Barbara Heller has an autoimmune disease called PBC. She takes the generic drug Ursodiol to prevent liver damage.
“The last refill that I got for Ursodiol cost $94.50 for three months, Heller said.
In August, she called for her usual three-month renewal, expecting her cost would still be under $100.
Instead, it was $1,212.30.
Generics have less and less competition. So they simply raise the prices to whatever they want. Make themselves just slightly cheaper than the premium branks. And then the insurance companies decide not to carry that generic in their low cost formulary.
Nothing requires an insurance company to pay the ‘generic’ co-pay price for any generic. In some disease categories, no drugs are covered in some of their formularies at the cheapest category.
And the insurance companies change this from month to month. So one month, the drug is covered with a $10 co-pay and the next you are responsible for the full drug cost.
I’ve already discussed how drugs that are hundreds of years old and predate the FDA are now being sold as proprietary ones with costs going from pennies a pill to hundreds of dollars.
You can’t search around for a cheaper drug. The consumer has no free-market pressure to bear. Live healthy or die is not a choice.
One of the key benefits of Obamacare has been to reduce the chances of becoming bankrupt or choosing between your health and eating. It focussed on the insurance for the medical field. There obviously are some places that still need dealing with, like pharmaceutical insurance.
Instead of discussing the repeal of Obamacare, putting people’s lives in real peril, we should be focussing on dealing with things like this.
I’m becoming convinced that free-market capitalism does not work well at the retail level. Perhaps it needs to be run more like a utility, where the market price is regulated to prevent these sorts of market distortions.
Image: Marko Javorac