When you need to fill a prescription, it pays to shop around. Prices for common drugs vary depending on where you go. This is true for big chains and small neighborhood pharmacies.
We did some fairly thorough research just recently on birth-control pills in the Tri-state area (New York, New Jersey and Connecticut). Price differences were sometimes shocking. For example, one popular birth control pill, Tri-Sprintec 28, ranged from $9 to $63, depending on where you shop. Another common one, Yaz-28, ranged from $68 to $112. Here is a description of the survey; for results, click on the interactive map here.
Here’s another thing: If you’re insured, you might be surprised to find out that, in many cases, prescriptions can be filled for less by paying out-of-pocket. Here’s a blog post we wrote about a man who found that a prescription would cost $12.10 without insurance, and $38 with.
This is not uncommon; here’s an article about an internist who sends patients to Costco to buy their prescriptions without invoking their insurance. The internist, Dr. David Belk, maintains a website with a lot of cost information; the section on medications notes that the cost of copays actually can have the effect of raising prices. So the Wal-Marts and Costcos of the world buy at cost, mark up a
bit and sell for cash, rather than going through the co-pay insurance route. He practices in California, and we have anecdotal information confirming that the same is true in New York, among other places we’ve collected pricing.
Many people are surprised to find how much prices vary, not just for birth-control pills but for a lot of other prescriptions. Our recent research project focused on birth-control pills because they’re widely used, and interesting for a number of reasons.
If you’re comparison shopping, one place to start is goodrx.com. This easy-to-navigate website allows you to punch in the prescription you need with the city you live in and – voila – it returns a full list of price comparisons at local drug stores. The site also includes discount coupons, but they’re not always accepted at your local store.
Here’s a New York State website that also allows you to look up competing prescription prices. But use sound judgment – some of the prices we found we just don’t believe. For example, the list includes a number of common birth-control pills for well over $1,000 at several New York pharmacies. Really?
Looking for one for your state? Here’s a somewhat dated list from the Robert Wood Johnson Foundation of state drug price lists.
These are all great resources but should be used with skepticism. During our phone reporting, we found several pharmacy prices listed online were outdated or inaccurate.
In New York, pharmacies are required to supply price lists to consumers on request: “Every pharmacy that sells drugs at retail must make Drug Retail Price Lists available” for the top 150 sellers, according to the New York State pharmacy regulation Web site. “Pharmacies should update their lists at least weekly. Consumers may request a computer-generated list to take with them when they leave the pharmacy.”
But those lists can have mistakes: in one case, we called a Brooklyn pharmacy with a price listing of $467 for one pack of a common birth-control pill. When we asked if the cash-pay price was really that much, they checked their database and sheepishly told us the price was actually $93. Apparently their software had “miscalculated.”
A friend who’s an adolescent medicine specialist writes: “I love smalltown, individually-owned pharmacies, but many of my patients use Target for Orthocylen/Sprintec/Mononessa/
In general, we recommend that you also ask about discounts. We had one pharmacist in New Haven tell us that he’d bring a $30 birth-control prescription down to $20 if the uninsured customer couldn’t afford it. That’s one of the perks about your independent neighborhood drug store (more about this to come.)
But why does the price vary so much? It’s not like the price of strawberries, which depends on a good harvest.
According to a recent story in the LA Times by David Lazarus, brand-name drugs will always carry the highest prices possible – mostly due to millions in research and development costs – while generic drugs are a little trickier. Lazarus quoted Bob Toomajian, who worked for 16 years as Kaiser Permanente’s drug purchasing manager for Southern California, as saying: “A lot of the prices for generics can’t be justified. Manufacturers are basically starting with the exorbitant prices that the branded guys charged and then setting their own prices at whatever level they think the market will bear.”
Moral of the story: prescription pricing websites are great, but it’s always best to get your quotes from the horse’s mouth -– so make a phone call before rushing out the door for that $12 birth control prescription.