1. Download free Tapatalk for iPhone or Tapatalk for Android for your phone and follow the SDN forums with push notifications.
    Dismiss Notice
Dismiss Notice
Hey Texans—join us for a DFW meetup! Click here to learn more.

US health care costs (microcosm)

Discussion in 'Pain Medicine' started by brori, Dec 18, 2008.

  1. brori

    10+ Year Member

    Joined:
    Sep 13, 2008
    Messages:
    639
    Likes Received:
    0
    Status:
    Attending Physician
    I am in India and came down with an URI with cough/fever/green phlegm production

    Cost of Z pack in India $1.50
    Cost of Z pack in US cash pay $37.00

    same packaging/blister packs

    Keep in mind that there are no pharmacology rep restrictions in India. Physicians here tell me they get 1st class flights and AV/media rooms from pharm industry

    What is going on? Can't be $35 mark up for US R&D.
     
  2. Note: SDN Members do not see this ad.

  3. algosdoc

    algosdoc algosdoc
    10+ Year Member

    Joined:
    May 3, 2005
    Messages:
    3,792
    Likes Received:
    1,501
    Status:
    Attending Physician
    A survey done last year found Indian drugs (unregulated) costs 10% as much as their US equivalent. A survey I did last year of patient costs for different narcotics retail in Canada and in the US found Canadians pay 1/3 as much retail for both generics and name brands, the same name brands by the same manufacturers in the US. The pharmaceutical industry had an average 18% profit margin year over year for over a decade, which is 50% more than any other industry in the US. It is all about greed that is an exponent of using Nafta, signed by Bill Clinton and negotiated by Bush the First, to extend patent protection to obscene lengths, up to 21 years. Oxycontin received their patent in the mid 90s and began sales around 1996, has patent protection through around 2013 unless they are granted an extension. Congress, which has the authority to change the laws has done nothing through both Republican and Democratic congresses, to bring any relief to the American public. The uninsured (48million) and underinsured (high deductables or drugs not covered under the plan) continue to grow in number in the US requiring more and more out of pocket costs, therefore paying the full cost of non-discounted drugs. On the other hand, it is worth shopping around for drug costs. Recently, a particular formulation of hydrocodone (generic) was $149 at CVS, $109 at Walmart, and $69 at a mom and pop local pharmacy nearby. BTW, Canadian drug costs are NOT subsidized by the government according to the pharmacies there. The US pharmacy industry is fleecing the American public.
     
  4. PMR 4 MSK

    PMR 4 MSK Large Member
    SDN Advisor 5+ Year Member

    Joined:
    Oct 1, 2007
    Messages:
    4,182
    Likes Received:
    24
    Status:
    Attending Physician
    I've noticed over the years that the non-chain pharmacies often have lower drug prices. Economics would dictatethat the price they pay wholesale would be higher than the chain stores for not buying in bulk. Therefore chain stores have a much larger profit margin. Coupled with country-wide stores, how do Mom and Pop pharmacies survive?
     
  5. Tenesma

    Tenesma Senior Member
    10+ Year Member

    Joined:
    Jun 11, 2002
    Messages:
    5,332
    Likes Received:
    127
    Status:
    Attending Physician
    i prescribed analpram for a patient... they have great insurance... they went to their pharmacy and it was $247 !!!!!

    so I told them to by generic preparation H (for the hydrocortisone) and generic pramoxine (available over the counter as well) - mix them together, and apply --- for a total cost of $5.50...

    are you kidding me???
     
  6. brori

    10+ Year Member

    Joined:
    Sep 13, 2008
    Messages:
    639
    Likes Received:
    0
    Status:
    Attending Physician
    Thanks for the feedback. I posted in several forums, generating similar discussions. The pharmacy forum, coincidence?, has a different perspective.
     
  7. Doctodd

    10+ Year Member

    Joined:
    Jul 4, 2005
    Messages:
    3,037
    Likes Received:
    291
    I dont know how the chain pharmacies run their business, but there is a Walgreens or CVS on almost every corner. In the area near my office, there is bare land all over the place, but the Walgreens and CVS on opposing corners were the first buildings built. Then came the banks and a Publix supermarket(which also has a pharmacy). I would venture to say the chain pharmacies dont make much money from their aisle products and make huge profits from the pharmacy alone. So the pharm companies arent the only ones making alot of money.

