There's a lot of talk about lowering the price of prescription drugs... and for good reason.
One study found that over the last 15 years, new drug prices increased 20% each year.
Another poll shows three out of 10 people don't take prescriptions as directed because of high costs.
Pat Elliott knows all about that.
"I've been living with this drug pricing nightmare for 14 years," Elliot said.
Elliot survived cancer and lives with rare leukemia.
She's spent years making tough choices between food, utilities and having to pay medical costs, including very high prescription drug costs.
"A cancer diagnosis itself is hard. But add to that the trauma of having to deal with possible pricing that might ruin you and your family financially is unconscionable," she said.
Elliot said she lost her Phoenix home, partly because of the costs she had to pay for life-saving drugs.
She said she hears many similar stories in the Facebook group she co-manages where Medicare issues are discussed.
"You can have good insurance, but still have a copay for that of $500 to several thousand dollars a month," she said.
Elliot gave one example of a leukemia-fighting drug called Gleevec. It costs thousands of dollars a month, as did its generic version, Imatinib, at its retail price.
Elliot found the same generic for less than $40 a month, at the online site Cost Plus Drugs. Businessman Mark Cuban started the site in 2022.
At Cost Plus, all pricing is the same and disclosed.
It lists the manufacturing costs, adds a 15% markup, a $3 pharmacy fee and $5 for shipping.
"The major problem is the lack of transparency. Consumers do not know what these drugs actually cost," Elliot said.
"A lot of people want there to be more transparency," said Dr. Hussain Lalani.
Dr. Lalani, a primary care physician and health policy researcher at Harvard Medical School and Brigham and Women's Hospital, said Cost Plus is a game changer.
He said drug pricing is pretty much a secret, starting with the Pharmacy Benefit Managers hired by insurers to negotiate those prices.
"But there are some perverse incentives that make it such that they don't always get the best deal. And if they do, they're incentivized to keep a little bit of it, and not maybe pass all of it along. And we don't actually know exactly what they do with all that money, because they don't tell anybody," Dr. Lalani said.
Dr. Lalani says wholesalers and pharmacies also add to the costs we pay. "The reality is they all make something off of us," he said.
So, he said showing how the prices are calculated makes Cost Plus Drugs unique.
The prescription site joined a growing number of discount generic prescription plans that are used without insurance.
While it gets high marks for transparency, Let Joe Know wanted to find out, can it give you the best price for prescriptions you may need?
LJK compared Cost Plus Drugs to four other generic prescription plans; Amazon Pharmacy, GoodRx, Walgreens Prescription Savings Club, and the Costco Membership Prescription Program.
LJK checked their prices for four popular generic prescriptions:
- Atorvastatin/Generic Lipitor to treat high cholesterol
- Levothyroxine/Generic Synthroid to treat thyroid issues
- Lisinopril/Generic Prinivil or Zestril for high blood pressure
- Bupropion XL/Generic Wellbutrin to treat depression
Comparing the same strength, 90-day supplies, adding all fees, and combining prices for a year, LJK found some big differences.
On the day checked, you'd pay $479 if you're a Walgreens Prescription Savings Club member, which includes a $20 annual fee.
With the Amazon Prime Prescription Saving Benefit, it would cost $391.80. That includes the $139 required Amazon Prime fee. If you've already paid for Prime, the cost for the prescriptions would be $252.80.
But for many generic prescriptions, Amazon also has an RX Pass Program for Prime members which could save you more. With that plan, three of the four prescriptions compared would be free with the $5 monthly fee. So, all four prescriptions for a year would be $39.20. Add the required $60 in yearly fees and $139 Prime membership and you'd pay $238.20 yearly.
With the Costco Membership Prescription Program, the total would be $352 and that includes a $60 membership fee. Non-members can fill prescriptions at Costco but may have different pricing.
With a GoodRx card, the cost would be $262 at the best-priced pharmacy listed, and remove any one-time deals.
The lowest price for all four prescriptions and a year's supply was Cost Plus Drugs. It would be $196 and that includes the $80 in shipping fees.
What if that pricing model was applied on a much broader scale?
Dr. Lalani and others with his research group, Program on Regulations, Therapeutics and Law (PORTAL), compared Cost Plus drug prices in 2022 to the prices paid by Medicare in 2020.
They found something stunning.
"We work on understanding the entire prescription drug market, starting from the approval of prescription drugs, all the way through patients accessing them. And we found that in a sample of about 77 generic drugs that Medicare could have saved about $3 billion if they had paid the Mark Cuban prices," Dr. Lalani said.
He says there are many reasons prescription prices are high.
"When you allow one person, one company to set the price for a drug, then there's no competition, and we rely on competition to lower prices. So that's one of the reasons, if it's a brand name drug, and only one company makes it, they can charge whatever they want. You know, the second reason is, our insurance companies and Medicare, we don't pool all of our bargaining power together. They each negotiate separately. And Medicare's just now starting to negotiate for the first time ever in history," Dr. Lalani said.
Those negotiated Medicare prices will be seen beginning in the year 2026.
Elliot continues looking for ways to save.
She said when a doctor prescribed a new drug with its big cost, she asked about the drug she used to take before. It's a drug that is now generic and much less costly.
"Now I pay $100 a month for that instead of paying $400 and some dollars for essentially a drug that does the same thing," she explained.
If you're insured, check your prescription coverage.
Your plan may offer the best prices.
These discount plans work best for people who are not insured, underinsured, or have high copays or a high deductible they won't meet.
Consumer Reports lists five ways to save on your prescriptions.
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