more on medical prices

Here’s a chart of prices that I have assembled so far:

Drug name, strength K-mart Shopper’s Wal-mart drugstore.com
Prevacid 30 mg   $163.95 $152.32 $141.99
Protonix 20 mg     $112.78 $123.09
Aciphex 20 mg     $152.46 $139.99
Nexium 20 mg $175.00 $154.95   $153.18
Nexium 40 mg   $154.95   $136.99
OTC Drug, strength K-mart Shopper’s Wal-mart drugstore.com
Prilosec OTC 20 mg   $19.28 [1]   $131.03
Omeprazole [4] 20 mg       $24.00
Ranitidine [4] 75 mg   $4.99 [2] $2.71 [3]  

All prices are for a 30 day supply, one per day.

[1] Prorated, price was $26.99 for 42 pills

[2] Prorated, price was $9.99 for 60 pills

[3] Prorated, price was $10.28 for 120 pills

[4] Generic

I’ve found that I can get ballpark quotes for scrip prices online at drugstore.com. This can be useful, as pharmacists seem to hate to give prices out over the phone. They are sometimes – but not always – the cheapest, but sometimes they have an anomaly, such as their price for OTC Prilosec. (I’ve included their price for generic Omeprazole 20 mg, though it’s still not as cheap as the brand name at Shopper’s. I imagine that they have some old stock left over from when it was prescription only, and patent protected. )

All of the above are proton pump inhibitors, except for the Ranitidine. I’ve included that because that’s what I use.

ranitidine, 75 mg, at Wal-mart

Yes, it’s hard to believe, but I’m satisfied with taking just one of these a day. I might take a second one if I’m going to a family get-together or something, but one little 9 cent pill preemptively takes care of any sour stomach problems I might have and retails at 50 times less than the Aciphex scrip I was taking before. There are several other OTC pills, but from research in my PDR and other sources, I’ve come to understand that this over the counter drug has the fewest side-effects. My doctor cleared my choice for daily use, although he said it was not as effective as my former prescription. That doesn’t matter, because it’s good enough for me and was less than half the cost of my former co-pay of $30/90 days.

So what’s my point here? I’m trying to demonstrate that having consumers pay the full market value of prescription drugs, instead of heaping the majority of the cost upon everyone else in the same insurance pool, can lead to a dramatic cost saving. That does not even take into account the effect of a large pool of consumers who suddenly start price shopping for medical services. I’m sure the standard economic rules will be in effect there too.

Is this switcharoo going to work for everyone? No, but the consumer choice of this pill over the pricey patented pill by a segment of the population will put downward pressure on the price of the prescription pills.

I’m not arguing that we should do away with medical insurance, I just think medical insurance ought to be more like a safety net rather than a hammock. Having the consumer pay for day to day ordinary expenses out of their own pocket creates a network-effect of driving down costs for everyone, while that safety net can kick in and cover any dramatic medical emergencies.

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