Wednesday, October 22, 2014
YOLO COUNTY NEWS
99 CENTS

Prices soar for some generic drugs

By
January 04, 2014 |

By Victoria Colliver
The widespread use of generic medications is supposed to save the health care system money, but huge price spikes in certain common, previously low-cost drugs is putting some of that savings in question.

Nosebleed-level price increases of more than 100 percent, 1,000 percent and, in some cases, 6,000 percent and above are making it difficult for pharmacists to fill some prescriptions because insurance companies have been slow to adjust their reimbursements to reflect the price spikes. Large chain pharmacies have felt the pinch, but it’s been especially hard on independent pharmacists.

“I had to turn away several patients for some pain medications,” said Benson Toy, a pharmacist at Marin Medical Pharmacy in San Rafael. He directed them to Costco, CVS/pharmacy and other retailers that can more easily absorb the costs.

Nearly 80 percent of all the drugs dispensed in the United States are generics, which are required to have the same active ingredients as the original brand-name versions, but are usually sold at reduced prices without patent protection. Generic drugs save consumers $8 billion to $10 billion a year, according to estimates from the Congressional Budget Office.

But pharmacists, patients and other health experts are alarmed by the cost hikes in generic drugs they’ve seen over the past year, and the acceleration in the number of drugs affected in recent months.

At Toy’s pharmacy, the cost of a bottle of the generic heart medication digoxin shot up from $131 in September to $989 a month later for the same dosage. He said tetracycline, an antibiotic used to treat bacterial infections, rose from $31 for a specific dosage to $450 over the past year.

No explanation for cost
In some cases, the increases can be explained by a manufacturing problem that puts the drug in short supply or a shortage of a key raw material used to make the medication. But in many of the cases, observers say, the extreme jump in price comes without an explanation and seems to make no sense.

Dr. David Belk, an Alameda internist who hosts a website called the True Cost of Healthcare, said he’s noticed that some generics will experience a price hike in a specific dosage of a drug, while the same drug at a different strength will stay the same. In other cases, he said, prices will shoot up and then drop in a short period of time.

For example, Belk said, irbesartan, a blood pressure drug, cost about 15 cents a pill in October. But when he checked the price of the 150-milligram dosage about a month later, it had shot up to about $3 a pill while the 300-mg and 75-mg dosages remained unchanged. He said he’s seen the price of levothyroxine, used to treat an underactive thyroid, fluctuate wildly.

“It’s sort of just a sucker punch,” Belk said. “You sell a few at a really high price for a few weeks, and then that just disappears.”

The Generic Pharmaceutical Association, which represents the generic drug manufacturers but has no role in setting prices, would not respond directly to questions about the spiraling prices of these drugs.

“As with many manufactured products, pricing reflects supply and demand,” said Ralph Neas, the association’s president and chief executive office, in a statement. “But, unlike for many other types of products, generic drug manufacturers cannot simply ramp up production immediately.”

Generics save billions
The pharmaceutical industry group released a study last month that showed use of generic medicines saved the U.S. health system $217 billion in 2012 and about $1.2 trillion from 2003 to 2012.

A new study by Philadelphia research firm Pembroke Consulting found that only about a third of generic drugs have gone up in price between November 2012 and November 2013, and most went up less than 25 percent in that period. But a small percentage saw huge price increases — in the 6,000 percent range, the study said.

Adam Fein, president of Pembroke Consulting, said why prices are jumping that much remains a mystery.

“I’ve talked to a lot of pharmacists and wholesalers and asked them about this, but have not been able to nail down a single cause,” he said. “We do have a more fragile supply chain for a lot of generic drugs.”

That means some generic drugs have such low profit margins that only one or two manufacturers produce the medication, he said. So if there’s a regulatory issue, a problem in production or a lack of raw materials, the price shoots up due to the laws of supply and demand.

A survey released in December by the National Community Pharmacists Association showed that 77 percent of pharmacists saw an upswing in generic drug prices 26 or more times over the previous six months.

“It’s really crazy. It seems to be growing as far as the number of drugs impacted,” said Kevin Schweers, spokesman for the community pharmacists’ group.

The most common generic increases reported in the survey were benazepril for high blood pressure; the antidepressant clomipramine; digoxin to control heart rate; divalproex for seizures and psychiatric conditions; the antibiotic doxycycline; budesonide for asthma; haloperidol for psychotic disorders; and levothyroxine, which is used to treat hypothyroidism.

Consumer impacts
Most people with health coverage are shielded from the cost increases because their co-payments are set contractually. But that’s not the case for people who have to pay cash.

Patients are also affected if they are sent to an unfamiliar pharmacy because their regular pharmacist can’t afford to fill the prescription.

Nina Murphy, of San Rafael, had been picking up a generic painkiller at Marin Medical Pharmacy for the past four years. So she was shocked when she learned in October that her pharmacist could no longer fill the prescription.

“It went up way more than just double,” said Murphy, 62, who declined to reveal the medications she takes. “Now I have to go to a big chain to get the pills.”

Murphy has chronic pain due to multiple car accidents and said going to different pharmacies is physically difficult for her.

“It’s a horrible thing that’s happening to the industry,” she said. “They’re not thinking about the inconvenience that this is causing to the patients.”

— Reach Victoria Colliver at vcolliver@sfchronicle.com

Comments

comments

San Francisco Chronicle

  • Recent Posts

  • Enter your email address to subscribe to this newspaper and receive notifications of new articles by email.

