By Bill Rusteberg
I conducted a price check today in a small two prescription drug store town in central Texas. I had been getting the prescription at a third pharmacy in town but they closed their doors several weeks ago. The price there was $22.
HEB Pharmacy
The girl behind the HEB prescription drug counter quoted a cash price of $34. “Damn, that’s 155% higher than what I’ve been paying! I said to the clerk. “Sorry Sir, prescription prices are going up these days!”
Brookshire Pharmacy
I drive over to Brookshires Pharmacy. “What’s your cash price for this prescription?” I asked the clerk.
As she scanned her computer a frown formed…….“This shows the price at $105, that’s way too high! Let me see what the price would be with a discount card” she said helpfully. “Oh, look! With a discount card the cash price is just $13!”
“How do I get one of those discount cards? I asked.
“No worries, Sir. I can give you the discount card at no charge. I will plug that information into our computer so every time you come in for a refill it will automatically show the discounted price.“
So, in this one-horse central Texas town the price difference between drug stores for this one prescription ranges between 155-262%.
If I had one of those typical plan sponsored prescription drug cards with low copays, I wouldn’t care what the prices are. My copay would remain the same no matter where I shopped for my prescriptions. Prices be damned.
“Screw my employer. he doesn’t pay me enough anyway!” says Joe Sixpack.
Plan sponsors would be wise to consider adopting a cash pay Rx program instead of PBM administered plans.
A cash pay Rx program could be structured like this:
- Prescriptions sent to concierge service that sources best pricing
- Prescription order is sent to the dispensing source with the best and lowest price
- Virtual credit card is loaded in the exact amount of the cost of the prescription that can only be used at the dispensing source with the lowest price
- Plan member picks up their prescription locally if needed immediately using their preloaded virtual credit care. Or the prescription is home delivered within 3 days.
- Patient pays nothing (copays are silly and have no material effect over plan finances)
When prices vary by as much as 262% isn’t shopping for best prices worth a try? We do it for everything else.
Just Imagine………Shopping for best prices! What a novel idea!
FROM A RETAIL MCALLEN TEXAS PHARMACIST: Bill, my cost is under $6
