Forensic Drug Prices, Follow the Money

It is a near universal complaint that prescription drug prices are too high. It is hard to call such a judgment valid without some specificity about just what we mean by 'price.'

There are a few possible prices for a given drug that I can identify, but there are undoubtedly several that I am not aware of. This post should be considered at least as much a request for information as a source. Not only price information is requested, but also information on the relationships between and among all of the players in the manufacture, distribution, sale and payment of and for prescription drugs.

First of all, what price does a consumer see when he picks up his prescription in the pharmacy? It depends on the particular consumer.

If the consumer has no health insurance, or if his health insurance doesn't include a prescription drug plan, then he probably pays the price marked on the box. We can call this the retail price. For a given prescription drug, the retail price will vary from one pharmacy to another, and it may be subject to coupons.

If the consumer has private health insurance ( either employer or non-group ) with a drug plan, he probably pays only a co-payment, which doesn't depend on the retail price, but may depend on whether the drug is a generic or not.

If a consumer has government health insurance, likely involving both state and Federal governments, but about which I have little detailed awareness, he MAY pay a discount off the retail price and be later re-imbursed for his payment upon filing a claim.

Share this