2017-08-10 / Opinion

Where you chose to buy your medications makes a difference


Collier County patients have seen an increase in the cost of prescription medications over the last few years. This rise is made worse by higher insurance deductibles, copays, the Medicare “doughnut hole” and the large number of uninsured patients.

Most patients when they take a new prescription to the pharmacy do not know if it will be free, inexpensive, covered by their health plan, or not covered and so expensive that they choose not to buy it. The care provided by the physician, for as good as it could be, is dependent on the patient being able to afford the prescribed medication.

What I find most shocking is that the price of medications is not regulated, even when it could be a lifesaving medication.

A clear example of this is on a 30-day supply of a medication used for asthma and rhinitis. Montelukast 10 mg is free at Publix; then prices vary from there, from $4 at Walmart to $131 at Walgreens (according to Walgreens pharmacist Janna L.). This could translate to an expenditure of $1,572 a year for those who do not know it is free at Publix. Other medications are less expensive at Walgreens when compared individually. The prices also vary depending on what side of town patients are buying their medications, even for the same chain pharmacies.

DE LEON DE LEON Fortunately, a few websites have become involved in creating transparency to this problem, GoodRx, HelpRx and Blink Health among them. Besides providing transparency, these websites also provide discounts or coupons for medications to be purchased from traditional retail pharmacies. These online services are addressing a very real need to educate patients on how to access their medications at affordable prices. Most of us price compare what we are buying against websites like Amazon or eBay; now we can do the same with needed prescription medications. These services function as follows:

¦ GoodRx negotiates specific prices with pharmacies for each medication and offers these discounts in the form of free coupons to the patient. Patients must take the printed coupon to the pharmacy of their selection.

¦ Blink Health negotiates directly with the manufacturer for a single price for each medication and sells them directly to the patients online to be picked up at a local pharmacy. In Collier County, they have partnered with CVS and Walmart.

¦ HelpRx negotiates a specific percentage of discount at one of its 17 participating pharmacy chains. These pharmacies include CVS, Walgreens and Walmart.

My experience has been that no pharmacy or service has the lowest or the highest prices. They attempt to lure the patients with one very good price on a single medication and compensate by charging more for others. Sometimes much more. Common pharmacies that I recommend for my patients are Costco, Walmart and the locally owned pharmacies. Of course, when I know that the medications are expensive, I guide them to browse the websites above for discounts or coupons. I also guide them to the manufacturer’s website as it may contain coupons or financial assistance.

I recommend the locally owned pharmacies not only to support the local economy, but because I have found them to be more conscientious with pricing. Some of them even offer free delivery and compounding services. Compound medications are made on site from the raw materials and are offered at a much cheaper price. These medications can be creams, hormones or topical pain medications. A local pharmacy is able to compound the raw material of Cialis and Viagra into a product of equal efficacy.

Price transparency is essential with the high cost of medications and with no law to protect patients. Most industrialized nations impose price restrictions and limit what pharmacies can charge for drugs, something that as voters we can ask our politicians to implement. For now, patients must become proactive shoppers of their prescription medications and rely on their physicians to lead them to the most cost-effective pharmacies. ¦

— Cesar De Leon, D. O., MHA is a board- certified family medicine physician at Naples Medical Center. Dr. De Leon serves as vice president of the Collier County Medical Society and as chair of the Family Practice department at Naples Community Hospital.

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