How Pharmacists are Helping to Address Rising Prescription Costs

By: Bryan Crockett

Spending hundreds of dollars a month, just to keep yourself alive? The United States is ranked one of the highest countries in prices for prescription drug medications. According to the New York Times, there is little government regulation on the pricing of prescription drugs, manufacturers are controlling the price—and is it too high?

I work at Costco Pharmacy in Murray, Utah as a pharmacy technician. I see customers every day spending hundreds of dollars monthly for routine drugs that they need to help balance and stabilize a healthier life. Medications such insulin, seizure pills, HIV, anaphylactic injectors and many more ring in at $800 to $2,000 for a 30-day supply.

When I tell patients the price of their medication, they often respond with, “Oh insurance will cover that.” But a lot of the time that’s not the case. Insurance plays a big role in how much you pay for prescription drugs, but in some cases it’s not enough. A 2015 poll conducted by the Henry J. Kaiser Family Foundation found that there are 28.5 million Americans without medical insurance. Yet even for those who have prescription drug insurance, many are still forced to pay cash price, especially given the increase in “high deductible” plans. People don’t always realize that even though their insurance is accepting the claim that’s being billed by the pharmacy, there is a set amount of money the customer has to pay before the insurance actually applies and helps lower the cost.

Can customers shop around for the cheapest medication prices? Sometimes.

But this doesn’t always drive prices down by forcing drug companies to compete. I gave it a try, calling around to three competing pharmacies—Walgreens, Wal-Mart and Costco—on three common drugs that are high in price. I picked Xarelto (20mg), Symbicort (160/4.5) and Truvada (200mg), each a 30-day supply. For Xarelto, Walgreens came in at  $436.19, Wal-Mart at $408.16 and Costco at $406.16. Symbicort at Walgreens runs at $340.99, Wal-Mart at $337.50 and Costco at $315.29. For Truvada, Walgreens costs $1,740.09, Wal-Mart $1,682.01 and Costco $1,610.05. These are not set prices, they can fluctuate every day depending whether or not the manufacturer raises cost or lowers the cost.

A Closer Look at the Cost of Common Drugs

Some medications don’t have generics and the prices for those medications with or with out insurance can be pricy.  EpiPen currently is one of the medications that do not have a generic equivalence. Epi-Pen cost recently has surged. At Walgreens their price is 735.09, Wal-Mart $683.47, and Costco $698.21 EpiPen is a medication that is used in an emergency of an allergic reaction. Epinephrine has been used for decades treating allergic reactions, and for no reason should be over $600 dollars.

Other options are available for the EpiPen. Daphne Chen from the Deseret News reported, that the University of Utah, and Intermountain health care have created a cheaper alternative.  They have gone away with using EpiPens in their practice and have gone to Epi-Kits. Epi-Kits are only $10 and they come with a vile of Epinephrine two syringes, two needles, and alcohol pads. Good news is that the EpiPen patent should be up at the end of 2017 so a generic will be made and prices should go down on that particular drug.

How Pharmacists are Helping

In most cases drugs that are brand name are several hundred dollars. Though not all medications have generic equivalence, some do, and pharmacist are frequently asked what they would recommend for a cheaper alternative. They can take on the role of suggesting—with doctor approval—less expensive alternatives.

Pharmacists go through four years of graduate school learning about different medications and what they treat, interactions between drugs, efficacious alternatives to medications, and much more to receive their PharmD in order to practice as a pharmacist.

Katharine Sangroniz is a pharmacist that currently works at Costco in Bountiful, Utah. She is “outraged” with the way drug companies price medications. “You are seeing so many price increases because more and more big name drug companies like Novartis, and Pfizer buy out smaller drug companies so that they don’t have to compete against them” Sangroniz said.

Sangroniz is one of many pharmacists who are happy to recommend alternative medications to patients. “It makes me feel beneficial as a pharmacist that people can trust us to help them with life or death health problems,” she said. She explained that because she has four years of straight medications knowledge, she is more experienced with what specific medications do and treat over a doctor that is more experienced in diagnosing.

Songroniz expressed how difficult it can be communicating with some doctors. “Some doctors don’t feel like we should be ‘over stepping’ our boundaries and undermining what the they have prescribed.”

Songroniz told me that some states have now authorized pharmacist-prescribing authority. “I would be ecstatic if that happened in Utah,” she said. She feels that she has so much to offer that doctors don’t see. She feels that doctors over prescribe, and that so much more could be beneficial to patient’s health with over the counter items. Songroniz told me that she doesn’t want to give a “bad name” for all doctors, but more and more doctors are just “prescribing to fix a quick problem, and collet there money.” She explained that if pharmacist and doctors helped each other with prescribing, it would be beneficial for the patients and health community.

Phi Tran, a student pharmacist that attends Roseman University of Pharmacy, feels similarly to Songroniz. She feels that pharmacists do play a huge role in helping with medication prescribing, especially OTC (over the counter) items. She expressed to me that in school they are taught extensively about OTC items. She said that in her role as a pharmacist in the near future, she is going to try and encourage patients to use OTC regimens over medication treatment.

Tran told me that at Rosman University, they are now required to do a MTM rotation, which stands for medication therapy management. It’s a program that all pharmacies are now required to do. Pharmacists will have to call the patients and ask how there are tolerating the medications and help suggest the best medication for them. Tran said, “it’s now a pharmacist’s duty as well as the doctors, that the patient is being treated correctly and with the right medication.” Tran told me they go over medications and other alternatives daily in school. She expressed “if you truly knew what the chemistry is about a drug you would be sick for the prices they charge.” She hopes in the near future that government will place strict regulations on the pricing of medication, but for now she feels that it’s everyone’s part to communicate for cheaper alternative medications.

With little regulation on drug pricing, pharmaceutical manufacturers can charge anything they want. And when someone’s life depends on a medication, they don’t have much of a choice about whether to pay it. With the price of prescription drugs increasing from 4 to 10 percent each year, many people are looking for new ways or cheaper medications to take that will work for helping treat the issue.