Costs of pharmacy drugs

In the news recent­ly you may have noticed that the cost of some med­ica­tions have been the head­line.

Addi­tion­al­ly even on Face­book there have been many dis­cus­sion about the cost of med­ica­tions.

There may be a rea­son why these costs keep going up and up and up…

Its not what you think..

The prob­lem is that we have seri­ous issues in this nation and pol­i­tics seems to have invad­ed every sin­gle aspect of our soci­ety.

Includ­ing health care.  source.

Ris­ing health care expen­di­tures with­in the Unit­ed States has been a major focus of pol­i­cy mak­ers, busi­ness own­ers, and indi­vid­u­als for years.

Accord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC), the per capi­ta nation­al health expen­di­tures in 2015 US dol­lars was $9,990, total nation­al health expen­di­tures were $3.2 tril­lion, and the per­cent of Gross Domes­tic Prod­uct (GDP) was 17.8% ¹ Fur­ther­more, pre­scrip­tion drug treat­ment account­ed for 10% of the over­all costs asso­ci­at­ed with nation­al health expen­di­tures in the US (2015 US $).¹

A 2013 report by Moses III et al, iden­ti­fied the top 4 dri­vers of health care costs in the US since 2000 as: 1) admin­is­tra­tive costs (5.6% per year); 2) price of health care ser­vices (4.2% per year); 3) price of drugs and med­ical devices (4% per year), and 4) price of pro­fes­sion­al ser­vices (3.6% per year)² Inter­est­ing­ly, this report did not find demand for health care ser­vices or aging of the pop­u­la­tion to sig­nif­i­cant­ly con­tribute to this increase in health care costs. Thus, the price of health care itself seems to be dri­ving the increase in costs. ²

To address these increas­es in costs relat­ed to pre­scrip­tion drugs, pri­vate employ­er groups, indi­vid­ual States, and the fed­er­al gov­ern­ment, have uti­lized the ser­vices of phar­ma­cy ben­e­fit man­agers (PBMs). His­tor­i­cal­ly, PBMs were “mid­dle­men” enti­ties designed to process pre­scrip­tion med­ica­tion claims (for a small fee per claim) for insur­ance com­pa­nies and plan spon­sors (ex. pri­vate employ­ers). ³

Today, PBMs have lever­aged their posi­tion as the “mid­dle­men” and now impact almost every aspect of the pre­scrip­tion drug mar­ket­place.³ For exam­ple, the top 3 PBMs with­in the coun­try man­age the drug ben­e­fits for approx­i­mate­ly 95% of the US pop­u­la­tion or 253 mil­lion Amer­i­can lives.⁴ Beyond their tra­di­tion­al claims pro­cess­ing, PBMs are now involved in drug uti­liza­tion review, drug plan for­mu­la­ry devel­op­ment, deter­min­ing which phar­ma­cies are includ­ed in the pre­scrip­tion drug plan’s net­work, decid­ing how much net­work phar­ma­cies will be reim­bursed for their ser­vices, and oper­at­ing mail order and spe­cial­ty phar­ma­cies them­selves.⁴

You can read the entire arti­cle here.

What I find of par­tic­u­lar inter­est is the dis­hon­est man­ner of these sys­tems where some­one is basi­cal­ly oper­at­ing in the mid­dle of the patient, doc­tor, phar­ma­cy, drug man­u­fac­tur­er, the insur­ance com­pa­nies that are paid to pro­vide drug cov­er­age and on and on it goes.   You see the prob­lem here?  The aver­age patient pays between 500.00 to 1800.00 for health insur­ance each month…  The gov­ern­ment pays mon­ey out as well…    So, what is the name of all that is good are we allow­ing dis­hon­est bureau­crat­ic Gestapo Mafia, types to influ­ence and ped­dle spe­cial inter­est ideas and pol­i­tics into what is essen­tial­ly the mon­ey of Amer­i­cans all over this nation?

What is that all about…

Seriously because I want to know…

How is it pos­si­ble that we have what amounts to a pro­tec­tion rack­et, extor­tion and more moral­ly rep­re­hen­si­ble behav­ior going on every day and the media are talk­ing about every­thing else but what they should be talk­ing about.