By Jared S. Hopkins and Josh Ulick
The cost of prescription drugs in the U.S. isn’t like the tabs for other products. The price for a single medicine can range by thousands of dollars depending on the drug plan.
It is a symptom of America’s complicated—and costly—system for paying for medicines.
Medicare is paying wildly different prices for the same drug, even for people insured under the same plan.
As a result, people covered by Medicare can be on the hook for thousands of dollars in additional out-of-pocket costs depending on where they live and which drug plan they choose.
Take commonly used generic versions of prostate-cancer treatment Zytiga. They have more than 2,200 prices in Medicare drug plans. The generics ring in at roughly $815 a month in northern Michigan, about half of what they cost in suburban Detroit, while jumping to $3,356 in a county along Lake Michigan, according to a recent analysis of Medicare data.
The same is true with other popular medicines such as psoriasis treatment Otezla, blood thinner Xarelto and generic versions of the cancer drug Tykerb, known as lapatinib, which has 460 prices, according to the analysis by 46brooklyn Research, a nonprofit drug-pricing analytics group.
“How would you like to go every year and figure out again what is the best plan?” said Paula Kirk, 70 years old, who has switched her Medicare prescription-drug plan since joining the program five years ago to get a better price for Tykerb, reducing her annual out-of-pocket costs by more than $2,500.
Kirk dipped into her retirement fund and her husband picked up part-time work to help pay for her prescriptions before switching to her current plan. “We’re just trying to get the cheaper rates for our prescriptions, that’s all we’re trying to do,” she said.
In her county in central Illinois, Kirk’s Centene Medicare drug plan priced the cancer drug at $3,622, while Humana priced the drug double the amount, 46brooklyn found. Lapatinib can cost even more in other parts of the country, including $10,000 in certain parts of California and more than $12,000 in the center of Pennsylvania.
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