I love math issues… let’s look at this example .. Medicare pays for how many doses of 20 mg or 40 mg ?
I checked on www.goodrx.com in my zip code lowest available price # 30 doses 20mg $0.25 each $ 7.42 & 40 mg $0.13 each $3.89
Cost Plus Drug Co. #30 @ $.019 =5.70 + 1.01 (15% profit) + $3 dispensing fee + $5.00 delivery fee = $14.71
I checked our Humana Part D and #30 esomeprazole 20mg $16.50 ($.55 each) – no coverage for 40 mg
since no strength or quantity was provided in the article, both strengths seem to be less expensive using www.goodrx.com It would appear that pharmacy dispensing fee, 15% profit margin & $5 shipping fee .. turns their price stated as in PENNIES ..turns into DOLLARS TOTAL COST. There are other cash discount cards like single care and others.
Cuban’s estimated Medicare cost – unless that is the cost that the PBM charges Medicare after paying the pharmacy and adding all their administration fees, could be true, but could possible point out how crooked the PBM industry is and why they are paying multiple million files for over charging various entities – mostly Medicare & Medicaid.
The truth is, when Congress passed the Medicare Part D & Medicare Advantage med bill, they turned this medication program for Medicare folks to FOR PROFIT INSURANCE COMPANIES and/or PBM companies, which are licensed insurance companies. Congress agreed that they would not allow Medicare to negotiate prices. The PBM industry for the last 50+ yrs have been extremely opaque on how their financial charges are determined. The Insurance/PBM industry has one of the largest pots of money to lobby Congress and this might explain why Congress handed the medication for Medicare folks to this FOR PROFIT INDUSTRY and Medicare agreed not to try to negotiate a discount/lower price on covered medications…. that was back in 2003 +/- Part D program became active Jan 1, 2006.
‘Let’s get this done,’ Mark Cuban tells Biden on Medicare savings study
Medicare recipients could have saved up to $3.6 billion on generic drug costs in 2020 if Medicare paid the same prices as investor Mark Cuban’s pharmacy, according to a study published June 20 in Annals of Internal Medicine. Mr. Cuban tweeted the results, urging President Joe Biden and other elected officials to “have your people call my people and let’s get this done.”
The pharmacy, Mark Cuban Cost Plus Drug Co., has quickly gained speed from about 100 generic drugs at its launch in January to more than 700 generic drugs six months later.
The researchers from the Program on Regulation, Therapeutics and Law at Boston-based Harvard Medical School and Brigham and Women’s Hospital identified 89 generic drugs for which they could compare prices between Mark Cuban Cost Plus Drug Co. and Medicare Part D plans.
If Medicare Part D plans matched Mr. Cuban’s prices for 77 of the 89 generic drugs, 37 percent of Medicare’s $9.6 billion 2020 drug costs could have been slashed, the study found. Twelve drugs did not cost less.
The researchers found the best results with esomeprazole, a drug that treats acid reflux heartburn, which could have saved CMS up to $293 million if Medicare paid the same amount as Cost Plus Drug Co. Medicare paid $1.77 per pill. Cost Plus Drug Co. gets it for $0.19.
Cost Plus Drug Co. sells its products with a $3 pharmacy dispensing fee, $5 shipping fee and a 15 percent profit margin.
“Our sole mission is to be the low-cost drug provider for as many drugs as we can possibly offer,” Mr. Cuban told Becker’s. “That is counter to most business interests, particularly over a long period of time.”
Filed under: General Problems
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