    How do your reps know about you? I have a couple of friends who are reps and one of them tells me he knows exactly how much of each drug each physician had filled that month.....and not just the drug he sells, but all of his competitors too!!! They have this information in a database but we cant get a scheduled prescription drug database?

    Personally my only drug is the Jack Lalanne juicer and some Vioxx i still have for after my weekend warrior days.

    T
     
  8. PMR 4 MSK

    PMR 4 MSK Large Member
    SDN Advisor 5+ Year Member

    Joined:
    Oct 1, 2007
    Messages:
    4,182
    Likes Received:
    24
    Status:
    Attending Physician
    I don't know about now, but it used to be Walgreens and some of the other larger chains would not sell that information - it's the smaller ones that sell it to an intermediate company and the pharmaceutical companies bought it from them. In some cases, they only had records of about 1/3 of my prescriptions.
     
  9. Doctodd

    10+ Year Member

    Joined:
    Jul 4, 2005
    Messages:
    3,037
    Likes Received:
    291
    i dont know how or what they use to get that info, but it isnt just from Walgreens. He would tell me Dr. Doe would fill 30 rx of Opana all month and it included various pharmacies. I also cant speak to the reliability of their data, but they had bonuses when their numbers were good. That was how they were graded.

    T
     
  10. Tenesma

    Tenesma Senior Member
    10+ Year Member

    Joined:
    Jun 11, 2002
    Messages:
    5,332
    Likes Received:
    127
    Status:
    Attending Physician
    are you kidding?

    they track EVERYTHING we do - and it is going to become EVEN easier to track when we all go e-prescribe....
     
  11. ampaphb

    ampaphb Interventional Spine
    10+ Year Member

    Joined:
    May 13, 2007
    Messages:
    4,352
    Likes Received:
    721
    Status:
    Attending Physician
    I just got a mailing from the AMA yesterday about this topic - if you don't want big pharma to track your prescribing habits, the AMA has established the Physician Data Restriction Program (PDRP) which you can sign up for at www.ama-assn.org/go/prescribingdata
     
  12. PMR 4 MSK

    PMR 4 MSK Large Member
    SDN Advisor 5+ Year Member

    Joined:
    Oct 1, 2007
    Messages:
    4,182
    Likes Received:
    24
    Status:
    Attending Physician
    Cool! Thanks Amp! I'm out.
     
  13. Ligament

    Ligament Interventional Pain Management
    Physician Lifetime Donor SDN Advisor Classifieds Approved 10+ Year Member

    Joined:
    Jan 8, 2002
    Messages:
    4,783
    Likes Received:
    1,164
    Status:
    Attending Physician
    Thanks ampaphb, FINALLY, a some value out of my AMA membership.
     
  14. Tenesma

    Tenesma Senior Member
    10+ Year Member

    Joined:
    Jun 11, 2002
    Messages:
    5,332
    Likes Received:
    127
    Status:
    Attending Physician
    i wish there was a way to be an AMA member without the annoying JAMA that comes along with it...
     
  15. Doctodd

    10+ Year Member

    Joined:
    Jul 4, 2005
    Messages:
    3,037
    Likes Received:
    291
    awesome find....my reps will be pissed. Do i really want to opt out however?....i like reps bringing breakfast sometimes.

    T
     
  16. Tenesma

    Tenesma Senior Member
    10+ Year Member

    Joined:
    Jun 11, 2002
    Messages:
    5,332
    Likes Received:
    127
    Status:
    Attending Physician
    i have a rule for reps: they cannot bring any goodies unless those goodies have an educational value --- at first they thought I meant pens, tissue boxes, etc... but now i have them trained to bring skeletons, parts of the spine, etc... with the obligatory "drug name" sticker... but at least it is useful...

    i am actually insulted when they bring food, etc, because i feel like it implies that my medical judgement can be purchased with a wrap, or some cookies...
     

Share This Page