Hidden Costs of Medicine

Hidden Costs

The whole question of insurance, drug costs, and pharmaceuticals is an area very dear to my heart.  This section is dedicated to the politics and relationships of these topics.  Another area of focus will be on Medicare and how pharmaceuticals, insurance, and hospitals interact with this government entitlement for those 65+.  We will also look at what is being discussed by our Congress and whether they are working to dismantle a system that has proven quite effective for the past 70+ years. Along with that, we will do a comparative study on the insurance coverage Congress gives itself and what is available to the average citizen.

As starters for this section, I will share a letter I came across while surfing the web. An anonymous author wrote a letter entitled Hidden Medication Costs for The Health Care Blog.  He/she learned the true costs of drugs after he/she retired and enrolled in Medicare.
This is what the writer wrote:

Just prior to retirement, my eyes suddenly began [to] tear and swell so much that it impacted my vision. The eye doctor diagnosed an allergic reaction and prescribed prednisone drops to reduce the swelling and antihistamine drops to combat the reaction. …….Per my employer’s plan I paid a relatively small co-pay for each prescription.
Three weeks later, on a follow-up visit, the doctor recommended that I continue the antihistamine drops for the duration of the allergy season. …. Now I was on Medicare so I checked the cost of the drops on the website of my Part D provider. It was $279. Could this be?? Oh indeed it could — and I had a high deductible and would have to pay all of it!! Of course, if I continued to need the drops, the plan would eventually assume more of the expense.”

As many do in these circumstances, the writer began to question whether there was not a cheaper alternative that would do the same trick.  As it turned out, yes, indeed there was.  The author continues:

“…. there were, in fact, two reasonable options: one a prescription which was ½ the price of the current prescription; the other a medication that had previously been script-only, but was now available OTC – the cost for this was $14.79. He [the doctor] suggested that I experiment with the alternatives to see if they were as effective as the current drops. Fortunately, the $14.79 version was just fine. Of course, it might not have been, but it was.

The last point that this author makes is probably the most important point in the article:

….had I not asked, it would not have been offered.  And had I not had a plan that exposed the cost of the expensive prescription, I would not have asked.

Believe it or not, there are many stories like this one: a patient learns of the forbidding costs of a drug or a procedure or a, you name it, and seeks to find a less expensive alternative, usually finding it.  One might go further and wonder why the doctor did not offer the cheapest option at the outset?  Tune in over the months as we present people’s stories and reflect on why such stories exist.

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