  • .

    News

    Marathon specialist Winter heads to cycling shrine

    By Bruce Gallaudet | From Page: A1 | Gallery

     
     
    County to fund pilot project for West Sac homeless

    By Anne Ternus-Bellamy | From Page: A1

    Pumpkin patch: a favorite tradition every autumn

    By Enterprise staff | From Page: A1 | Gallery

     
    Tuesday’s smoky air hailed from Colusa County

    By Lauren Keene | From Page: A2

     
    Vandals damage two Woodland schools

    By Enterprise staff | From Page: A2

    Hearing postponed for man suspected in 7 killings

    By The Associated Press | From Page: A2 | Gallery

     
    Canadian soldier shot at war memorial

    By The Associated Press | From Page: A2 | Gallery

    Heavy metal

    By Lauren Keene | From Page: A2 | Gallery

     
    Pedal around Davis on weekly bike ride

    By Enterprise staff | From Page: A3

    Apply soon to be a Master Gardener

    By Enterprise staff | From Page: A3

     
    Terez will perform at Wine’d Down Thursday

    By Enterprise staff | From Page: A3

    Super-fun 5K run will support UCD students

    By Enterprise staff | From Page: A3

     
    Davis Arts Center: a call to artists for Holiday Sale Wall of Art

    By Erie Vitiello | From Page: A3 | Gallery

    Author showcases field biology as he revels in nature

    By Special to The Enterprise | From Page: A3 | Gallery

     
    Entries due Nov. 1 in VFW essay contests

    By Enterprise staff | From Page: A4

    Teen services grant applications due this week

    By Anne Ternus-Bellamy | From Page: A4

     
    Voice of the Wood plans family Halloween show

    By Special to The Enterprise | From Page: A4 | Gallery

     
    Wine-tasting and auction benefit Advanced Treble Choir

    By Anne Ternus-Bellamy | From Page: A4

    Garamendi will speak at U.N. Day event

    By Special to The Enterprise | From Page: A4

     
    Kids form a lifelong habit of drinking water

    By Special to The Enterprise | From Page: A5

    Farmers Market hosts Fall Festival

    By Special to The Enterprise | From Page: A5 | Gallery

     
    A Taste of India dinner benefits Davis Community Meals

    By Enterprise staff | From Page: A5 | Gallery

    Wolk sets ‘Morning with the Mayor’

    By Enterprise staff | From Page: A5

     
    Volunteers sought to chip in on parks cleanup

    By Enterprise staff | From Page: A5

    Composting workshop set at Grace Garden

    By Enterprise staff | From Page: A5

     
    Setting a good example

    By Sue Cockrell | From Page: A5

    No-till doesn’t help cold, wet farmlands

    By Special to The Enterprise | From Page: A5

     
    Women and men want the same things in cars … usually

    By The Associated Press | From Page: A6

    California state parks show off fall color

    By Kimberly Yarris | From Page: A7

     
    October is fall car care month

    By Special to The Enterprise | From Page: A7

    Soda bottlers spend big to fight S.F. ban

    By San Francisco Chronicle | From Page: A9

     
    Railroad work will close Eighth Street

    By Special to The Enterprise | From Page: A9

    Special education information night scheduled

    By Jeff Hudson | From Page: A9

     
    Soroptimists offer ‘Living Your Dream’ grants

    By Enterprise staff | From Page: A9

    Halloween Carnival planned Oct. 26

    By Enterprise staff | From Page: A9

     
    Mondavi Center gift shop plans holiday sale

    By Enterprise staff | From Page: A9

    Clinton sounding like a candidate in S.F. appearance

    By San Francisco Chronicle | From Page: A12

     
    .

    Forum

    Bad business over the phone

    By Creators Syndicate | From Page: B5

     
    Vote no on Prop. 1, because it’s no solution

    By Special to The Enterprise | From Page: A8

    Slower travel on new stretch

    By Letters to the Editor | From Page: A8

     
    David Fitzsimmons cartoon

    By Debbie Davis | From Page: A8

    Support choruses in schools

    By Letters to the Editor | From Page: A8

     
    Archer’s the go-to person

    By Letters to the Editor | From Page: A8

    Adams has what we need

    By Letters to the Editor | From Page: A8

     
    Life vests are a must when rafting

    By Letters to the Editor | From Page: A8

     
    .

    Sports

    UCD women’s soccer postseason hopes flickering

    By Bruce Gallaudet | From Page: B1 | Gallery

     
    A typical Blue Devil girls water polo win

    By Enterprise staff | From Page: B1

    DHS boys hold off Rio Americano in the pool

    By Enterprise staff | From Page: B1

     
    Devils are on track for volleyball playoffs after win

    By Evan Ream | From Page: B1 | Gallery

    Giants rip Royals in Game 1

    By The Associated Press | From Page: B1 | Gallery

     
    AYSO roundup: Local winners have the Eye of the Tiger

    By Enterprise staff | From Page: B3 | Gallery

    Alliance/Legacy roundup: Italia cruises past Chico

    By Enterprise staff | From Page: B3 | Gallery

     
    Sports briefs: Fipps earns another preseason hoops award

    By Enterprise staff | From Page: B8

    .

    Features

    .

    Business

    .

    Obituaries

    Clement ‘George’ Hebert

    By Special to The Enterprise | From Page: A4

     
    Mariana Brumbaugh Henwood

    By Special to The Enterprise | From Page: A4

    .

    Comics