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Author Topic: prescription drug price gouging- possible scam?  (Read 584 times)
brimic
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« on: January 10, 2019, 08:36:01 AM »

One of my coworkers who was just diagnosed as Type II diabetic last November asked me about what I paid for my Metformin.
I said, about $5-6/ 3 month supply.

He replies "WTF!!! They are charging me $1200 for a refill."

We both looked into it, sure enough, the price after insurance was $1200, for a generic drug.

I looked a bit deeper into it... it appears to be the same stuff, but has a letter or two changed in the name of it.

I also priced it on my plan- the total cost was $7500 for a 90 day supply.

What looks to have occurred was that he was prescribed late in 2018, so his insurance deductible was met, and he 'only' had to pay $60 for his first  prescription. In 2019, the uninsured price jumps up to meet his deductible.

I dug further. Yep, the drug normally costs $0.03/pill, but one company makes it for $26+/pill- it appears they profit heavily off of clerical mistakes.
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brimic
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« Reply #1 on: January 10, 2019, 09:25:55 AM »

https://asweetlife.org/the-hugely-inflated-prices-of-glumetza-and-metformin-er/

In the comments section someone lists the exact drug my coworker was taking.
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AJ Dual
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« Reply #2 on: January 10, 2019, 10:03:50 AM »

It's a common tactic to take an old generic off-patent drug that's incredibly cheap, and tweak it just a bit to make it enteric coated, or a hard slow-dissolving extended release pill, and then throw the $100 per pill new wonder drug pricing on it.

Sometimes it's even just an unusual dose size, where 10mg and 50mg are common, but nobody makes a 35mg, so someone produces it,  and charges exorbitant prices for it.

Presumably most of these are tactics hoping people just pay their copays at the pharmacy and never pay attention to the actual prices. Although sometimes ER formulations of a drug are a different compound entirely, and break down into the actual desired drug in your body, and I'd assume that's about as expensive to design, test, and get approved as a completely unique drug.

I actually sympathize with brand new high-tech drugs costing hundreds per dose, or thousands for a month's supply. On cost basis and a modest margin, after a decade-plus of development and testing, then FDA approval, cheaper prices probably would be a net loss. And people without the means to pay or who would die, they have back-channel discounts through the company directly, their doctor,  drug reps. even.

Download the GoodRx app, look up the drug when your doc mentions it, and discuss generics and alternatives like prescribing 2x the pills at 1/2 the dose when it's cheaper.  Normally, a good physician does this anyway.
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brimic
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« Reply #3 on: January 10, 2019, 10:17:37 AM »

Quote
It's a common tactic to take an old generic off-patent drug that's incredibly cheap, and tweak it just a bit to make it enteric coated, or a hard slow-dissolving extended release pill, and then throw the $100 per pill new wonder drug pricing on it.

I've seen all kinds of patent troll nonsense while working for pharma, one was extending a patent because they were able to find a new indication in dogs.  undecided

The stuff my coworker showed me was generic.
I'm wondering if it was an orphaned drug with someone picking it up and producing it as a generic, giving them a period of time of exclusivity.
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HankB
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« Reply #4 on: January 10, 2019, 11:00:29 AM »


Sometimes it's even just an unusual dose size, where 10mg and 50mg are common, but nobody makes a 35mg, so someone produces it,  and charges exorbitant prices for it.
That happened to my mother for one of her drugs - she had been getting a 1000mg dose (2x500mg) and one day the pharmacy gave her a prescription with huge 1000mg tablets, which she called "horse pills." MUCH more expensive, by nearly 2 orders of magnitude. We balked, and insisted the pharmacy go back to the older 2x500mg. Now the pharmacy balked - so we don't do business there any more. (Mom's doctor confirmed the 2x500mg dosage she'd been taking for a couple of years was fine.)
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Mike Irwin
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« Reply #5 on: January 10, 2019, 11:19:03 AM »

Why did the pharmacy balk?

Were they getting a substantially higher filling premium on the more expensive version?
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« Reply #6 on: January 10, 2019, 01:40:16 PM »

Have y'all checked out Kroger's Rx Savings Club? It's free and that along with Good Rx will save you a TON of money! Metformin? 60 to 90 days worth, FREE! Omeprazole or Pantoprazole? 90 days worth, $6!
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« Reply #7 on: January 10, 2019, 03:39:51 PM »

Why did the pharmacy balk?

Were they getting a substantially higher filling premium on the more expensive version?
I think they simply saw it as a P4P . . . that is, a Program For Profit. They used the excuse that the doc had prescribed 1000mg, not 2 x 500 mg.

Now, SOME drugs are apparently sensitive to the individual pill dosage, but Mom's med was not one of those.
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RocketMan
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« Reply #8 on: January 10, 2019, 05:59:22 PM »

The common gout medication colchicine went from about $15 for around 30 days worth, to over $150 for the same amount in the last couple of years.  It was a dirt cheap, easily manufactured common medication that has been available forever.  Not any more.
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« Reply #9 on: January 11, 2019, 05:02:04 AM »

The common gout medication colchicine went from about $15 for around 30 days worth, to over $150 for the same amount in the last couple of years.  It was a dirt cheap, easily manufactured common medication that has been available forever.  Not any more.

This post made me wonder what could cause that, so I did a little searching and came across this site:

https://www.goodrx.com/blog/colcrys-colchicine-new-fda-approved-authorized-generic/

Money quotes:
Quote
Clcrys (colchicine) is used for the prevention and treatment of gout flares in adults. Colchicine was previously available as an inexpensive generic, unapproved by the FDA, but became patented as brand-name Colcrys in 2009. Now, finally, a generic is available again, which may mean prices will start to come back down.

