Posted by: Chris Maloney | March 26, 2011

Definition of What is Wrong with Healthcare: Prescriptions.

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I was looking at a recent report that dispense as written prescriptions cost 7 billion dollars a year.  For those that don’t know (the healthy among us) dispense as written means that patients receive the patented, brand name drugs rather than the generics. 

Let’s be clear, there are some minor variations.  But what is most likely is that the patients do not feel comfortable taking the generic drug.  It does affect how they react to it, because if you’re nervous taking something, you’re going to be more aware of side effects. 

But the sheer cost of going with a brand versus a generic is staggering.  Who is footing the bill?  Us. 

Prescriptions are the definition of what is wrong with healthcare in the U.S.  I cheered when they expanded prescription coverage for the elderly.  We all did.  Older patients on a fixed income shouldn’t have to decide between their medications and eating. 

But I started thinking.  Where is that money going?  Not to the lovely people who live in my neighborhood.  They could do with an extra couple hundred dollars a month.  That money is going directly to the pharmaceutical industry.  If they called it the:  “Hey, charge whatever you want.  U.S. taxpayers will pick up the tab,” legislation, I don’t think it would pass. 

And we are saying that.  Charge whatever you want, whatever the “market” will bear.  But the consumer in this case doesn’t have to pay for what he or she receives.  So there is no upper limit. 

I went to the store to pick up something for my son for a minor skin ailment.  It cost me nothing.  The bill to insurance?  $306.11.  Really?  If I had to pay that, I’d tell them to keep it.  The stuff is only worth about $20 to me, the same as if it were over the counter with all the other skin creams.  But because it’s patented and via prescription, they can charge that amount. 

And why only $300?  Why not $3000?  That’s what they’re charging for chemotherapy drugs.  It’s what the market will bear, or what competitors are charging for similar products. 

I understand that pharmaceutical companies have to do extensive research.  But I also know that the amount of research they do pales in comparison to the amount of advertising they do, and it also pales in comparison to their double digit returns to stockholders. 

When the U.S. pays for basic research, do we charge the pharmaceutical industry for its use?  When all the wonderful foundations sponsor research, do the drug companies turn around and give the patients a discount on medications?  No, it’s really a one way money stream. 

I’m sorry, we need to start handing the prescription drug money directly to the people responsible for paying for it.  If you’d handed me $306.11 and said:  “either use this on this medication or any other way that would support your health,” I would have gone over and purchased the $20 over-the-counter stuff and a whole lot of groceries. 

I wonder what my neighbors would do with their prescription money?  What if they just got to spend the difference between brands and generic?  I think it might make more of a difference to them than it does to the industry. 


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