What Are Your Prescription Drugs Really Costing You?
David Belew loves his work. Ask him about his pharmacy and a smile fills his face. He radiates with pride. Dave is the second generation of Belew Drugs, a local independent community pharmacy begun by his father decades ago. The store is nestled in a small shopping center on Broadway. From humble beginnings, Belew now owns three pharmacies.
Just up the street, on the corner of Washington Pike and Whittle Springs Rd. is Mac’s Pharmacy. Owner Mac Wilhoit, like young Mr. Belew, is proud of his store. And, like Belew, Mac owns more than one pharmacy . Mac’s son, Mike, operates the store in Powell.
A steady stream of customers flow in and out of Mac’s. They are served by Mac and his staff, some of whom are students in pharmacy programs in three local programs, the University of Tennessee, South College and East Tennessee State University. Mac is vibrant, and welcoming. There’s an openness about him that resonates with his customers and this interviewer.
On the north side of the city, at 815 Merchants Road, Bob Boyd serves his clients at Norwood Pharmacy, like he has for decades. He knows them well, and they know him.
Dave, Mac and Bob are some of the remaining islands of independent community pharmacies (ICPs) amidst a sea of big box pharmacy retailers. ICPs in Knoxville are outnumbered some ten to one. In a city which, like the nation, sees all pharmacies alike, what consumers don’t know about big box stores can hurt them financially -- to the tune of thousands of dollars each year per person.*
I know this because of what happened to me. A year ago this month, I went for a routine check up with my cardiologist in Michigan. Three days later, I was getting four stents placed in my arteries. With today’s technology, it’s virtually an outpatient procedure. Before leaving Michigan, the doctor gave me four prescriptions, which you’ll see below. The important thing to pay attention to is what happened next.
Rather than wait to fill the scripts in Tennessee, I went to the Target store in a nearby shopping center.
I handed them the script for Plavix, a blood thinner, and asked for the cash price of the generic version to save money. The generic is called Clopidogrel; their price $126 for 30 tablets. I thanked the clerk and moved on. Second stop, Krogers, in the same strip of stores. Same script, $54 for 30 days. A local independent community pharmacy about a mile away quoted $18 for the same script and earned my business.
Follow me, now. When I returned to Tennessee, I priced Clopidogrel at Krogers, expecting a $54 quote. Their price, $196. Target on the east side was within a dollar or two. At a number of independent community pharmacies in the city, and in local communities to the east, prices ranged from $12-$19 -- all things being equal.
Now, if you’re insured, you may not see this spread. You’ll pay a co-pay, perhaps, and be on your way. But Knoxville has tens of thousands of people without prescription drug coverage. They need to know the difference between (a) big box chains -- like the one on the corner of healthy and happy that charges the higher prices -- (b) its competitive counterpart that usually has the store on the opposite corner -- and (c) the community pharmacies that have served the city for decades.
Why do they need to know this? Because, for many those price differentials drive some gut wrenching, life decisions -- like. “Do I pay for these meds, or my rent?” “Do I manage my health or feed my children?”
To drive the point home, consider that I only referenced one drug. I needed four. The four together came to roughly $49/month at independents like Belew, Mac’s, Norwood and others. At the big box stores, the ones that . advertise endlessly on television, OVER $350. Dear reader, it means I could buy a seven month’s supply for what the big box stores charge for ONE month! I could use that money to pay for all or part of six month’s rent or six month’s groceries.
As you think about that, i draw your attention to my home town, Cheshire, Connecticut. Growing up there in the middle 1950s-1960s, I recall there were three independent community pharmacies: Morton’s Pharmacy on the south side; Carrington’s by the church green; and, Cheshire Pharmacy, on the corner of W. Main and Maple Ave. Of them, Morton’s was the only one with a soda fountain.
Today, there are none. Instead, there are a number of big box pharmacies, both stand-alone and inside the grocery chain stores. Morton’s is a CVS. I priced out the same four drugs. They range from $160 $208/month, or $1920-$2496/year. That’s between four and five times more than an independent. Cheshire is an upscale community, where money is less of an issue.But while the town has no independent community pharmacies, they do have residents who are uninsured. Like Knoxville, those people face difficult choices. Unlike Knoxville, they have fewer options. Fortunately, though, they have Costco, whose prices are a fraction of the cost. And, Costco Pharmacy sells to everyone, so there’s no need to have a membership.
