I wasn’t going to write about drug prices again because I like my pharmacist and don’t want to create any ill will toward him or Bismarck-Mandan pharmacists in general. Our pharmacists are not to blame for the outrageous behavior in the prescription drug business. They’re simply retailers, pawns in the big game of chess being played by the pharmaceutical and insurance industries.
My pharmacist is not to blame for what you are about to read. In fact, he provided me the information that enabled me first, to see red, and second, to write about this.
Some background. A dozen years ago, as I was gradually going blind in my right eye, my optometrist sent me to see an ophthalmologist — try spelling that without looking it up! — saying neither new glasses nor contact lenses would do anything about it. My new doctor sent me to Minnesota, where I had a cornea transplant. It worked. As a follow-up to surgery, he prescribed some eye drops, which I take to this day, one drop in my right eye every morning.
The drops are called Lotemax, manufactured and distributed worldwide by a company called Bausch & Lomb. When I saw my first bottle of the drops, I was reassured, because I remember my dad, an optometrist, used to buy his patients’ glasses from a Bausch & Lomb outlet in Bismarck when I was a boy. The B&L salesman, I think his name was Steve Goetz, was a regular visitor to our house during pheasant season in the 1950s and ’60s.
Well, I used the Lotemax drops faithfully, my new cornea worked, but after a few years, I noticed the price started to creep up. Even with prescription drug insurance, I was beginning to question why that little bottle of eye drops cost so much. At the time, I was hearing that people like me — retirees living on fixed incomes — had found out that they could get prescription drugs much cheaper by going to Canada to buy them. I started investigating.
The company I found was Canada Drugs, and indeed they were way cheaper. So last year, I sent them my prescription and they sent me about a nine-month supply at a pretty reasonable cost. I don’t remember the cost now. But it was worth doing. I’ve written about this company before, when I had to buy gout medicine.
I had purchased three little bottles of Lotemax, and when I opened the third one, in the spring of this year I realized that my supply was going to run out by fall, and I needed to reorder. The problem is, the Canada Drugs option is no longer available here. One of its sister companies got tangled up in a fake cancer drug scandal, and the whole conglomerate they were part of was banned from doing business in the U.S. I have no doubt that the U.S. pharmaceutical industry and its powerful lobbyists were instrumental in making that happen because the company was stealing a good bit of business from people like me. That meant I was left at the mercy of the U.S. companies and their high prices.
EXCEPT … never underestimate the Canadians. Canada Drugs sold or shared its e-mail list with another Canadian company, and I started getting offers from them. I got one in late June this year, just when I needed to order Lotemax, that was too good to ignore. The e-mail said that in honor of America’s Independence Day celebration, this company — which I won’t name, so the big U. S. bad guys don’t go after them, too, but I’ll tell you if you send me an e-mail (firstname.lastname@example.org) — was offering a 40 percent discount to its U.S. customers if we ordered during the Fourth of July week. Great marketing! An offer too good to pass up, I thought.
But first I needed a frame of reference, so I stopped by my pharmacy and said I was running out of eye drops and asked them what it would cost me to refill my prescription. The drops come in little 5-millileter bottles, which last between three and four months depending on how hard I squeeze that bottle each morning. I wanted to order the same three little bottles I had gotten last year from Canada.
The nice pharmacist’s assistant punched some numbers into her computer and said my insurance company wouldn’t pay for more than one bottle at a time (at my age, I suppose that’s reasonable — they didn’t want me croaking with two unused bottles of expensive eye drops).
She said my co-pay on one bottle — about three months’ worth — would be $66. I asked how much the insurance company would be paying. She said their share was $153. I said thanks, I wanted to talk to my doctor and would get back to her.
I left the pharmacy thinking I would call my doctor and ask him if, 12 years after my transplant, I really needed to use this stuff any more. But first, when I got home, I clicked on the website in this new company’s e-mail to do a price comparison.
Here’s the deal. My insurance company and I would pay a total of $219 for one 5-millileter bottle of eye drops. That bottle would last about three to four months if I didn’t squeeze too hard. Let’s say 100 drops. That’s about $2.20 a drop.
My new Canada company offered to sell me THREE 5-millileter bottles for $113.58, AND it’s giving me that 40 percent “Happy Birthday America” discount, bringing my price for the three bottles down to $68.15. That’s about $23 a bottle, or 23 cents a drop. About one-tenth of what my U. S. pharmacy quoted me. For exactly the same product. From exactly the same company. Bausch & Lomb.
So, I could order three bottles for about the same price as I would have to pay for one bottle at my pharmacy. I’d be saving more than $40 per bottle for those little 5-millileter bottles. And I’d be saving my insurance company $459.
The difference? The Canadian company got the bottles from Bausch & Lomb’s London operation. My pharmacy had to buy them from Bausch & Lomb’s U.S. operation. The only bad news here is, my pharmacist, who I like a lot, was going to lose his cut of the $219 per bottle that my insurance company and I would have paid him. Which probably wasn’t much — most of the money was likely going to Bausch & Lomb.
