Or “Levothyroxine costs how much?”
Last week I went into our local Costco to pick up my husband’s 90-day supply of levothyroxine, a generic thyroid replacement medication.
He has been taking levothyroxine every day for three years, since he had his thyroid gland removed due to thyroid cancer. And he will need to continue taking it every day for the rest of his life.
Luckily, a three-month supply only costs us about $18 (and that’s without prescription drug coverage).
So imagine my surprise when the pharmacy clerk asked for $45.69!
“Are you sure?” I asked, thinking she might have given me the wrong prescription. “I’ve been getting this filled here for years, and it never costs more than twenty dollars.”
But she had the right prescription. She asked me to wait, and she would check with someone in the back about the price. At that moment, another woman came in to pick up a prescription. I told the clerk to go ahead and help the woman, and I would be happy to wait.
I heard the woman exclaim, “What? It’s never cost that much before! Are you sure?” I glanced at the cash register: $45.69.
The clerk muttered to herself, “This has been happening all morning!” She excused herself and rushed into the back room.
I looked sympathetically at the other woman. “Levothyroxine?” I asked.
“Yes! I don’t understand. I’ve been taking it for ten years and it’s never cost that much!”
Well, that’s because we haven’t had a levothyroxine shortage before.
Drug shortages = price increases
I declined filling that prescription (yes, you can do that and not be charged) because I wanted to understand why levothyroxine had suddenly more than doubled in price. Was it just at Costco, or was it everywhere?
First I went to the Food and Drug Administration’s website. They keep an updated list of all current drug shortages. I found out there was a shortage of a particular brand name of levothyroxine, Levoxyl (Pfizer). The drug is backordered and will not be available until 2014.
The FDA directed me to a site specific to Levoxyl, and there I learned that Pfizer had recalled the drug because of quality control issues. Furthermore, “… it is anticipated that the company may not be able to restart production until 2014.”
Doing a little more research, I discovered that another brand-name levothyroxine, Levothyroid (Forest), has also been recalled. Unlike Pfizer, Forest Pharmaceuticals has simply decided to discontinue making the drug altogether.
With two brand-name drugs no longer available, the cost of other thyroid drugs, including generic, has skyrocketed (as I found out).
Those of us buying thyroid medication are not the only ones who have experienced this problem. Two common antibiotics, doxycycline and tetracycline, have been in short supply or not available at all. Prescriptions of these generics that used to cost under $10 are now costing between $50 and $150. Or doctors are being forced to prescribe new, more expensive antibiotics when just a few months ago a cheaper generic would have been available.
Last year, during a shortage of the cold sore medication acyclovir (Zovirax), a friend told me that a small tube would have cost her over $600, if she had not had drug coverage. Luckily, her co-pay was only $25.
Drug shortages, especially of generics, can be extremely expensive for people with high-cost health conditions, such as cancer, diabetes, asthma and MS.
Related reading: New York Times, How a Cabal Keeps Generics Scarce
Shop around for the best price
Many of us don’t have drug coverage. Of course, Obamacare mandates that all new insurance plans have some form of prescription drug coverage, but that could take a number of forms. You might have a co-pay; about $25 for a generic and $50 for a name-brand drug. Or, you might get a discount, with the price going towards your deductible (your really, really high deductible).
So high costs of prescription drugs, especially when unexpected, will still be a problem. (Not to mention that if insurance companies have to pay more for the drugs, they will simply charge higher premiums next year!)
As I mentioned in an earlier post, it pays to shop around for the best price. Most large pharmacies, such as Costco, will let you do an online price search. Or you can call. Ask about discounts for mail order or 90-day supplies.
If a medication suddenly jumps in price, ask the pharmacist if he or she knows why. Is there a shortage? How long is it likely to last? Can you wait to fill your prescription?
I chose to transfer my husband’s prescription to Wal-Mart’s $4 Prescription Program. A 90-day supply of his levothyroxine will only cost $10 and it will be delivered by mail. No more waiting in line at Costco—bonus!