At the end of the day, it’s up to each of us to decide where to shop. I have insurance, with a co-pay which varies by the pharmacy I choose. I could pay a lower amount if I use the insurances company’s preferred pharmacy or their mail order company but I don’t. I want to make sure my uninsured friends have options, so I support my local independent community pharmacy, at the corner of fairness and compassion. I hope you do, too.
There’s an app for that: If you want to check prices on prescription drugs, a new app available online for free is: www.goodrx.com The site is pretty informative and easy to use. just put in the name of the drug you want, the strength and number of tablets, along with you zip code and the app does the rest. Most times you don’t need their coupon. You just need to know which places have the best prices. Start by calling to confirm.I think you’ll find as good a deal or better at Independent Community Pharmacies every time.
Good Shopping.
The Canadian Option for Brand Name Drugs
To be clear, brand name drugs are those that are still under patent. Since there are no generic equivalents, the prices generally are many times higher. For example, blood thinner Plavix retails for over $200, whereas the generic, Clopidogrel sells for between $12 and $196, as previously noted.
The alternative for brand names is to buy them from Canada.
No kidding. The Canadian government negotiated pricing with drug manufacturers and those negotiated prices are light years from what Americans pay, in any pharmacy. An acquaintance was paying over $1100/month for three drugs: Strattera, Seroquel and Abilify. Today, she gets them from Canada, for less than $200.
The state of Maine** passed a law permitting the importation of prescription drugs from Canada. The results were that the city of Portland, ME, saved some $200,000/year. A small manufacturer of wood sticks used in popsicles and corn dogs saved $400,000. Across the state, tens of thousands of Maine’s citizens are enjoying the benefits. One man saved $100/month on drugs for his son’s asthma.
In Maine, where wages are modest at best, $100 goes a long way. It’s that way in Tennessee, too. So, a law to permit importing prescription drugs could save cities like Nashville, Memphis, Chattanooga, Knoxville and others thousands as well. The savings for Tennessee’s citizens and Tennessee corporations can be in the millions.
There is plenty of precedence for importation. If Tennessee were to do that, they would be following actions taken by others:
“In fact, New Hampshire, Minnesota, Wisconsin, Rhode Island and North Dakota have already launched state Web sites that help consumers order prescriptions online from approved Canadian pharmacies. The cities of Springfield, Mass.; Montgomery, Ala. and Burlington, Vt. also operate voluntary mail-in programs that supply municipal workers and retirees with prescription medications from Canada.” http://www.csg.org/knowledgecenter/docs/TA0406DrugImport.pdf
Other Ways to Save
Buy the drug in double the dose and cut the tablets. Many drugs come with a score mark exactly for that purpose. For example, the man who buys Viagra in 50mg strength pays something like $30.50/tablet. The 100mg tablet sells for, you guessed it, $30.50/tablet. If he buys the 100 mg and cuts it in half, he has doubled the number of tablets, or halved his costs. You get the picture. Using the same example, Viagra 50mg through Canada retails for $12.33/tablet; the 100mg, $13.35. You do the math.
Now, this doesn’t work for all drugs. Time release drugs are an example. Ask your doctor for advice. And, while you’re at it, ask for free samples.
Middle class incomes have been declining for decades. The result is family budgets are strained to the breaking point. Independent community pharmacies understand that, as they always have. They show their understanding by keeping their prices reasonable and manageable for the majority of their clients. Big box stores don’t share that same concern. Their business model is less social, driven as it is by the need to maximize profits at all costs, while putting on a false front. It’s the story of the labrador and the Scorpion*.
Some states have representation, while others have elected officials who feign representation but have little to show in results. Those states with proper representation have laws permitting the importation of prescription drugs with positive results all around; savings for state and local governments (your tax dollars); savings for corporations with prescription drug benefit plans; savings for individuals and their families. Tennessee is not one of them. Perhaps someday, newly elected Tennessee legislators will come to serve, and things will improve for all Tennesseans. Perhaps.
Joe Malgeri
Dandridge, TN
February 20, 2104
* Why generic drugs don’t necessarily mean lower prices
** Maine’s prescription for drug savings: Go foreign
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