Every once in a while on this blog, I like to direct your attention to something pharmacy or drug related that I find interesting, amusing, or alarming. As your progress in your career one of the most common questions that you will be asked is, "Why does this medication cost so much?". Here is a brief article I saw online: http://www.fiercepharma.com/story/europe-pays-40-less-drugs-u-s/2009-07-08
I have worked with enough patients and families to try and determine the most cost effective treatments to know that we have an inherently flawed system in the United States. Here, patients are *told* by their doctor what to use and end up paying the bill for their physician's whims. I believe there will be great need for pharmacists by governmental agencies and insurance groups in the future to handle cases where physicians use poor processes by which they choose the medications they prescribe.
Case in point: Why use Nexium (esomeprazole) instead of generic Prilosec (omeprazole)? One is being marketed like crazy by a drug company and costs $4-5 a day. The other can be purchased for about 1/10 that amount. Not much difference other than that. A couple of years ago the president of the AMA castigated his fellow physicians for prescribing Nexium due to it's cost and the lack of benefit when compared to the generic PPI available. Despite all this, Nexium is one of the top selling drugs in the world. You know who is paying for all those little purple pills? Yep, you and I - the people paying taxes (Medicaid and Medicare) and insurance premiums.
I challenge you to be an advocate for your patients in your professional practice. Ask patients why they are taking a medication that is prescribed. Inquire with the physician why a certain agent was chosen if you feel an alternative might be as effective. You will have earned your degree - you must use it.
I'll step down from my soapbox for now.
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For a real eye-opening experience, look at the difference in pricing that we have here in the United States, at our own retail pharmacy outlets. For example, an Rx for generic Zofran can cost you $65 at Costco or $650 at CVS. You can see many many more examples of major price discrepancies at the website: www.LesliesList.org. All pharmacists should have a look at it.
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