Apr 23, 2010

The Drug Buy

I take a daily medication to help keep a mild case of hypertension in check. Normally, my doctor writes a prescription for a 90 day supply with three refills... a years worth of this med... during my annual physical exam. That prescription is then sent in to the drug provider designated by my health care insurance plan. When it's time to order another 90 day refill, I go online and place the order, paying a co-pay of $15. The prescription is then filled and the medication sent via US mail. Because of our nomadic lifestyle, it get's sent to my "address" -- my top-notch mail-forwarding service in Beaver Dam, Wisconsin. The next bundle of mail from our forwarding service that gets sent to us along the trail will then include the prescription med that, by the time I get it, has traveled more miles than a near-sighted cat being chased by the hood ornament of a cross-country Mack truck.

Well, the other day I noticed that the number of pills left in my last bottle of this medication was less than the number of days until my next doctor's appointment in May... the result of a timing issue between physicals. What to do..?

I called my Doc (actually his assistant) and arranged to have a prescription for a single 30 day supply of this medication electronically sent to a pharmacy near our camp in Iowa. I would then run over to the pharmacy and pick it up... problem resolved. She asked where I'd like the prescription sent. Not knowing particular pharmacies in the area, I was aware that there's a Super Walmart just down the road... and that's where I had her send it.

The next day we were out exploring and we stopped to pick up the order. The drug I take is an older drug and has a generic, which my health plan requires if I want to get by with just the $15 per 90 day supply co-pay. But since I'm getting this order outside off my plan's maintenance medication program, I figured I'd probably be paying "big-time" for this 30 day supply even though I'll still be getting a generic. So I was prepared when I headed for the pharmacy... check book, credit card, insurance card, drug plan card, grubby clothes so I'd look a little destitute, maybe needy of a good deal, resolved to be on my best behavior, prepared to do a fake Grand Mal seizure when I was told the price... which was bound to be high, very high.  I was ready for $50... oh, I would have happily settled for $50... but was fearing $80 maybe more than $100. These dang drug companies! Those greedy insurance companies... always ready to stick it to those who don't jump through the right hoops in the right order. Dang-it...I was ready!

They found my prescription, it was all bagged up and ready to go. (OK, here goes --) "and how much will that be?" as I reached for my check book.

"That'll be 4 dollars."

"What?... are you talking per pill?"

"No sir... it's 4 dollars total"

"What?... are these sugar pills?... placebos?... cough drops?  I mean, a medium bag of M&M's cost more than $4"

"No sir... this is the medication you ordered."

"And there's 30 tablets in there?"

"Yes sir"

"Why is it only 4 dollars?  What's going on here? Is this candid camera?"... as I look around for the hidden camera.

"No sir... Walmart has a prescription program for hundreds of commonly prescribed medications. They're all $4 for a month's supply... and only $10 for a 90 day supply."

"Don't I have to give you my insurance card or drug plan card or Walmart savings card, or fill out any paperwork, or be part of a club or something?"

"No sir. This is as complicated as it gets... you give me 4 dollars... and I'll give you this bag."

"What?... that's less than my super-duper special deal worked out by my health care plan that ships my medications to the moon and back..." Befuddled, I just didn't know what else to say. I quietly put my checkbook back in one pocket, found a couple crumpled $1s and some pocket change in another, paid for the order, and walked out of the store mumbling... "four dollars... just four dollars... what the..."

Later it occurred to me that this experience, the underlying idea, may play a part in lowering health care costs in the USA... inject a little more competition into the system. Don't just assume you're getting the best deal... look around, question your doctor, ask for alternatives that may be less cost,  do you really need this or that test?...push back a little. How often in the past few years have we heard about unexpected serious side-effects from the latest and greatest and grossly expensive medication that TV adds have convinced many of us we've got to have... and has turned out to not be fully tested or fraudulently approved for sale or actually dangerous. Speaking for myself, I think I like the idea of the staying with the older and proven medication.

And I may stop slamming Walmart for ruining America.

Hmmm, I wonder if Walgreens could do it for 3 dollars?


Beyond Branson; Pondering Future Travel

This past Tuesday, we moved from Branson to a very nice Corps of Engineer’s Park on Wappapello Lake.  We’re in the Redman Creek CG. This fac...