Say goodbye to private pharmacies in usa

Sorry to not address any of the replies on this thread, but your Original Post is striking.

Are you really on two drugs that are $10/day each? I understand your post is about the future of the pharmacy business, but $600/mo for drugs is madness. Absolute madness.

David you don't know the half of it. In my business I broker health insurance. these days I only do Medicare and because of this I deal with folks who are on a fixed/limited income and many are on quit a few drugs some of them very expensive. I have seen people who have as many as 20 prescription and many of them are very expensive if purchased over the counter. One of my biggest challanges is to find the plan that does the best job of covering their drug. I remember one individual who's out of pocket drug costs was over $13,000 per year. he wanted to change plans and the one he was looking at would have cost him over $16000. You see not all plans cover the same drugs and it is a balancing act to find the right plan. They all follow a formulary and not the the formulary's vary from plan to plan. I use a computer program to help me determine the drug costs under all the plans. in the case of the individual above I was able to get his total out of pocket costs down to less then $6000 per year. I had a pharmacist as me one day which was the best plan for drug and my answer was it depends on what drugs the person is taking. There are programs out there to get folks extra help with their prescription drug but one has to either work i the field every day to know what it takes to qualify for them. It is a shame because roughly half of the people in this country on social security would qualify for some sort help and don't know it.
 
don, Ive watched prescription coverage for the seniors decline over the past 15 years.
Once the chains knock out most competition, they will be dictating what drugs they will pay for.
there will no longer be options.
A lot of medicare plans limit which drugs now, but wait until most of these plans are administered by the same corps that own the pharmacies.
The public is in for a rude awakening. Seniors are going to take a lot of punches.
 
Very scary.

I'm under my wifes plan. She is a teacher and her plan under Cigna is excellent.

I pay every 90 days about $100 for a 90 day supply of my medications and my wife's cost is about $45.00.

I get an invoice of what I would of paid at a pharmacy without my insurance.
Advair alone is $300 per month
4 blood pressure medications
lipitor
arthritis medication
All toll it's about $900/month

My wifes thyroid and cancer medication is around $300/mo.

$1200/month will be more than her social security income.

When she retires in 2 years at 67 we'll have no more coverage.

What the heck is the average Joe going to do??
 
everyone will have to adjust to taking less expensive generic drugs.
there will be a lot of compromising by physicians and patients.
When I was in the hospital for 5 days in 2010, 3 of my current prescriptions were not available in the hosp pharmacy/formulary.
they took my own personal prescription bottles and relabeled them with their labels, that was ok as long as the doctor approved it.
The staff changed my medication to something similar the first day without telling me. I was wired up to machines, but I told the nurse I still can swing my arms and get out a good punch, who gets whacked first.
Amazing, without telling me anything, drugs aren't covered in hospital, they don't care.
times are a changing.(who sung that song?)
 
its a scary thought, 40% of everyones social security when they retire will be going for medications and doctor visits.
maybe 50,. 60 %.
And there will be no compromises from chain stores.
 
its a scary thought, 40% of everyones social security when they retire will be going for medications and doctor visits.
maybe 50,. 60 %.
And there will be no compromises from chain stores.

gee allen I don't see it as bad a picture as you paint actually I get better and lower cost care from medicare then I would from the VA. Under the VA I would pay $15 to see my Primary care physician, pay $9 for my prescriptions and have to make an appointment 90 in advance just to see my PCP. Also if I am hospitalized under the VA I pay $1186 plus a $10/day per diam
Under my Medicare plan my Primary care doctor who I can get in to see same day if need be. Cost for PCP $0. all my scrips are generic so they are $0 and If I were hospitalized I would pay $150 for a max of 7 days then nothing. This is far less then the 30-40% you mentioned.
 
David you don't know the half of it.

Don, that really is scary. Greed makes me sad. I understand these companies have to pay to comply with lots of government rules and that "most" of their research doesn't result in successful drugs. I understand that's all expensive. But the greed is still mind boggling.
 
gee allen I don't see it as bad a picture as you paint actually I get better and lower cost care from medicare then I would from the VA. Under the VA I would pay $15 to see my Primary care physician, pay $9 for my prescriptions and have to make an appointment 90 in advance just to see my PCP. Also if I am hospitalized under the VA I pay $1186 plus a $10/day per diam
Under my Medicare plan my Primary care doctor who I can get in to see same day if need be. Cost for PCP $0. all my scrips are generic so they are $0 and If I were hospitalized I would pay $150 for a max of 7 days then nothing. This is far less then the 30-40% you mentioned.

yep. as long as the meds you need are on the formulary, and generic, and you don't get sick often, your costs are low.

what about the cost of medicare part b and d?

if you take a all in one inclusive plan, that cost money also, and there are always copays, doctor, labs, drugs?

what is part b, like 105 bucks a month if you don't earn any income?

part d cant be cheap, no drug programs are cheap.

ss average monthly benefit in America is about what, 1200? paying for medicare b and d or all inclusive will probably run average 20% right off the top. (Im sure it will be more than that not including any copays).
 
