This visit was going to be another learning experience. As I drove up to the ranch house, there he was, beer in hand, waiting. “What took you so long! I have something to tell you and it’s a god damn disgrace!”
By Molly Mulebriar
Recently I visited an old friend in the Cuero, Texas area. I had not seen him in over a week, and I was looking forward to the visit. Bill is my mentor. I have learned quite a lot from him over the years about the health care delivery system’s best kept secrets that drive costs in this country at the expense of the consumer.
This visit was going to be another learning experience. As I drove up to the ranch house, there he was, beer in hand waiting for me. “What took you so long, I have an interesting story to tell you Molly!” It’s about the egregious pricing of prescription drugs. It’s a god damn disgrace, hidden by insurance companies, pharmacy benefit managers, insurance consultants and everyone else in the health care industry!” he ranted.
“Whoa, slow down, I haven’t even been offered a beer yet, what’s this all about?” I responded.
“Did you know that a 30 day supply of Lantanaprost costs $92 at HEB in Victoria, $76 at Walgreens in the same town, and then over in little Cuero, Texas, it costs $25 at a mom and pop drug store!”
“Bill, why should you care, you have insurance don’t you? All you have to pay is your copay, right?”
“Nope, have no insurance for prescription drugs. Waste of money in my opinion. I shop around for the best prices. But wait until I tell you what a PBM told me!”
“A good friend of mine who I trust works for a PBM. I asked him to confirm if he pays all pharmacies the same for each drug, and in this case, what would that be.”
His response: “We would pay the pharmacy just over $13 and it wouldn’t really matter which of the 3 pharmacies you mentioned. I can’t read the NDC on your picture but the one I used is 17478-0625-12.”
So there you have it. Pharmacies get $13 from this PBM for Lantanprost. At that I assume the pharmacy makes a profit. So what is the real cost? $3, $4, $5????????????????????????
Bill says he will discuss this with his pharmacist upon refill. That should be interesting.
Send comments to riskmanager@riskmanagers.us
From Stop Loss Carrier Rep:
You are Cervantes, going up against Windmills! You are Sisyphus rolling a stone up the hill ! You are a Christian being thrown againist the Lions. You are Joe Buckner going up against Ali. But I am rooting for William keep punching, you inspire me!!
