Variations in Generic Prescription Drug Pricing - One More Factor in Our HealthCare Crisis

As if aging was not hideous enough, a trip past my glass kitchen cabinet where I now store a multitude of prescription drugs, is a constant reminder that I am no longer in the springtime of my existence.

Synthroid for my radiated thyroid, prescription Protonix for heartburn, high blood pressure pills, cholesterol meds, and most recently a bottle of Plavix from having an aortic aneurysm repair.  Oh, Joy and Happiness!

It could be much worse, I guess, and my recovery from the stent placement has proceeded to the point where I can almost, but not quite, cross my legs again - without wincing in pain.  What did make me wince, however, was the monthly out of pocket cost to swallow down the daily doses required to keep me upright.

All this pill popping was a relatively new phenomenon for me so despite my vast experience in managing a number of medical practices, I had no idea how much these colorful and varied shaped disease fighters cost.

My husband's medical plan requires that we pay up- front for our prescriptions.  We then mail the receipts and wait to be reimbursed at 80% of the cost.  The check always arrives in a timely manner, but until very recently, I was shelling out about three hundred a month to the lovely person behind the counter at my local CVS.  I pay less for my 2012 Honda lease - and it's much, much bigger.  One realizes why so many seniors have to make the choice between eating and taking their prescribed medications and I consider myself lucky that I could squeeze our budget to cover these costs without having to eat Ritz crackers for our evening meal.

I decided to investigate and was shocked to find that there was an overwhelming difference in the costs of prescription medication from place to place.  Not just a one or two dollar difference, mind you, but differences so staggering that there is really no reasonable explanation.

Plavix is now available as the generic Clopidogrel.  For thirty pills at CVS, the up-front cost was $157.49.  At Pathmark, the same prescription cost me $11.30.

The generic prescription Protonix was $89.00 at CVS.  Pathmark - $11.00 even.

How can this possibly make sense?   I sent an e-mail to CVS on Friday asking for an explanation and I can't imagine what they could tell me to account for the difference in pricing.   If the drugs cost them that much to purchase and so many patients pay only a co-pay of $15.00 or $20.00, how can CVS afford to stay in business ?   Do the uninsured or self pay patients make up the difference?

I can't claim to know what the insurance companies are reimbursing pharmacies for drugs covered under a co-pay plan, but if it is $157.49 for Clopidogrel, then how does Pathmark afford to stay in business. Do they supply the drug manufacturers with free food?  

There has been much discussion regarding the institution of federally controlled health care, but shouldn't there be some consistency in what patients are charged for services?  In medicine, we cannot charge our patients over and above the contracted reasonable and customary fees.  Shouldn't there be a reasonable fee for medications as well?