Paying a bigger price for cheaper prescription drugs

Prescription drugs at a pharmacy.


Jeremy Hobson: It's hard out there for a CEO. That's the word from insiders at Pfizer who say the company's board was worried about how CEO Jeffrey Kindler was handling the stress of his job. Kindler sudden retirement was announced earlier this week. As for the customers of a drug company like Pfizer, well life's about to get more stressful for them too. One major health insurer recently told consumers that prices are about to go up.

For more on this, let's bring in LA Times consumer columnist David Lazarus. David, welcome back.

David Lazarus: Thank you.

HOBSON: So you're experiencing this problem in a very personal way.

LAZARUS: Well I am, in the sense that UnitedHealthcare -- which is my employer-provided insurer -- has just raised the cost of one of the most widely prescribed insulins out there, it's called Novolog. And as it happens, I'm a Type-1 diabetic. I'm going to see my co-pay rise 250 percent as a result of this, raising my annual insulin costs to over $800.

HOBSON: Over $800. So it's a really big impact on your wallet.

LAZARUS: And this isn't just about me and it's not just about insulin, this about anyone who takes a prescription drug to manage some sort of condition and is essentially a captive of the insurance industry when they dictate terms. Because in some cases, as with insulin, there is no generic equivalent; you can't switch to something else that will be cheaper but still have the same desired effect. So when an insurer says, it's going to be this way or you're going to pay a lot more out-of-pocket, well, I and anyone else who has a chronic condition is suddenly backed against a wall, not to put too fine a point on it, and held hostage by such a decision.

HOBSON: Why is this happening right now, David?

LAZARUS: It's happening because there's a lot of pressure to reign in medical costs. And that pressure is warranted -- medical costs are soaring, it's one of the reasons our insurance premiums are going up, and it's one of the reasons our health care system is so out of whack. So no one really begrudges an insurer wanting to try to keep these costs down, but in the case of certain medicines, where there is no generic equivalent, it's just simply a matter of fairness and access to the treatment that's going to allow you to manage your condition. If there was a cheaper alternative, great -- I would use it -- but there isn't. And in fact, endocrinologists say that the switch that UnitedHealthcare would like me to make could in fact affect my condition overall and perhaps exacerbate the situation.

HOBSON: Yeah as if a chronic medical condition isn't tough enough. David Lazarus, consumer columnist for the L.A. Times, thanks again for joining us.

LAZARUS: A pleasure.

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About 8 years ago, UnitedHealthcare told patients that Eli Lilly & Co. insulins were moving to Tier 3, meaning they have the highest co-pays and lowest coverage. At the time, the company was switching to Novo Nordisk as it's "preferred" insulin brand. Now, they are switching back. While it's true that insurance companies do this to reign in costs, there are also some games that drug manufacturers are playing. Why was Lilly's Humalog dropped a decade ago in favor of Novo's Novolog, only to be switched back a few years later?

What about choosing to buy the at medicine online pharmacies by choosing the generics and reducing the cost of spending for the health care. I have been saving by this especially for antibiotics and few medications for which cost is more with insurance.
I have been shopping at InternationalDrugMart.com and I find them very reliable too

RE: form (not function):
I believe "endocrinologist," properly spelled, has no "h."

Feel free to delete this, whether or not the spelling typo is corrected.

Lack of choices is a big problem here. No generics and no alternative insurers as they all might just follow suit.

This story hit home as I am dealing with a similar situation. My wife has MS and takes daily injections to control the disease. Our healthcare provider, Blue Cross Blue Shield of Alabama, announced that our medication costs are going up. This year we paid a $25 copay for 2 months worth of medication. Next year we will pay a $100 copay for only a 1 month supply plus 10% of the drug cost up to $5,000. So my cost will go from $150/yr to around $6,000/yr. As described in the article, the only option available to us is to stop treatment. There is no alternative medication and generics are not available.

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