What Does It Cost?

Column by Paul Hein.

Exclusive to STR

The only drug I take, and have taken for decades, is a beta-blocker which is widely available and relatively cheap (as drugs go!)

I got it at the pharmacy in a local grocery chain where we often shop. It was convenient, and I became acquainted with the pharmacists who were knowledgeable and friendly.

The cost of a 90 day supply of the drug was about $12, bringing my yearly expense for medication to less than 50 bucks. At one point, one of the pharmacists suggested I look into part D drug coverage which could, for some unknown reason, only be purchased at certain times, which was then. The cost of such coverage, however, would be significantly more than the cost of the drug. Now I don’t want to brag, but the fact is that I graduated—with some distinction---from grammar school, and am nobody’s fool. So I quickly realized that saving 50 bucks by spending several times that was--how shall I put it--STUPID!

One day, while refilling my prescription, the druggist mentioned that the next refill would not be $12, but nearly $60! Why? Well, I had no drug insurance as part of my Medicare Supplement. But that wasn’t new; all my insurance information had been available to them for many months. No one seemed able to explain why I had been getting for $12 what, supposedly, should have been $60.

Well, never mind. I would go elsewhere. There are coupons for everything nowadays, and that, as I discovered, includes drugs. I found a coupon for my drug that was good at a local discount store pharmacy. I went there, coupon and Rx in hand, and got the medicine for around $10. From $12 to $60, to $10. Same drug, same dose, same number of pills. Is this making sense?

Ah, insurance! My wife, whose insurance was covered by a firm of which she was a principal shareholder, cost about $235 each quarter. For the same period, my premium, in a similar group plan, was about $780. Both policies with the same company, both with Plan F. She had drug coverage, I did not. Makes sense, no? So I arranged for different insurance that, for a fraction of the cost of the earlier policy, would include drug coverage. But because I had not purchased drug coverage earlier, I would be fined $43/month in addition to the regular insurance premium. In other words, for not purchasing something I neither needed nor wanted years ago (and still do not need), and which would cost me more than I would save, I would be punished to the extent of about $500 each year for as long as I lived. This is self-evidently logical and reasonable, right?

Today I went back to my grocery/pharmacy, because we had some shopping to do there. This time I was armed with my new insurance card. The pharmacists were not the ones I had known before, and the new man spent a lot of time at his computer typing, reading, scratching his head before muttering, “Is this a new policy? It doesn’t show up.” I assured him it was only a few months old. More typing, staring at the screen, then “It says here you’re allergic to this drug.” No, I’ve been taking it for years; took some this very morning. I’m definitely not allergic to it. Why would I refill a prescription for something I was allergic to? (Won’t it be wonderful when/if computers are ever perfected?) Eventually he announced that he could fill the prescription, and the cost for a 90 day supply would be $39. I didn’t think that made sense.

I took my Rx and insurance card to a different pharmacy, and promptly had my pills--90 days worth--for $10.43.

Hence the question: What Does It Cost? Is it $10, $12, $39, or $60? It’s the same medicine, same dose, 90 days supply. The company that makes the drug, and the pharmacy that sells it for $10, are not charitable institutions. They make a profit, and are certainly entitled to it. But if they can make a profit for $10, how can the $39, or $60, be explained? Because the store selling it for $10 is a “preferred provider”? But what does that mean?

I’m not sure, but I suspect that a gaggle of clerks are laboring away in their little cubicles, transferring money from one account to another according to arcane rules which they themselves do not understand. Something to do with cronyism, perhaps? Preferred providers get the business, and have their losses covered by the Rulers--which means us?

I don’t know, and I doubt if those who do will tell me. It’s best for me to not worry about such things, and let the experts handle it.

That must be why everything is going so swimmingly. The Rulers have everything under control. Not to worry, all is well. Just shut up and take your pills.

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Columns on STR: 134