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Prescription medications are supposed to help us stay healthy, but the reality of the U.S. prescription system can leave patients feeling frustrated and overwhelmed by high costs. While the blame is often placed on the price of drugs themselves, there are hidden factors driving up costs that many patients aren’t aware of. Let's dive into three uncomfortable facts about prescriptions in the U.S. that everyone should know.
1. Insurance Middlemen Make Prescriptions More Expensive
If you've ever wondered why your medication is so pricey, the answer often lies in the insurance system, specifically with the Pharmacy Benefit Managers (PBMs). PBMs are middlemen between insurance companies, drug manufacturers, and pharmacies, and their primary goal is to negotiate prices and determine which medications are covered by insurance. However, instead of reducing costs, PBMs have been found to actually increase them.
A recent study published in JAMA Health Forum found that PBMs can take up to 40% of the costs associated with prescription drugs. That means nearly half of what you’re paying for your medication is going straight into the pockets of these middlemen rather than towards the actual drug cost or even your pharmacy source.
2. PBMs Steer Patients to Their Own Pharmacies, Often Charging Up to 10 Times More
Another uncomfortable fact is that PBMs have been known to steer patients towards their own pharmacies, which are often more expensive than local, independent ones. By using tactics like restricting coverage or charging higher copays for out-of-network pharmacies, PBMs effectively funnel patients into using their in-house options. The catch? These pharmacies can charge up to 10 times more than what local pharmacies offer for the same medications.
This strategy not only limits patient choice but also drives up healthcare costs for everyone involved. Supporting your local, independent pharmacy can save you money while also supporting a business that genuinely cares about your health rather than just profits.
3. Generic Medications in the U.S. Are Among the Cheapest in the World
Contrary to what many people believe, the U.S. actually has some of the lowest prices for generic medications in the world. A report from KFF Health News highlights that the U.S. often pays less for generics compared to other high-income countries. However, this is often overshadowed by the exorbitant prices of brand-name drugs, which can cost up to 10 times more in the U.S. than in other nations source.
The problem isn't with generics but with how the system is set up to favor high-cost brand-name medications. This means patients are often paying far more than they need to for their prescriptions, all while being told that insurance is supposed to save them money.
The Forest Park Pharmacy Difference
At Forest Park Pharmacy, we understand the frustrations that come with navigating the prescription system. That’s why we operate on a cost-plus model, cutting out the PBM middleman to provide transparent, affordable pricing on medications. We believe in putting patients over profits, helping you access the prescriptions you need without the unnecessary markups.