Prescription Follies

The other morning, I had a flashback to the days when I used to watch my stepfather line up nine pills in front of him at the breakfast table and proceed to take each one as he drank his orange juice. I remember marveling to myself at how his system was handling that potent cocktail of drugs. But I never gave a thought to how much he must be paying for them, or how he kept it all straight. Last week, I had the worst bout of allergies I’ve ever had, coupled with some gum surgery and what turned out to be the onset of a head cold, all of which led me to my new personal record of five pills at one sitting. And this got me thinking about the economics of the drug industry.

It’s no secret that we baby boomers are heading into our peak drug purchasing years, and I’m sure the big drug companies are very happy with this demographic trend. In the past, I haven’t thought too much about medical and prescription expenses, or about the insurance that pays for them, although I vividly remember a stretch of thirteen months when money was very tight and we were without insurance. Every time I had an ache or pain, I was sure it was foretelling “the big one,” some ultraserious disease which would either kill me, bankrupt the family, or both. But somehow, when you have insurance, you kind of ignore the financial aspects of health care. It’s just a copayment, right?

But we recently had an experience that convinced me that I need to pay better attention.
Melanie, the Platinum wife, actually prompted this discovery…(Occasionally, we reverse roles, and she becomes the thriftier of the two of us … but I digress). She regularly takes PremPro, one of those hormonal supplements that just about every woman in our age bracket seems to take. I had switched to buying her medication online, through her insurance carrier, as they offered a copay for a three month supply of $62.50, compared to the $75.00 ($25X3) we were paying if we bought it monthly at CVS. This worked the first time I tried it, but the next time I ordered it, we got one month’s worth for a copay of $41.22. I guess I just figured she didn’t have enough refills left for three months, and put it out of my mind.

I don’t know how many times we paid the $41.22 after that before Melanie noticed it. “We should check on that,” she noted, which in wifespeak means, of course, that I should check on it. When I finally did, I noticed that the prescription now says “60 day supply,” which I didn’t remember seeing before. Sure enough, Melanie remembered that during her last checkup, she had mentioned to her doctor that she tries to only take the PremPro every other day...(We both subscribe to the philosophy of taking as little medication as possible). Apparently, her doctor wrote up her next prescription as "every other day," which must affect the copay. At least, that’s one theory. But the funny thing was that the "retail copay" still showed as $25.00.

So Melanie suggested that we try CVS. Sure enough, it’s $25.00.

Now in the overall scheme of things, the $16.22 difference is not going to make or break or break many people. But it’s the exact same product. And one that we purchase 6-7 times a year. My neglect would basically have let $100.00 a year slip through our fingers. So I consider that little incident to be a wake up call. I’m going to pay more attention from now on.

And with all the medications we boomers are going to be buying over the next 2-3 decades, I think you’d better pay more attention too. - Bob