Unscrupulous Bastards: "'Reality Bites" concluded

Finally, after wailing and gnashing of teeth, down to two pills, I get an automated call from Wally World. My prescription is ready for pick up... 1,200 bucks before co-pay...600 bucks after. It could be worse...

I look for my gun while calling "the messenger." Hello. why is it that every time I refill this prescription the price goes up? Blah blah blah, blah, blah blah, further research, development of new drugs, research, blah blah blah, 14 million annual for a CEO, blah, blah, his private jet, pilot, fuel, stewards, blah, and the 5 BILLION spent on advertising.

Excuse me? 5 Billion? For advertising?

Does any one else have a problem with the Prescription Drug Cartel spending that much money (or any money at all, for that matter) to advertise their products to the general population, as if we can just run down to the Pharm and pick them up? Oh, that's right, I'm supposed to "ask my doctor if they are right for me" because he doesn't have a clue as to what's out there. I mean, isn't it the doctors job to prescribe the right medication? Why put the general non-medical population through the agony of pharmaceutical commercials showing senior couples playing tennis without knee pain, walking on beaches with fewer symptoms, getting aroused, whatever, followed by an Evelyn Wood speed-reading graduate reciting through a list of side effects that's worse than the disease? Like, shouldn't our doctors know the drug we need, and if they don't know shouldn't they be able to find out (Google?) the best treatment for whatever ails us? Why does The Drug Cartels spend 5 BILLION dollars a year pushing their pills on us? Why not pass that savings on to the consumer?

I picture a meeting at Consortium MERCK.inc. Smartly dressed execs sit around a solid mahogany boardroom table in rich Corinthian Leather chairs and discuss how to charge more money for drugs, even as the cost to make them declines. Even old drugs are going up, things like EpiPens, and it seems price increases have little to nothing to do with increased costs of manufacture. No, as far as the Cartel is concerned, the correct price is what ever the market will bear. Meeting adjourned. (Here's an interesting article in Forbes Magazine: Why Did That Drug Price Increase 6,000%? It's The Law)

I throw a hissy fit at the increasing cost of Eliquis...cursing everyone from greedy corporate gougers, to Doctors, to lawyers, to myself...for being part of a problem that's going to bankrupt the system before our children have a chance to use it. 

Bobbie goes on line (Good RX.com) to see if anyone has a better price than Wally World, you know, before I kill someone. They don't. But she learns something else, and it doesn't make sense to either one of us. 

Before insurance,180 pills of 2.5mg Eliquis (a 90 day supply @ two per day) costs $1300 (That's $5200 per year for people without prescription insurance!). My Silverscript Prescription plan pays about half (thank God)... until I reach what is commonly referred to in the "business" of ripping off customers, as "the donut hole." 

Those that can afford it buy prescription coverage in case our meds get too expensive, right? So then insurance companies go to work devising ways to protect their profits. Welcome to the Donut Hole loophole... basically a "lid" on what the insurance company will pay per calendar year. Once you fall into the Donut Hole, you are on your own for the rest of the calendar year for drug costs. Having fun yet?

Then Bobbie notices that Wally World offers 90  5.0 mg tablets (a 90 day supply if I cut them in half) at a cost of $692 dollars before insurance co-pay. It doesn't take a math whiz to figure out that if I can talk one of my Docs into prescribing the 5.0 mg pill I can save thousands of dollars a year and lessen our out of pocket once we hit the donut hole. Sweet!

I call the pharmacy, tell them what we found on-line and ask if it's true. She affirms that the cost of a 90 day supply of 5.0 mg tablets is half the cost of 2.5 mg. I tell her to restock my 2.5 script, then call the most agreeable of my two dueling doctors. Here we go again... trying to save 50% on Eliquis.

Doc's busy, and his nurse is a little pissed when I tell her I had Wally restock the prescription that put everyone through hell, trying to get miscommunications straightened out. I explain to her about the 50% reduction in cost if Doc would prescribe a 5 mg pill that I cut in half. 
PLEASE (weep). 
Time slips through the hourglass, but my wish is finally granted. Just cut my drug cost in half. Yes! 
Except...

Houston, we have a problem. Again?

It seems the co-pay insurance company already paid the Co-pay on the 2.5 script that got restocked. So now they deny payment on the new 5.0 mg dose. Right back where I started from...paying the full amount. Four phone calls later, down to my last pill, the "Red Sea of bureaucracy" parts and I'm dancing my way to the Promised Land on dry ground. Now I know how Moses felt. It's a miracle. Maybe there is a God. 

The Wally Pharmer can't explain why the price of 5 mg doses cost half as much as the 2.5, though she suspected it has something to do with the fact that doctors generally prescribe the 2.5 mg pill, thus, it is the most popular dosage. Demand based pricing. Welcome to America. Socialized medicine is sounding better all the time. Ber-nie Bernie Ber-nie.... 

Look, there are as many backdoor ways to gouge the medical system and squeeze customer's wallets as there are Lawyers. If I sound cynical it's because corporate greed fertilizes my cynicism, just like an innocent child dying from cancer fertilizes my agnosticism. It defies logic; the same drug, just a bigger pill, and it costs half as much per dose. You tell me. 

FYI, for those of you who think "Generic" availability will eventually drive down prices, you've got a long wait, baby. After the 7-year monopoly patent expires (Orphan Drug Act), Wally Pharmer tells me that there are new laws that allow the maker of a drug to be first in line to make the Generic version... for an additional 3 years. 
Unscrupulous Bastards  

Still, the lesson is to not assume; do your homework; look in dark corners; Use Good RX.com to shop and compare; Check pricing on different dosages. So what if you have to cut a pill in half; saving 50 percent off a really big number, is a big number... and you get to keep it. 

Till the next "glitch" inspired rant...
mark, bidding you good health and happy days!

My revised reading list:

Aw, The good ol' days...

The new Presidential Seal...