When Cheryl Kennedy’s 4-year-old daughter was diagnosed with pinworms, her doctor prescribed a drug called Albenza.
A few years ago, an Albenza prescription cost $6. But when Kennedy’s daughter was prescribed the drug, the price was nearly $700, even with insurance.
WHY IT HAPPENS
Some drugs, such as Albenza, are prescribed so infrequently that when their patent expires, no company applies to the FDA to make a low-cost generic version. But a few years ago some drug companies started seeing a business opportunity in these overlooked drugs and began purchasing the rights to them–then jacking up the prices. That’s what happened in 2015 in the highly publicized case of Martin Shkreli, then the CEO of Turing Pharmaceuticals.
He bought the rights to the antiparasitic drug Daraprim–and raised the price from $13.50 a pill to $750
Ask your doctor whether a related but less expensive drug is an option. When Kennedy asked, her doctor suggested trying Reese’s Pinworm Medicine, an over-the-counter drug that cost less than $15, it worked.
NUMBER THREE | A Cheap Generic Becomes Pricey
When Kiwi C. migraines began to worsen, her nurse practitioner switched her from generic Topamax to a new drug, Qudexy XR. Both contained the drug topirimate. But Qudexy XR is a new version, tweaked by a drug-maker to come in a larger dose that is released over time.
The biggest difference is the price–less than $15 for the old generic and about $600 for the newly branded one. Because Kiwi C. has no insurance and would have to pay full retail, she ended up not filling the prescription at all.
WHY IT HAPPENS
Drugmakers often tweak older drugs, then apply for a new patent, allowing them to charge more for the “improved” product. But those charges are often minor–a slightly larger dose, or time-released—and the new drugs aren’t much better than the original.
Sometimes generic drug prices spike in another way: not in higher costs for new “branded” drugs but in skyrocketing prices of the original generic. About 20 percent of generics have had price hikes of at least 100 between 2013 and 2017, according to an analysis by the Drug Channels Institute, a consulting firm.
That includes basic meds such as the antibiotics tetracycline, the diabetes drug metformin, and the blood pressure drug captopril. Those increases can occur when several drug companies stop making a generic, and the ones that still do take advantage of the reduced competition to charge more, according to a report from the Government Accountability Office.
The net result for consumers is a double-whammy: higher costs for old standbys and expensive, newly branded meds that may not be necessary or covered by insurance.
Ask your doctor whether an older drug would work just as well. For example, Kiwi plans to ask her healthcare provider to switch back to generic topirimate but get two prescriptions: one for 100 mg and another for 50 mg. The combined cost: about $24 through the price-comparison tool GoodRx.