Jackel Loc: California

As a 35-year plus former Federal Gov't employee, I pay $250, or so, a month from my pension, and benefit with a $20, and less, co-pay for our meds. No charge (co-pay) for doctors' visits, clinic or hospital visits.

bwana Loc: Bergen, Alberta, Canada

It appears to be an American problem. The same drugs sell outside the USA for 10-25% of the US price. I know a lot of Americans buy drugs from reputable pharmacies in Canada for less than their medical insurance covers for the same drugs bought in the USA. In a country where corporations rule, the price is whatever the buyer will pay...

frjack Loc: Boston, MA

The FCC is complicit in the price of medications. When I was a young doc prescription medication advertising on TV was unheard of. It was considered unethical in some understandings. Some OTC stuff was advertised, especially aspirin and Alka-seltzer (I can still see the I-can't-believe-I-ate-the-whole-thing ads) and laxatives (are three enough are six too many?). However, now the advertising, and the promise, both implicit and explicit, of a wonderful life has crossed a boundaries of decency, ethics, and patient safety. Broadcast advertising is not inexpensive. The ads are slick. They promise much. Most disturbing are the advertisements for the second generation anti-psychotic medications that are useful as adjunctive medication in certain (double underline) situations of insufficient response to a standard antidepressant. But these medications are shilled not as potent anti-psychotic medications but as anti-depressant boosters without mention of some very serious potential side effects. The "patients" are as young and attractive as the ones in beer commercials (always wondered why one never sees beer guts or muffin tops on the bathing suit clad beer drinkers).

A number of years ago a patient presented to my office (I am dual-trained in internal medicine and psychiatry) requesting paroxetine by brand name because she was having trouble sleeping. It was touted as an effect of the medication on the tube. At best sleepiness was a side effect (as was weight gain, which she did not need). She admitted she had been hospitalized for depression twice but remained vague about how long and where. I missed a red flag. After examining her I concluded she was not depressed. Refused to write the Rx. She was not happy but not hostile or angry about it. After her second appointment when I again refused she informed me she would not return. No hostility on either her part or mine. She was actually a very nice lady but I could/would not prescribe a medication that was not indicated by her complaints or the results of examination.

Flash forward about six months. Frantic call from family who found my card in her things. She found a doc to prescribe the medication. However, there was now a serious problem. Yes she had had depression. What the patient did not reveal was that she was manic-depressive and had been hospitalized twice for severe mania not depression. Her sibling who called gave me all the details. The medication pushed her into a psychotic manic episode from which she never fully recovered despite discontinuation of the medication. I cared for her for about a year before she was moved to a full-time nursing facility. Very sad situation.

"Ask your doctor if you are a candidate for . . . . . . (fill in the blank)" The message is that your doctor will happily write a prescription for the expensive and potentially devastating medication upon your request. As misleading advertising is permitted and encouraged things will only get worse and the costs of drugs will continue to escalate so as to pay for the advertising spots, the actors and actresses who do not appear at all ill, and the crew that films the shots at multiple locations to increase the cinematic veracity. Cigarette advertising has been banned for years. There are strictures on alcohol advertising. Why does the FCC allow drug companies to advertise medications that while effective in the right situation require careful deliberation before prescribing and follow-up afterwards? Antipsychotics as adjuncts, antidepressants, and immunosuppressants are serious medications that are not meant for amateurs or to be self-prescribed. Yet they are touted in prime time. There is something wrong with the picture.

sb Loc: Florida's East Coast

That has nothing to do with the "Cost" of drugs. That is your copayment. The VA covers the rest of the cost. So even if you are getting Gleevec for your leukemia ( cost is about $10,000 per month for 30 capsules) you will pay $9. The good news, though, is that the VA is allowed to negotiate drug prices, so they probably pay less than the MSRP.

machia Loc: NJ

R&D .
Legal .
Regulations .

sb Loc: Florida's East Coast

I agree wholeheartedly. And I love the advice: "Tell your doctor if you have had a liver transplant,..etc." I hope your doctor would know that, but I suppose in an era where a lot of folks just go to the local urgent care it cannot be assumed that "your doctor" would KNOW that you had a liver transplant!

jerryc41 Loc: Catskill Mts of NY

Right, but list prices are still ridiculous for many drugs, and insurance companies pay based on the list price. That drives up the cost of healthcare. When a company raises the price of a drug from $400 to $4,000, that's strictly greed. The ridiculous salaries CEOs receive don't help the situation.

jerryc41 Loc: Catskill Mts of NY

Imagine the accountant sitting down with his calculator and coming up with a cost of $333 for each pill.

EDIT: This story from several years ago always stuck with me. A big star made a deal with a movie studio to take no salary but to get a percentage of the profits. The movie was a huge success, but the star received nothing. Why? Creative bookkeeping. On paper, the movie didn't make any profit at all. They even joked about it at the Academy Awards as the film won in various categories. The moral of this story is, you can play with the figures any way you want to get the results you want. It's the same with drug companies.

Nosaj Loc: Sarasota, Florida

In addition and, as a serious cause, is the fact that, under the current federal law, the Medicare administration is NOT ALLOWED, by law, under any circumstance, to negotiate drug prices with pharmaceuticals. This is the big loophole that Congress built into the Medicare system back in the 2000's. As a result, the drug manufacturers have been taking advantage across the board.

1Feathercrest Loc: NEPA

NO, We don't need drugs to maintain our lives! What we NEED is healthy food. The crap in the markets is increasingly less nutritious, loaded with pesticides, and often genetically modified. If we could be assured of good food, drug and chemical free water we would not need the artificial boost of more chemicals (drugs) to combat the illnesses caused by the FDA, the agriculture department, big Pharma, our lobbied congress, mega farms with only a bottom line management.

viscountdriver Loc: East Kent UK

I take a load of drugs-all free but then I am an old man in the UK.

Impressionist

Unlike other countries like Canada we let them get away with murder. Ethics and Medicine in this country is an oxymoron.

mas24 Loc: Southern CA

I understand your motive. Good, healthy, nutritious, non chemically treated foods can maintain good health. And exercise added is even better. However, everyone's immune system is not equal. No matter how well you eat, you can still get sick. And no fresh veggies, meats, and fruits, are going to cure all sicknesses. Every one gets sick, at least once in their lives. And they need drugs sometimes. If you don't need any drugs whatsoever, for the rest of your life. I salute you.

camerapapi Loc: Miami, Fl.

Amen.

TriX Loc: Raleigh, NC

Take a look at Blink Health (online). Huge discounts for many drugs, especially generics. Just pay online and pick up at your usual pharmacy. Exactly like using your insurance, just a different payer and substantially less expensive for many drugs, although no help on some of the new expensive non generics. GoodRX is another alternative, but it involves printing coupons which you then take to your pharmacy. Both sites show comparison prices at major pharmacies.