<p>I went and got my dad’s meds yesterday- no change. </p>
<p>However, he has Medicaid so maybe that makes a difference?</p>
<p>Also no change. CVS. D’s meds. Again, it can depend on the plan one chose. In our case, I had checked to learn what tiers each med fell on, which was part of my decision making when I chose. </p>
<p>Personally, no. But, I have witnessed much of this type of chaos at Target the pharmacy. I go to Target, a lot and know the lead pharmacist. for our region. He says it’s a mess, although I don’t know if that just means Target or others, as well. But, they are dealing with some unpleasant customer surprises. </p>
<p>I’ve gotten several prescriptions filled, some new, some refills - no difference in price on any of my refills. </p>
<p><a href=“http://www.nbc-2.com/story/24002336/generic-drug-prices-soaring-in-southwest-florida#.Uuar3cs8KK0”>http://www.nbc-2.com/story/24002336/generic-drug-prices-soaring-in-southwest-florida#.Uuar3cs8KK0</a></p>
<p>Well, I think I found the problem with the scripts. He lives in South West Florida. Everyone who had a 3 month supply of drugs may be finding out now their generic drugs increased but no one knows why?</p>
<p>Huh.</p>
<p>It makes no sense that drug prices would only be in increasing in SFla. If the drug companies are increasing the price it would be more for everyone no matter where they live. </p>
<p>Okay, it’s not only in Florida and it has nothing to do with drug companies increasing prices. Insurance companies are changing prescription coverage on the new policies. </p>
<p>Flossy, the article says that generic drug prices are increasing for people who do not have insurance, because the drug companies have increased prices. You can try to attribute this to the ACA, but you’ll have to come up with an explanation that does not involve insurance companies, because this involves people purchasing medications directly from the pharmacy with no insurance.</p>
<p>Edited to add: People who have prescription drug coverage would not see such changes, if they are occurring. Your insurance policy specifies what you have to pay for generic drugs, and AFAIK it doesn’t make reference to the base price of the generics.</p>
<p><a href=“Bloomberg - Are you a robot?”>Bloomberg - Are you a robot?;
<p>well, here is another article (just one of many). I could fall into the internet hole on this one and not come up. Its the pharm. companies, its generic and its everywhere. </p>
<p>I have read some cool stuff about Costco. Apparently for those without any insurance they charge only what it cost them (Costco) to buy it… </p>
<p>One of my prescriptions last month was mentioned in the article (dioxycline) and I paid $5 for 14 pills, the regular price I pay for most of my prescriptions. What my insurance company paid CVS for this drug I have no idea. </p>
<p>
</p>
<p>(from the Businessweek article linked by sax)</p>
<p>In other words, pharmaceutical companies are raising the prices of generics because they can. Greed is eternal.</p>
<p><a href=“Drug Channels: Retail Generic Drug Costs Go Up, Up, and Away”>http://www.drugchannels.net/2013/11/retail-generic-drug-costs-go-up-up-and.html</a></p>
<p>…"Retail generic drugs usually get cheaper over time. But our exclusive analysis (below) shows that about one-third of generic drugs have gotten more expensive in the past twelve months.</p>
<p>Even more surprising, a small number have skyrocketed. Twelve drugs’ costs have increased by more than 2,000%. </p>
<p>Drug shortages appear to be the primary culprit. Contrary to what some people believe, exploding generic costs are the one thing that can’t be blamed on Obamacare."…</p>
<p>this was a pretty good article with an amazing but disturbing chart of the biggest drug price increases.</p>
<p>I had a prescription for a generic antibiotic filled at Walgreens a couple of weeks ago. It cost about $4 for 14 pills… </p>
<p>Also, I had a prescription for a 2 week supply of doxycycline filled last summer at Rite-Aid(one of the drugs mentioned in the article Sax posted) — I’m not sure what I was charged, because I was also getting amoxycillin at the same time and the cost was about $36 for both prescriptions together – at the time I didn’t pay much attention because I had no reference point as to what it should cost. But I certainly didn’t pay as much as the $3.65 per pill cited in the article. Probably more like $1.40 a pill at most. </p>
<p>Anyway, it sounds like an isolated issue that is specific a handful of medications that are in short supply. It could be an issue for someone without any insurance at all, or with a high-deductible plan that doesn’t cover prescriptions. With insurance the person would get their regular prescription drug benefit for generics. </p>
<p>The real problem with many expensive brand drugs is that they will no longer be included in the formularly for exchange plans. Many people are going to learn about this after they get sick. My group plan covers non-formulary drugs.</p>
<p>No change in my med prices either. Sounds like Target, like many players in this, is taking advantage of the confusion to make a few extra bucks.</p>
<p>Sorry to disappoint you, Goldenpooch, but ACA requires that all health plans have an “exceptions process” in place that allows patients to request and gain access to clinically appropriate drugs that aren’t covered by the health plan (in addition to internal and external appeal processes). So, if a health plan does not cover a particular drug that a patient absolutely needs, their doctor can certify medical necessity to extend coverage. </p>
<p>Not true. If insurer feels a generic or another drug will provide similar benefit they can deny a non-formulary drug. Problem is your doctor may not agree. Also, they can deny a drug because there is a less effective drug they want you to take first before the drug prescribed by your doctor. Many off-label drugs or experimental drugs are used for conditions which have not been approved by the FDA. Although they have been proven to be effective, the insurance company can deny use of the drug. This is not by any means a black or white situation, where the doctor and the insurance company are always going to agree. </p>