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Ok Allen since you asked

Medicare part B is like you said is $105 ($104.90)/mo Medicare part A as long as you or your spouse has worked 40 quarters (10 full years) is paid for. part A is you inpatient care and you pay $1186 per addmitance. Medicare part B is out patent care and is 80/20 insurance with a $142 deductable. Neither include your Rx.

A part-d Rx can run you anywhere from $12 to -$100/mo depending on the carrier and the formulary.

You can buy a supplement insurance to pay all or part of what medicare doesn't pay and that will run you $100-300/month depending on the level of risk you are willing to assume and your age.

There are medicare advantage plans where you essentially tell medicare you want to get you care from a particular insurance plan. You agree to use their network of provider and pay the contracted co-payments. For this medicare pays the premium to the carrier. Most Advantage plans include part D Rx coverage at no additional charge.
In my case I pay the part B premium of $104.90 and have an Advantage plan that costs me no additional premium and it includes my drug coverage. It is an HMO plan which many might object to but I made sure my providers were all in network so for me it is no big deal.Beside $0 to see my PCP $15 for specialist and the other benefits my plan has a max out of pocket of $3400 that means no matter what happens I will never pay more then that in a year no matter what kind of treatment I need.
 
now to address the low income aspect of your question. It is very true that the average Social security payment is around $1200($1246 actually). If someone is on SS and earns less then 1437 as an individual or less then $1937 as a couple they qualify for a low income subsidy. That mean their Part D premium will be paid and they pay any where from $0-$6.50 for any and all drugs depending on Income and type of drug. Also if they earn less then $1293 as and individual or $1745 as a couple they qualify to have their part B ($104.90) premium paid. there are also other benefits for lower income levels but I am only trying to address your question. Hope this helps a little to understand the system.
 
Ok Allen since you asked

no matter what happens I will never pay more then that in a year no matter what kind of treatment I need.


understood, but you have to use only in network physicians?
if you choose a surgeon that isn't network, youre saying if the surgery is 15000 dollars, you only have to pay 3400 and the HMO picks up the rest?
only asking because in network doesn't work for a ton of people Ive run across in my lifetime.
 
No Allen I have to only use their network. If I am not willing to staying network with the HMO then I am better off using a Supplement. I took on individual off of an HMO last Oct and put him on a Supplement. He had cancer and wanted to seek treatment outside of the network. His premium was $300 per month for the sup. but with the Chemo even in network he was going to reach the Max out of pockets so either way he was going to spend a little over $3000 with the sup he had no additional out of pocket. It can get very complicated but that's why my client rely on me to help em sort out he best way to work within the system.
 
Allen, I'm not sure of the situation where you live. My wife is a (now retired) pharmacist and had to turn down work long after she wanted to quit. One independant pharmacist spends money lavishly (houses, airplanes, boats, jewelry, etc.). It seems a new pharmacy opens every month in town. Admittedly by chain stores like Fred's. Our Wal-Mart does a huge rx business. Of course, we know they buy in bulk and take losses on some meds just to get people into the store. Yes, cost of some meds is shocking. My wife takes an eye med that is several hundred dollars for a bottle that is 0.07 oz. Fortunately her opthamologist is an old friend of ours and he gives her free samples of it. None of us know what is ultimately going to happen with O-care. Scary.
 
you cant paint with a broad brush, I know there are plenty of pharmacists that retired multi millionaires.
don't misunderstand what Im saying. There are plenty of jobs available.
Im not bitter because I closed. I chose to retire. I did very well. I have not a single complaint about how my career choice treated me.
Everyone made money before the insurance companies got stingy. Some stores still make money. They have their clientele and will always make money.
Im still in touch with a few retail pharmacists. They are all millionaires, have owned their pharmacies for decades, but they are healthy and still make a few bucks, but complain its not going to last much longer.
If you have to kill yourself for 125-135 thousand a year, worrying all the time, it pays to go work for a hospital or chain, easy, clean work, and just cash your pay check every week without any headaches.
You have to figure out what stress is worth for you.
(and again, not saying its any more or less stressful than running any other business on earth, afterall, its a business, it just takes 6 years of schooling to get the license these days)



If you cant support the business with the front merchandise, the writing is on the wall.
 
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