VERY varying pharmacy prescription drug prices ...
 

I took a close look at my Medicare Monthly Prescription Drug Summary and noticed that I had two identical prescriptions for antibiotics called in to two different pharmacies two weeks apart in February. Each prescription was for a week’s supply (22 capsules) of a tier 2 antibiotic, called in by the same provider. These were the charges that I paid out of pocket: Publix: $37.46, Walgreens: $16.20.

Whew! One considerably more than double the other?! I called the insurance company to make sure I wasn’t missing anything, and it was explained to me that because I am still in the process of meeting my deductible, the cost was determined not by them but rather by the individual pharmacies.

I spoke to the pharmacy manager at Publix, who explained that she does not determine prices, that when they fill a prescription, their computerized system determines the charge. She suggested that I contact the Publix regional pharmacy manager who, she said, could explain; I did call and leave a message for him but never received a callback. I will follow up....

I told this story to a knowledgeable friend who assured me that I should not necessarily consider Walgreens the “knight in shining armor” as far as prescription prices are concerned. Sure enough! I went there yesterday to fill two ongoing prescriptions (that is, 90-day supplies, refillable three times), both basic generic medications, and the total came to $62.34 ($40.72 + $21.62). This seemed awfully high to me, and for the first time I refused the meds and asked for the paper prescriptions back. No problem.

I then took them to Walmart (a store I generally will not shop in for various reasons—nothing to do with prices); the total cost of the two there was $42.81 ($24.00 + $18.81). Walgreens and Walmart were close to each other on one of them but—whew again!—very different on the other. I don’t have the time to go from pharmacy to pharmacy. If Costco were closer, I would go there; two things about Costco Pharmacy—and not everyone knows these—one does not have to be a Costco member to use their pharmacy, AND they have a mail order component which can be found at Welcome to Costco Wholesale.

I share this long story for what it’s worth. . . .

And a great story it is. And here is another odd piece to the quagmire. Publix issues free antibiotics (with prescription) for six different antibiotics. I don't have the list at hand but they will supply you with it.

Check out Healthwarehouse.com. We have used them and are much less expensive than Walgreens. Prices comparable to Costco but probably less. They are a regulated online pharmacy.

The only problem with an online pharmacy is that the prescription has to be mailed to you--and you thus have to wait for it. For some things it's all right to do this (I've used Costco.com for this), but when one needs, say, an antibiotic or a pain medication, one must have it immediately. My experience is that no retail pharmacy will tell you what a prescription will cost until it is actually filled and billed to an insurance company (which I suspect--though I may be wrong--is ridiculous). Even if I am wrong--or for that matter even if I'm right--I can still reject the prescription and get the original document back to take elsewhere.

The issue with the free antibiotics that Publix has is your doctor has to write for it. Many doctors know them, some don't.
Doxycycline was on the list until about a month ago...free..now can cost up to 200 bucks..matter of supply...just happens....and we (the docs) don't know about it until some one calls us.
Often one of the free ones is fine for your problem....ask your doctor or if you are lucky they will already know and write for it.

Hi - Part of my work in NH is to do Medicare Counseling (including helping to review Medicare Part D plans) under the SHIP Program. Florida has a similar program - SHINE - Home. Part of the issue could be that Part D plans can now have "Preferred Pharmacies", and that also accounts for some of the cost differences you're seeing. You can do a personalized Part D comparison on Medicare.gov: the official U.S. government site for Medicare or work with a SHINE person - they have regular times they're available at TV.

Many thanks!
 

Thanks for the suggestion! Let me go backward a bit and explain that when Medicare Part D was first created, I was not only not eligible for it but at the time I had coverage that was superior. Even so, I was quite vocal about how terrible the plan was set up, as it appeared to support the insurance and pharmaceutical industries more than the senior consumer. In time, however, I was required to select a Part D plan, and so I researched … and I researched … and I researched. I still could not figure out in which direction to go.

I made an appointment with someone in the office up north, comparable to what you’re suggesting, and began with my list of questions. After a long pause, the woman explained that she was a volunteer, that at that point I already knew more than she or any of her colleagues knew, and that would I consider being a volunteer there?! Unfortunately I could not, because of the distance from home, but if not for that, I would have been happy to.

So I am familiar with the plans and how they work. In my situation, all the pharmacies involved in my original posting—Publix, Walgreens, and Walmart—and others as well—are preferred providers. Initially I took that to mean that the cost would be the same no matter which I used. Wrong! The reason I started this thread was to share with others what happened to me in the hopes that I can prevent at least one person—and hopefully more—from being taken advantage of (a polite way of saying “being victimized” or “being ripped off”…).

Just to add a small point of information. I suggest consumers, which is all of us, read the CDC recommendation on what diagnoses do and do NOT require an antibiotic. You will likely be surprised to learn that for almost all patients no antibiotic should be given for either bronchitis nor sinusitis.
CDC - Get Smart: Acute Bronchitis (Chest Cold)
CDC - Get Smart: Sinus Infection (Sinusitis)

And never needed when the diagnosis is viral upper respiratory infection also known as a cold. Doctors may write an antibiotic when it is not needed to keep you happy if it seems you expect one. Speak up, tell the doctor you only want a medication if it is clearly needed. This approach will lower your medication cost to zero sometimes.

"How Drug Costs Compare" (Consumer Reports May 2013)
 

This chart appears in the May 2013 issue of Consumer Reports with their comment: "In our pharmacies study, Costco had the lowest retail prices overall and CVS the highest for five widely prescribed generics." The chart speaks for itself.

Wow, this is crucial....
 

I just noticed this chart. How much clearer can this be??? We should be publicizing this as well as asking our doctors to bring it to the attention of their patients!!!

If all pharmacies prices were the same, it would be Price Fixing. I think you have done a great job of tracking things down., I am sell Health insurance and you would be surprised of the people who do not know or care what they have until they are sick. Then whammo

A few wks ago, abc news had a piece about varying prices for THE SAME DRUG
They recommended an app called
GoodRx
You can find it in itunes or the Google play store
The app works like this:
You type in your zip code and the medication's name
Then it lists the pharmacy and the price for that med
It even gives the generic's price
We find Walgreen's prices to be the worst
Good luck w the app!

Great tip.....got the GoodRX app and love it...thanks.
The apps that we practicing doctors use every day, used to give the price range....they no longer do that...I would suggest you tell you personal doctors about this app....hopefully they will use this before they prescribe a particular medicine....shamefully we often don't know what the stuff we write for costs.

guess we really do need a costco here :)

"From your mouth to God's ears!" Well, at least to Costco's CEO. For those who don't know, Costco Pharmacy has a mail-order component, so for routine ongoing prescriptions, you can get them in the mail at often the lowest rates of any local pharmacy. For what it's worth....