Fran Barker called today. She was in a panic because the cost of her monthly prescription of 150 mg amitriptyline tablets had gone up to $130 from $13 the month before.
Amitriptyline has been available in this country since 1961, and the 100 mg strength was on Walmart’s list of $4/month drugs the last time I looked at it a few months ago.
I called Fran’s pharmacy. Two of the 75 mg tablets would be less expensive, about $75 for a one month supply, but this would still be a hardship for Fran, who is disabled and lacks prescription coverage.
A few months ago I read that the older, generic statin drugs for cholesterol were suddenly not on Walmart’s $4 list due to sudden price increases by the manufacturers.
Something similar happened to insulin a few years ago – it went from a few dollars to $80 per vial without any explanation that I was aware of.
I have Googled around a few times to try to find out what is happening, or what people think is happening, but the dramatic price increases I have run into don’t seem to be getting much press.
It appears to me that the pharmaceutical companies have stopped their price competition, possibly by secretly dividing up the market and definitely by limiting supplies. If that is true, antitrust laws are likely being broken. Meanwhile, people with chronic illnesses are being squeezed financially even more than they already have been.
Generic drugs used to be a low margin product for manufacturers, but a major profit for drug stores. With newer generics, whose brand name competitors are still on the market, pharmacies may buy them for 10% of what they pay for the brand and sell them for 70% of the brand name price. Now, with their purchase prices going up on one generic after another, their markup is likely shrinking to the levels of brand name drugs. This will likely drive independent pharmacies out of business.
We already had a great deal of mystery and intrigue around pharmaceutical pricing and actual insurance payments for prescription drugs. Just like doctors and patients have trouble figuring out how much MRIs and artificial knee joints cost, the real cost of pharmaceuticals is often unobtainable. I can try to choose lower cost medications by looking up the average retail cost on Epocrates, but insurance companies and drug manufacturers often negotiate deals that make favored otherwise expensive drugs cost less than non-favored drugs with lower published prices.
This whole drug price situation is really the stuff of mobster movies. Or imagine a sitcom about what happens when gasoline (petrol) prices increase by 900% overnight. That wouldn’t be funny for very long. People would complain loudly about being held hostage or extorted.
But is anybody complaining about what is happening now with drug prices? Am I just not hearing about it because I gave up watching TV? Or am I an early voice in the wilderness? You tell me…
A Country Doctor Writes: 
Just saw something about this on CBS news tonight. A man in the report said his drug company was switching him from a generic dementia drug to the brand name version which will be around $300 a month! My husband was on Keppra and we were paying over $300 a month for it until we got extra help from the govt. Now he takes the generic brand..only about $5.00 a month..a big difference! Who can afford $300 a month..especially if they have to take a number of medications?
Please don’t forget to mention that the pharmacy will randomly switch you from one generic drug formulation to another without warning. The exact formula for each generic drug is slightly different from the others, and all this switching around can adversely affect your health if you are taking a medication that needs to be carefully calibrated (e.g. heart pills).
Thank you for bringing this to light. It is becoming a real problem with many medications.
My normal 90-day supply of generic Norvasc 10 mg from Walmart has been only $5 (I have Humana coverage), but I haven’t filled it for about two months. Could be a surprise in store? BUT my doc added another prescription for BP last week, and when I went to pick it up at Walmart it was $131 for a 30-day supply. And this included the $70 insurance payment. I refused to buy it and will try to get a less costly prescription from my doc. If not, I’ll just stick with my 145/65 numbers and keep my fingers crossed. I am 70 and otherwise in perfect health, overweight by about 15 pounds but I walk every day 30-40 minutes. My father and grandfather dropped dead of heart attacks before the age of 70. What’s a retiree to do??
I’ve had a similar problem with one of my medications. Digoxin jumped from $5.00 generic to $36/mo to $60/mo in a four month period at our local pharmacy. Neither the pharmacy or google could find a reason. But, if I switched the prescription to Express Scripts I could all of a sudden get a 90 day supply for $10. Yup, the manufacturer is directly competing with pharmacies by undercutting them on price and limiting supply.