Thursday, March 10, 2011

A drug ripoff, and it's not from the drug companies By Jerry Brainum

It's no secret that the cost of many prescription drugs are prohibitive. One reason for this, or so says the pharmaceutical industry, is the high cost of producing and testing new drugs. This can run into the billion dollar area for some drugs. So the drug companies feel that it's only fair for them to pass the cost of producing these drugs on to the public. But "public" must be further qualified. In reality, part of the reason why drugs cost so much is that health insurance companies pay for them. This doesn't come without a price, either, since a major reason for the current exorbitant cost of individual health insurance is the insurers passing on the costs to their subscribers. This it true despite the considerable bulk discount that health insurers actually pay for the drugs. In many cases, this amounts to pennies for drugs that they charge hundreds for.
     But pharmaceutical companies and health insurers are not the only villains in this drama. Drug stores are also quite adept at scamming their customers. The hardest hit are those without insurance, who must pay the full cost of the drug. One example of this came to light when I conducted an informal survey of a particular drug called Arimidex. Arimidex was developed in 1995 to treat women suffering from post-menopausal breast cancer. It works by inhibiting the aromatase enzyme, which converts androgens  into estrogen. Since it lowers estrogen levels, it helps treat women with estrogen-sensitive breast cancer. Arimidex is a potent drug, capable of lowering estrogen levels by up to 90%. Many of the anabolic steroid drugs used by bodybuilders and other athletes are based on testosterone, which can be converted into estrogen through the actions of the aromatase enzyme. This can lead to estrogen-based symptoms in men, including gynocomastia, or breast enlargement, water retention, and increased subcutaneous fat deposition. While another drug, Tamoxifen citrate, or Nolvadex, was the previous gold standard to control estrogen in bodybuilders on steroids, Nolvadex is merely an estrogen receptor blocker. Arimidex, in contrast, works at the root of the problem by preventing the synthesis of estrogen in the first place. As such, it became the preferred drug to control higher estrogen levels in men.
      As with other specialized drugs, the cost of Arimidex was astronomical. When it was first released, the price averaged eight dollars per pill. Over the ensuing years, the price of Arimidex has dropped, but not by much. It is considered an "insurance" drug, with the cost largely paid for by health insurance companies. Because of that, the price had remained high over the years. In my survey, I found that the current cost of Arimidex at a Wal-Mart Pharmacy for 30 tablets was $437.84. But in July, 2010, the patent on Arimidex expired, which allowed it to be sold under its generic name, anastrozole. One notable advantage of generic drugs is that they are usually considerably less expensive than the original brand name drugs. And this, too, proved true with Arimidex. Generic anastrozole at Wal-Mart costs $199.98 for a 30-day supply. Better, but still quite expensive at $6.66 per pill. I checked a few other pharmacies for the cost of generic anastrozole. At Walgreens, the cost was $380 for a 30-day supply. Target wasn't much better, charging $340. CVS, which often touts its less expensive drug charges, nonetheless charged $361.
     But the big surprise came when I checked the Costco pharmacy. Their charge for a 30-day supply of anastrozole was $24.67. How could this be? Why would other drug stores charge 10-times more for the same drug? It turns out that Costco sells the drug at a wholesale price, with a 15% markup. This illustrates two things: 1) It shows just how inexpensive this drug really is;2) It shows just how much the other drug stores are ripping off their customers, and it has nothing to do with the drug companies making the drug.The rip-off drug stores are charging the higher rate because anastrozole is a recently released generic, and the stores want to make as much money as they can on it. They feel that they can do this because the original trade name drug, Arimidex, was so much more expensive. Another reason why they charge so much is that they know that the majority of those who buy this drug have health insurance, and therefore aren't concerned about the cost.
     But what is really amounts to is pure greed on the part of the drug stores that sell anastrozole for such unrealistic inflated prices. They are just as guilty of ripping off the public as the pharmaceutical industry and the oil industry. And for those of you with health insurance who look at this as a moot issue, let me assure you that we are all paying for this avarice in one form or another.