Questiona for you Rapunzel.
If in your opinion, no one should use brand name medications, how would you propose that the companies justify all the money they spend for R&D? Do you think that the industry has come out with enough medications and that every company should quit trying to improve or develop new meds?
I didn't say that no one should use brand name medications, I said that people should look at the price of a medication, and then decide whether or not to use it based on whether or not you would pay for it if you had to pay the total price out of pocket. There is a difference. Some drugs are worth it, especially those that are truly innovative and treat real problems. Many drugs are not good enough to justify the price difference.
As an example, I have horrible sinus issues. A little over a month ago Skunky brought me a new sinus spray called Veramyst to try. The stuff is incredible, it replaces the generic Claritin and Sudafed I took everyday and manages to clear my sinuses (something not even surgery could do). This spray has truly improved my quality of life. When I had the rx filled, I did ask the pharmacist to check the real cost of the drug as I always do. It is $96 for a one month supply. I felt I would be willing to pay that for the benefits I've seen, so I went ahead and got it for my $50 copay.
I think drug companies should be able to make a decent profit from new drugs that are significant improvements over what was previously available. Unfortunately, I think many drug companies take advantage of the influence they enjoy over the FDA and the thrid party payor system to make obscene profits on marginally better drugs that no one would buy with their own money if they had to pay retail.
As far as short acting vs. long acting- Don't you think that if you had to take a med (even generic) 3 times a day...the brand name once daily may be pretty close in cost for an insurance company? (the co-pay may be less on the short acting for consumers, but insurance still absorbs the cost of all 90 pills)
Actually, I know that the cost is much higher for both me and the insurance company when I elect to buy a convenience long-acting drug.
As a matter of fact, Skunky had a little infection last spring and had to take a 30 day course of Augmentin, which is available generically. The company that makes Augmentin was able to extend the patent by making an extended release version. Skunky's doctor prescribed the Augmentin XR -- one pill a day instead of two. Augmentin XR Cost $360/Copay $40, Augmentin $8. I'd have never thought it was worth $352 of my own money to not have to take another pill at bedtime -- it was an abuse of the non-consumer based health system for the doctor to prescribe it and for Skunky to fill it.
Samples- I have always thought of samples being a help to insurance companies. Just think about how many free samples the average american gets on a yearly basis. If all patients began to refuse samples, the insurance companies again would absorb the millions maybe billions of dollars once paid by the pharma companies. Another thing to think about....How many times have you gotten a sample for 7 days of a medication...you didn't like it (maybe due to side effects) so you called your physician and got them to change your medication. If you didn't use samples for your trial period, you may have very well been written 30 days of the medication by your doctor. Now the insurance company has paid for 30 day of pills and you only took 7 before throwing the rest out and getting another 30 day supply of a different medication. I am sure there are plenty out there who have also been given enough meds to cover their entire treatment with no prescription, the insurance company definately benefited there!!
Since 1996 the average expenditure on drugs pp/pm (per person per month) for health plans has increased by 600%. Insurance companies make profits based on a percentage of pp/pm expenditures, so their profits grow larger as total healthcare expenditures go up. It's the person paying for insurance whose premium goes up that pays for the drug. As long as pharma charges are the same for United Healthcare as for Aetna, they don't care about the costs (except maybe when the drug is truly innovative and widely needed and they haven't underwritten for it). The drug companies don't give the samples because they are altruistic or looking to save the insurance companies a little money. If they wanted to save the consumer or payor money, they could lower the price of the drug. The drug company knows the sample is the cost of getting access to the doctor, so that they can influence his prescribing habits. And they do influence the prescribing habits of the doctor, as study after study has proven.
Drug companies are businesses, and their purpose for existing is to make money. I have no problem with individual drug reps, they are generally very attractive and charming people -- by design. It's an excellent living, and is no worse than any other kind of sales. My problem is with the doctors who are supposed to be the highest order of professionals and allow themselves to be so easily influenced. I find many of them see writing high cost prescriptions and reaping the freebies as a way of sticking it to the insurance companies who have jerked them around so much since 1996. Since 1996, physician incomes have become stagnant or gone down when adjusted for inflation. 1996 is also the year pharma companies were allowed to begin direct to consumer advertising. I save my pure disgust, however, for the doctors who are leaders in their profession and take speaking fees from pharma to pimp their drugs to peers as a way to supplement their incomes. How do you feel about the trend toward peer to peer marketing of pharmaceuticals, PharmRep?
who gets those, not me.
;-)