But like I said, I’m a senior citizen on a fixed income, and that $40 is nothing to sneeze at. And not just that — it is the principle of the thing — the drug companies here are getting away with highway robbery. Screw them.
So, guess what I did. I called the 800-number in the e-mail and talked to a nice fellow in Winnipeg. Told him what I wanted. He placed the order. Then he told me to send a check for $68.15. Same old problem I wrote about a year or so ago. They were not allowed to let me pay with a credit card.
As my customer service rep in Winnipeg told me last year:
“U.S. based special interest groups have spent many years and millions of dollars campaigning companies like Visa, MasterCard, banks, payment processors and anyone else they can throw propaganda at to deny credit card processing services to LICENSED pharmacies that choose to engage in assisting patients in countries all around the world access CHOICE and AFFORDABLE medications when faced with prices that are simply too high locally.
“As a result, we have had to go back in time somewhat. But no matter what, we believe in a fundamental human right that all people should have access to the medications and medical care necessary to live a healthy and productive life. I’ve been working with Canadian mail-order pharmacies since the industry started back in 2001, and I can tell you that slowly but surely Big Pharma, with the help of their not so secretly funded special interest groups are doing a great job of making it increasingly difficult for people to be able to follow their doctor prescribed therapy.”
In other words, Big Pharma U.S. was doing everything it could do to make it hard for me to order drugs from Canada, hoping that the Canadian companies would find it too much hassle, or that I’d get discouraged and just pay their outrageous prices here. Well, didn’t work on me or my Canadian company. We’re doing business.
So what I had to do is send a check, from which they would get my bank routing number and account number, and they would debit my bank account $68.15. And the drops would be shipped to me from their London pharmacy.
I did it. But that’s not the end of the story. I got a call from the company saying it needed a new prescription from my doctor. I said I would get one and send it to them. The company said no, just give it your doctor’s name and the company will call him and get it by e-mail or fax (I think they ended up using fax). That took a week or so, and the company began processing my order. That took a few weeks. I got an e-mail saying the drops were shipped from its London pharmacy on Aug. 21.
Well, unfortunately, they never arrived. On Sept. 23, I got a phone call from the company asking if I had received my drops. It has a 30-day delivery guarantee (I guess the mail can be slow between London and Bismarck), and it was checking with me to see if I had gotten the drops, and if they weren’t delivered within 30 days after they were shipped, the company would send a new order.
I said I hadn’t gotten them, so the company said it would process a new order and get back to me. It called the next day and said the drops were out of stock at the London pharmacy and it was looking for a pharmacy in Canada to ship them to me. The company called again a couple of days later and said it had found some in Winnipeg and would be shipping them the next day. One little problem. I had ordered three bottles of 5 millimeters each. The pharmacy they were coming from in Winnipeg only had 10-millileter bottles, so it was sending me two of those — a total of 20 millileter instead of the 15 millileters I had ordered. But because of all the delays, it was not charging me any more for them — my $68.15 is all I would pay.
They arrived Friday. Twenty millileters for $68.15. If I had bought those in the U.S., it would have been $264 for me and $612 from my insurance company, a total of $876. And I would have had to order them one bottle at a time. Now I have at least a year’s supply. About 400 drops.
So every morning, I put 17 cents worth of eye drops in my right eye, if I’m careful and don’t squeeze too hard. Instead of a two dollars and twenty cents worth.
There seems to be a story almost daily in some media outlet about the cost of prescription drugs. Even the Bismarck Tribune, which reported last month that my friend, Roger Roehl, has to go to Canada to get the drugs to treat his leukemia, which are keeping him alive. Congress and the president just continue to give this lip service, while Big Pharma’s lobbyists hold them at bay.
It took me three months to get my eye drops. I hope it will go more smoothly when I need to refill next year. But hey, I’ve always like Winnipeg. I think I’ll take a little late summer vacation next year and go pick them up in person. Because, sadly, I don’t expect anything to change here. And I’d kind of like to meet these nice people who are helping me.
Footnote: A few years ago I had cataract surgery, and my ophthalmologist prescribed some more, different, drops, one in each eye before going to bed at night. I got ’em. They weren’t nearly as pricey as the drugs after my cornea transplant. Until … I started noticing the price creeping up on those too. Up, and up, and up, until one day when it was time to renew my prescription, I told the nice nurse that I thought I was going to quit using them because with my Medicare and health insurance, it would be cheaper for me to come in and have cataract surgery every couple of years than to pay for those expensive drops. Well, to my surprise, she said “Guess what? There’s a generic version of those drops now, way cheaper.”
So I went to my pharmacist with a prescription for the generics. Wow! I just filled my prescription again last week, and I got three bottles for less than $5. I didn’t ask what the insurance company’s share was, but I’d guess I’m saving them a bunch of money, too.
I’m not sure why I can get a generic for one of my eye drops but not for the other, but I’d guess it has something to do with Big Pharma lobbyists and Congress and the president. Well, my eyes and I say, “Screw them all.”