospital pays $5 for a bottle of pills, I'll only pay $7.50. Surprising that antibiotics I paid $40 for last year actually only cost $3.50 and I could have gotten them for less than $10. Pharm companies are in the business to make money. A profit margin of 700% seems a bit excessive to me. Sorry.. I'm about to turn it into a rant.
For us, living in such a rural community, you either pay what they ask, or drive 25 miles (or 45) to a city where there is "competition". That's where they get us. You can spend $20 in gas to save $10 on a script, or you can pay $15 extra at the counter and save yourself $5 in gas..

If any of your scripts are from those companies that offer assistance, I'd recommend contacting them. With a 700% profit margin on common folks, they can surely afford to offer a few folks discounts and free meds. Astra zeneca is the one that comes to mind, but there are several companies out there that do the same.

[oldtrap59]

I heard on the news yesterday that phizer wants to sell Lipitor over the counter. Seems they feel that if this is allowed they won't loose so much of the money they now make with it when their patent rights run out this fall. My wife took this drug at one time but now takes something called Zocor which her doctor says does the same thing at a lower price.(Zocor is on the $4 plan at the grocery store) Now what bothers me is that here we have a drug company asking our good old FDA to ok them selling lipitor over the counter so they can compete price wise with the generics that will be on the market. (news report said that phizer takes in about 11 billion a year off this one drug) For those of you that don't use or know about lipitor, it's a drug that not used properly can do especially liver damage. This means regular test need to be done by the doctor to make sure the user isn't blowing out their liver. Sounds like Phizer is more worried about their profit then the people they serve to me.

Btw We like most thought that drug prices were pretty much the same everywhere till our doctor suggested us shopping around. Man did we get our eyes opened up.

Oldtrap

[kyratshooter]

Actually they want to go OTC so they will not have to compete with the generics. They can force their competators to OTC status and insurcance nor the generic plan neither one will cover their cost on most plans.

I have had several meds go OTC and my insurance quit covering due to nonprescrition status. My out of pocket cost has doubled on several of these meds.

[crashdive123]

And what the news report that stated Phizer takes in about 11 billion off of this one drug failed to mention is that only about 1 out of every 100 drugs developed by pharmaceutical companies make it to market. That's a whole lot of R&D on things that never make any money. Pharmaceutical companies turn about a 17% profit margin. Better than some big industries and worse than others.

[Blasfemo]

OT - Brookshires might offer a generic antibiotic at or below cost to get you in the door.
is this a pharmacy shop or something in lines of a walmart m8?? and can they sell antibiotics? if it is possible its great that would never happen here... paracetamol and thats that any antibiotics only in a pharmacy...

[Rick]

It's a grocery store chain. Many grocery store chains here in the U.S. have pharmacies within their building. Similarly, many pharmacies sell things like milk and bread within their stores. It does not matter where a pharmacy is located. It still has to follow the same FDA rules and regulations.

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[yellowcab]

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�айт (http://keepagoodoffing.ru)�айт (http://keepsmthinhand.ru)�айт (http://kentishglory.ru)�айт (http://kerbweight.ru)�айт (http://kerrrotation.ru)�айт (http://keymanassurance.ru)�айт (http://keyserum.ru)�айт (http://kickplate.ru)�айт (http://killthefattedcalf.ru)�айт (http://kilowattsecond.ru)�айт (http://kingweakfish.ru)�айт (http://kinozones.ru)�айт (http://kleinbottle.ru)�айт (http://kneejoint.ru)�айт (http://knifesethouse.ru)
�айт (http://knockonatom.ru)�айт (http://knowledgestate.ru)�айт (http://kondoferromagnet.ru)�айт (http://labeledgraph.ru)�айт (http://laborracket.ru)�айт (http://labourearnings.ru)�айт (http://labourleasing.ru)�айт (http://laburnumtree.ru)�айт (http://lacingcourse.ru)�айт (http://lacrimalpoint.ru)�айт (http://lactogenicfactor.ru)�айт (http://lacunarycoefficient.ru)�айт (http://ladletreatediron.ru)�айт (http://laggingload.ru)�айт (http://laissezaller.ru)
�айт (http://lambdatransition.ru)�айт (http://laminatedmaterial.ru)�айт (http://lammasshoot.ru)�айт (http://lamphouse.ru)�айт (http://lancecorporal.ru)�айт (http://lancingdie.ru)�айт (http://landingdoor.ru)�айт (http://landmarksensor.ru)�айт (http://landreform.ru)�айт (http://landuseratio.ru)�айт (http://languagelaboratory.ru)�айт (http://largeheart.ru)�айт (http://lasercalibration.ru)�айт (http://laserlens.ru)�айт (http://laserpulse.ru)

[yellowcab]

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�айт (http://obstructivepatent.ru)�айт (http://oceanmining.ru)�айт (http://octupolephonon.ru)�айт (http://offlinesystem.ru)�айт (http://offsetholder.ru)�айт (http://olibanumresinoid.ru)�айт (http://onesticket.ru)�айт (http://packedspheres.ru)�айт (http://pagingterminal.ru)�айт (http://palatinebones.ru)�айт (http://palmberry.ru)�айт (http://papercoating.ru)�айт (http://paraconvexgroup.ru)�айт (http://parasolmonoplane.ru)�айт (http://parkingbrake.ru)
�айт (http://partfamily.ru)�айт (http://partialmajorant.ru)�айт (http://quadrupleworm.ru)�айт (http://qualitybooster.ru)�айт (http://quasimoney.ru)�айт (http://quenchedspark.ru)�айт (http://quodrecuperet.ru)�айт (http://rabbetledge.ru)�айт (http://radialchaser.ru)�айт (http://radiationestimator.ru)�айт (http://railwaybridge.ru)�айт (http://randomcoloration.ru)�айт (http://rapidgrowth.ru)�айт (http://rattlesnakemaster.ru)�айт (http://reachthroughregion.ru)
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�айт (http://scarcecommodity.ru)�айт (http://scrapermat.ru)�айт (http://screwingunit.ru)�айт (http://seawaterpump.ru)�айт (http://secondaryblock.ru)�айт (http://secularclergy.ru)�айт (http://seismicefficiency.ru)�айт (http://selectivediffuser.ru)�айт (http://semiasphalticflux.ru)�айт (http://semifinishmachining.ru)�айт (http://spicetrade.ru)�айт (http://spysale.ru)�айт (http://stungun.ru)�айт (http://tacticaldiameter.ru)�айт (http://tailstockcenter.ru)
�айт (http://tamecurve.ru)�айт (http://tapecorrection.ru)�айт (http://tappingchuck.ru)�айт (http://taskreasoning.ru)�айт (http://technicalgrade.ru)�айт (http://telangiectaticlipoma.ru)�айт (http://telescopicdamper.ru)�айт (http://temperateclimate.ru)�айт (http://temperedmeasure.ru)�айт (http://tenementbuilding.ru)tuchkas (http://tuchkas.ru/)�айт (http://ultramaficrock.ru)�айт (http://ultraviolettesting.ru)