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I went to my local Walgreen's Pharmacy to refill a prescription and confirmed to myself – once again – that Big Pharma is a major problem in our country.

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Big Pharma Plays Us for Patsies—Michael Hertz

I had previously had a prescription of thirty capsule of Duloxetine 30 mg, for which I had paid about $30. But my pain doctor had upped the dosage from 30 to 60 milligrams, and I was completing the first round of pills by taking 30 mg at night and 30 mg in the morning. For the refill, the pain doctor had decided for me to continue that regime. But independently, my neurologist had prescribed 60 mg of the same drug to be taken once a day and had sent the prescription to the pharmacy. So waiting for me at the pharmacy was the neurologist's prescription consisting of thirty pills of 60 mg each and the pain doctor's prescription of sixty pills of 30 mg. In other words, the total amount of drug for each prescription was the same, so you would figure that the cost of each prescription would be about the same.

But it was not. The thirty pills of 60 mg each was $31. The sixty pills of 30 mg each was $47. I asked the pharmacist why there would be such a big difference, and she said, “There were twice as many pills.” Which isn't much of an explanation. Can it cost so much to make a pill that the price for 60 pills is 50% more than the price for 30 pills with the same total amount of drug?

Moreover, when I bought the original thirty pills of 30 mg each, the price wasn't much less that the $31 for thirty pills at 60 mg. I looked up the price of thirty Duloxetine 60 mg pills on, and they wanted $21.00. But the price of thirty Duloxetine 30 mg pills on the same website was $23.40. In other words, it cost more to get the lower dosage pills that the higher dosage with the same number of pills. What does that mean? The only reasonable explanation might be that sells so many more 60mg than 30mg that the price drops, but that doesn't seem very likely.

You might want to compare the cost of Duloxetine, which is the generic version of Cymbalta, to the brand name drug. Thirty Cymbalta 60mg costs $249.60. In other words, the generic costs less than 10% of the brand name product. The pharmacy indirectly drew attention to this, stating that the retail price of Duloxetine 60mg was $246.99. “Your Insurance Saved You: $215.99,” it said. Of course, we know that the insurance had nothing to do with it. The saving came from getting the generic version rather than the brand name version. Why would Walgreen's tell a bald-faced lie?

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The drug industry and the insurance industry must think that we're complete idiots. They want us to think that drug insurance creates savings in the price of drugs, even though the saving is due to buying generic rather than brand names. They price drugs in the retail market is a way that makes no sense, except that you know it makes them plenty of money.

Americans are angry about the cost of drugs, which are much higher here than in other developed countries. The article shows that Cymbalta costs around $240 in the U.S. but $110 in Canada and $46 in the U.K. We already know that the costs in the U.S. make no sense.

“According to the International Federation of Health Plans, Americans pay anywhere from two to six times more than the rest of the world for brand name prescription drugs. Specialty and cancer drugs tend to be the most expensive, but the sky-high prices can be found in commonly used meds as well. For example:

Cymbalta (for depression): $194 in the United States, compared to $46 in England and $52 in the Netherlands. In fact, there is also a generic version of Cymbalta so these prices reflect having a cheaper alternative.”

These latter articles makes you wonder whether they're discussing Cymbalta or Duloxetine or both without making any distinction. The discussion about drugs is as confusing as the pricing at Walgreen's.


Michael Hertz