Quote
Colchicine had been used and sold in the US for many years but had not been reviewed by the FDA for safety and efficacy. The manufacturer of Colcrys submitted an application for review to the FDA in 2009, and they were awarded a three-year exclusivity period (meaning they were the only ones who could market Colcrys in the US).

So why all of a sudden did someone call the feds?

I found this article about the lawsuit that forced genaric Colchicine to be reintroduced:

https://www.modernhealthcare.com/article/20150115/NEWS/301159978

Money quote:
Quote
Colchicine has been used by the medical community for decades to treat people with gout as well as patients with familial Mediterranean fever. It was allowed to be sold without approval from the Food and Drug Administration because it had been on the market before the current approval process existed. An estimated 2% of drugs available in the U.S. in 2006 were unapproved.

Safety concerns about these drugs led to the creation in 2006 of an FDA program that encouraged manufacturers to gain regulatory approval of unapproved therapies. Unapproved colchicine was associated with at least 117 non-overdose deaths, half of which were due to drug interactions, Kalah Auchincloss, acting director of the FDA's Office of Unapproved Drugs and Labeling Compliance, told Modern Healthcare last year.

....

While clinical trials yield new data about the drug's dosing and efficacy, going through the approval process led the company to increase the cost of the drug. Colchicine's rise from 10 cents to $5 a pill troubled consumers who saw the price of their prescriptions rapidly increase

So someone called the feds, and then everyone got pinched.

WHICH IS WHAT HAPPENS WHEN YOU CALL THE FEDS.
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brimic
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« Reply #10 on: January 11, 2019, 05:31:36 AM »

Colchicine, IIRC, was a case where a drug company did a study to prove that it works, paid the FDA a huge sum of money, and were given exclusivity to manufacture the drug, they of course, increased the price of it by 10000%
The first time I took it, it cost almost nothing. The last time I took it, it was $5 a pill. The stuff is a life saver if you have an accute gout flareup.
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« Reply #11 on: January 11, 2019, 06:36:53 AM »

Clinical studies, FDA filing fees, etc. cost a lot of money to get a drug formulation approved.

Companies need to recover those costs.
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dogmush
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« Reply #12 on: January 11, 2019, 07:13:58 AM »

Clinical studies, FDA filing fees, etc. cost a lot of money to get a drug formulation approved.

Companies need to recover those costs.

And, as was mentioned in the story I linked, they need to recover the lion's share of them in three years, as that was the length of the exclusivity period the FDA approved. 

Pretty simple math:  Cost of approval+profit margin needed+cost of manufacture/number of scrips  in 3 years= cost per pill for the exclusivity period.  Maybe factor in a loss of sales afterwards due to the "evil drug company screwed me last year I'm going to the competitor" folks.

Now you have an FDA approved drug, which you did not have when it was cheap before.  Sounds like some folks don't think that was worth the cost, which is valid, but not the fault of the drug company.  It's the fault of the folks that push to have everything approved by the Feds.
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brimic
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« Reply #13 on: January 11, 2019, 08:40:54 AM »

And, as was mentioned in the story I linked, they need to recover the lion's share of them in three years, as that was the length of the exclusivity period the FDA approved. 

Pretty simple math:  Cost of approval+profit margin needed+cost of manufacture/number of scrips  in 3 years= cost per pill for the exclusivity period.  Maybe factor in a loss of sales afterwards due to the "evil drug company screwed me last year I'm going to the competitor" folks.

Now you have an FDA approved drug, which you did not have when it was cheap before.  Sounds like some folks don't think that was worth the cost, which is valid, but not the fault of the drug company.  It's the fault of the folks that push to have everything approved by the Feds.

Colchicine works. Its been in use for a few thousand years. Government always dumbs things down and makes them more expensive.
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brimic
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« Reply #14 on: January 11, 2019, 08:43:29 AM »

Whenever criticism of the mere existence of the FDA comes up, its always MUH Thalidomide! or MUH Ethylene Glycol!

The big pro-government guys can only cite two instances where the FDA didn't bumble, and the examples were 60 and 100+ years ago.
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« Reply #15 on: January 11, 2019, 04:40:23 PM »

The price of colchicine has come down, from about $5/tablet to just $4.95 a tablet.  At least that was the price when I went to the pharmacy last October to buy some.
Generic my swollen red painful big toe.  They are well past the exclusivity period.
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« Reply #16 on: January 11, 2019, 04:54:03 PM »

Now you have an FDA approved drug, which you did not have when it was cheap before.  Sounds like some folks don't think that was worth the cost, which is valid, but not the fault of the drug company.  It's the fault of the folks that push to have everything approved by the Feds.

The last is a good point.  I mean, I think I like having an approval process to filter out the snake oil, but does it really need to be a billion dollar process?  Should it be that a person who is dependent upon a drug that has been around for a long time, who has been taking it in a known-off label way for their condition, can be forced to pay orders of magnitude more for it because some company got an FDA approval stamp for using said drug in a new way?
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« Reply #17 on: January 11, 2019, 05:15:02 PM »

AFAIK, aspirin is not approved by the FDA -- because it's older than the FDA.  I wonder what happens if some ahole company files the approval paperwork and tries to get an exclusive license to make it?  (OTOH, it probably has too many side-effects to be approved)
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