Did I just See The Future? If so, It’s Pharma-Or Die

Okay, I’m sitting on the waiting bench at the big box pharmacy. There’s a guy at the counter: lean, middle-aged, in a white tee shirt, looks like he works hard. He’s waiting too, seems jumpy.

A pharmacy clerk comes in view, stepping from behind the long rack where dozens of plastic bags holding filled prescriptions are hanging. She says something to the guy, and all I catch is “Five seventy five.”

The guy steps back.

“What?” he says, and he’s angry. “I’m not paying that.” He makes a fist, but doesn’t raise it.  “I’ll just die.”

I glance back at the clerk. Did she mean “Five dollars and 75 cents” per pill? Or was it “Five hundred and seventy five dollars per dose”? Like for an Epi-pen?

She looks unhappy, but more resigned than intimidated, as if she’s heard this before. Mumbles about the guy could talk to his doctor, maybe get it changed to something lower-priced. She has a plastic card in her hand, extending it toward him.

He snatches the card. “I’ll just die,” he says again, in almost a shout, wheels and strides away.

The clerk pauses for a beat, then speaks to a well-dressed woman who stepped in front before I could stand up from the waiting bench.

I shrug it off, lean back, figuring this is a time for feeling grateful. I’ve got Medicare Part D drug coverage; premiums keep going up, but it lowers the counter price a bunch. Besides, if I had to, I can skip these pills; they’re for helping old guys pee. Doing without for awhile wouldn’t kill me.  I’m lucky.

And it’s my turn. Name, date of birth? The clerk’s fingers click as I repeat them. I’m asked these so often nowadays I figure it’s for more than ID, must also be a dementia screener: have I forgotten one or the other since last time? I don’t like that thought.

The clerk looks up. “Insurance won’t pay for this until the 21st,” she says. (It’s the 7th.)

“Really? But I’ve only got three pills left.”

She shrugs. Heard this before too. “Well, you could pay the cash price now, if you want.”

“How much would that be?”

She needs to consult the screen in the back. More clicks. She says: “It would be more than a hundred dollars.”

And it’s a generic pill. “Remind me what the insured price would be?”

Peers down again. A few taps. “It won’t tell me that til the 21st.” She isn’t looking up.

I Pause. I don’t make a fist. I don’t shout.

But I say, “I think I’ll wait til the 21st,” and start to walk away, then glance back and add, “I’m not gonna die,” over my shoulder.

And I won’t; not from that at any rate. So I still have plenty to be grateful about.

But the feeling isn’t coming up so easy now.

True story; today.

 

 

6 thoughts on “Did I just See The Future? If so, It’s Pharma-Or Die”

  1. I can sympathize: I take a prescription that retails for $3466.99 per 30-day dose (I am reading that off a pharmacy receipt from a 16 months ago.) Yes, $116 per pill. Because my insurance company classes it as a “specialty” drug, my co-pay is 40% of the retail cost, or about $1400. And I would die in four or five months if I couldn’t get it.

    Fortunately, I have a co-pay card from the manufacturer, so I pay nothing. But I live in constant fear that the manufacturer will end the co-pay program, or that Congress will finally manage to repeal the ACA and my insurance company will decide I’m too expensive to keep on.

    Welcome to America: the only developed nation on the planet where people have to worry about such things.

  2. I also had, myself, a “Oh Shucks!” moment about 16 years ago.
    I was being treated for Lymphoma, Stage 4 at my HMO.

    My Oncologist (cancer doctor) wrote me a Rx for a drug that would increase my red blood cell production. This is very important as the chemo (poison, really) kills lots of your good cells while looking for bad cells to terminate. (They didn’t call it “collateral damage”, but that was what it sounded like to me.)

    I went to my HMO pharmacy and when the called my name, the 30 day supply of pills was $1,300.00 Back in 2002 that was still alot of money. I said “Really?” She said “Yes”. Most people have insurance and you don’t.

    Somehow, I was sold a health insurance policy that did not include drug coverage. It seems I was sold a policy (I was self employed) that didn’t include drugs. She said “Sorry”.

    I said: “Not your fault. It’s this “health care system that doesn’t value life unless you can pay to play.

    My oncologist was not so happy, either. Luckily, he had some “samples” that he gave me. Those only lasted a few months and then I heard the drug company had stopped providing them.

    I wonder how many die each day in our “wealthy” county in the name of “free enterprise medicine” ?

    Why do we still allow this to happen?

    What does this say about our country?

    Today’s news included a story about Medicare not doing so well as the Republican Income Tax Bill of 2017 cut the revenue forecasted to be collected. It also has messed with the Social Security projections… . as has lower than projected earnings by USA’s workers.

    So, Chuck, we better enjoy our “entitlements” while we still can.

    PS: Not on topic, but the elections in November 2018 and then in 2020 will mean a good life or and early death for millions of Americans. Is it really possible that our generation over 66 will once again vote for someone like President Trump and the Republican congress that ran on “kill Obamacare”?

  3. Chuck, if you took your pills as directed you should have enough to get you through till the renewal date. In that case you may have a bottle somewhere in your dwelling with enough pills to get you to the renewal date or past. A very frequent problem with us oldsters is that we lose a bottle of our pills in our stuff. Just tonight Bob and I lost two different things that we had to search and search for. But we are away from home and that makes it even more challenging to keep track of our stuff. I hope you look around and find the pills. As I suspect they are there.

    You can also look at your check account or credit card bill or receipts to see when you last paid for the pills and that might confirm how many you should or shouldn’t have left.

    1. Thee know, thee was right. This morning, in the back of the cupboard where new & old pills collect, I found a bottle with a batch of the missing meds: the full prescription overflowed the smaller bottle I had transferred the others to, in order to save space along the other ones. So it turns out I do have enough to get to the 21st. The cost of the coming refill, though, is still a mystery; and recent price trends, even for generics, has been up, often sharply.

  4. We can’t live without healthcare, economic insecurity is emotionally crippling, and lack of education whenever needed in life dooms people to peonage. So what if we assert, in the form of amendments to the constitution, the right to free healthcare, the right to economic security, and the right to free education? Without these, life is stripped from us, either quickly or slowly. How can any compromise on these rights be moral?

  5. Thanks for sharing your story. I can so relate. My insurance pays for my refills when I order them via mail. Via the pharmacy in town? I pay full price. Go figure. And, no, I will not die.

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