<p>As I keep repeating on this thread, there is no way you want to get in a big fight with your insurance company if you need a particular drug. Who needs the hassle. People make it seem the insurance company will immediately acquiesce once an appeal is commenced. This is naive in the extreme.</p>
<p>Insurance companies are not significantly reducing the formularies for exchange plans if they were they were intending to allow their policyholders to use these prohibited drugs. No, they are trying to keep the premiums from going through the roof because of all these so-called essential benefits they now have to cover and to offset the higher costs from a sicker pool of customers. It’s not about ensuring the patient is afforded the best care possible if they get very sick. </p>
<p>Please don’t tell me it has always been this way. My non-grandfathered plan covered non-formulary drugs as does my current group plan. It’s the exchange plans and the off-exchange plans which no longer cover non-formularly drugs. They have also quietly narrowed the formularies so that many drugs are no longer covered. Problem is most people have no idea this is happening when they purchase these plans. They just assume everything is going to be okay when they get sick. </p>
<p>GP, as I have mentioned before, you are correct in that the formularies of many plans have been stripped down for some of the cheaper plans on the exchange, but you are incorrect that the formulary issue didn’t exist prior to ACA…and in my opinion, you are incorrect that this is necessarily a bad thing in terms of health.</p>
<p>Here are the things to expect or consider:</p>
<p>A) on many of the exchange plans, your pharma now goes against the deductible as opposed to straight copay. This is, in part, why an HSA option for people who use expensive Meds. For folks who’ve not studied up, this is going to look like a sudden increase in cost on their Meds. In actual fact, they are just seeing what the Meds cost the insurer previously. I predict the use of generics will increase when consumers are actually conscious of the cost.</p>
<p>B) Step-therapy has always been and continues to be the method to address coverage of non-formulary medications. I am actually in favor of step therapy, because it can be both cost-saving, more beneficial to the consumer, and educates doctors in that it actually makes them think about whether a $200 drug is actually more effective than a $10 drug. A good example of this would be Celebrex compared with naprosyne, an older and more effective, and cheaper option that doesn’t increase women’s risk of heart attacks :)</p>
<p>C) If we’d all like truly more affordable healthcare, we should separate pharma entirely from healthcare insurance and sell it by separate rider both on the exchange and to employer groups. That would be an eye-opener 
I know this due to the fact that these two items are “separate” in Canadian universal healthcare, where you’re looking at about a 40% differential in % of GDP with no worse health outcomes statistically :)</p>
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<p>It’s what you’d do, if it was your money. </p>
<p>Let’s look at a similar situation. Your refrigerator is on the fritz, so you call in the appliance repairman. He says, we can try fixing this little valve which costs $10. That works 75% of the time. If that doesn’t work, you can buy a new refrigerator. Do you try fixing the valve, or do you just go right to the new refrigerator? If it’s your money, you try the valve. If someone else is paying, you just go for the new fridge.</p>
<p>It’s the same thing with a drug. You go to the doctor for purple-spot-itis. The doctor knows that the $10 drug works 3/4s of the time and the $2000 drug is more effective- it works all the time. It’s not your money, it’s not the doctors money, so you both want that $2000 drug. But that’s ridiculous. You should try the $10 drug first. You don’t buy a new refrigerator without trying to fix the old one. </p>
<p>Stupid people, unlike people in this thread, think that doctors shouldn’t have to consider cost. They think that the insurers have unlimited money (I guess it comes from the fairies) and therefore when they go to the doctor they should be entitled to any treatment they want, no matter the cost, even if a less expensive treatment might be just as good. They think that the patient, who doesn’t have to consider the cost, and the doctor, who also doesn’t have to consider the cost, should get together and ask for the moon and have someone else pay for it. Nobody in this thread is stupid. We know that insurance money comes from our premiums, and if people can have expensive treatments on demand, our premiums will go up.</p>
<p>there is no way you want to get in a big fight with your insurance company if you need a particular drug. Who needs the hassle.
Darned straight I would tussle with them IF a doc and I could justify medical necessity. </p>
<p>Darned straight this issue existed prior to ACA. </p>
<p>Researching trial and on-going stats for drugs (and medical procedures) is actually interesting. While GP continues to take a very individual approach (what she wants, what she thinks she may need, real or imagined,) it doesn’t perfectly arc out to everyone. Formula X may now be handled differently because it does not work out to a “common need.” </p>
<p>There is a process in place for special consideration. No, it is not guaranteed approval. But YES, it allows for approvals. You can say til you’re blue in the face that maaaaybe something won’t be approved or maybe some doc won’t take some patient or some sort of insurance. </p>
<p>There’s a line between active concern and active distrust.</p>