Generic drugs and insurance; some drugs cost more when you use your insurance according to a NY Times investigation.
In our very complicated healthcare system, we rely on insurance companies to pay a portion of our bills for us and to negotiate fees.
Currently, drug prices continue to escalate due to drug manufacturers price hikes as well as wholesalers and PBM’s (pharmacy benefit managers) such as express scripts. Their business model of rebates and profits are inflationary, confusing and are not necessarily helpful in today’s health environment.
The cost of tests such as an MRI are maintained by insurance companies through their negotiated contracts, and often are in excess of $800 dollars if you use your insurance, yet most of these facilities will do these tests for $500 or less if you pay cash.
The same goes for certain generic drugs, according to a recent NY Times investigation that says that 10 percent of the transactions for generic drugs may cost you less if you buy them on your own without insurance.
Knowing how insurers price and get kickbacks through PBM’s through rebates, how does the consumer tell if they are getting a fair price for the drug and when should you just pay for it on your own. Consumer Reports has suggested that certain chains wildly mark up generics to enhance their profits, while Costco and even Walmart may offer many of these same drugs for less.
If you are taking generic drugs, it may pay for you to shop around for the best deal and ask about the price with and without insurance.
Check out the NY Times article below
Prescription Drugs May Cost More With Insurance Than Without It
By CHARLES ORNSTEIN and KATIE THOMAS DEC. 9, 2017
Having health insurance is supposed to save you money on your prescriptions. But increasingly, consumers are finding that isn’t the case.
Patrik Swanljung found this out when he went to fill a prescription for a generic cholesterol drug. In May, Mr. Swanljung handed his Medicare prescription card to the pharmacist at his local Walgreens and was told that he owed $83.94 for a three-month supply.
Alarmed at that price, Mr. Swanljung went online and found Blink Health, a start-up, offering the same drug — generic Crestor — for $45.89.
It had struck a better deal than did his insurer, United Healthcare. “It’s completely ridiculous,” said Mr. Swanljung, 72, who lives in Anacortes, Wash.