11

The cost of drugs is important to The cost of drugs is important to consumers…consumers…

According to a 2003 report* 11.7% of the population in According to a 2003 report* 11.7% of the population in Michigan (1,162,797 citizens) are uninsured:Michigan (1,162,797 citizens) are uninsured:

almost all of them are under the age of 65;almost all of them are under the age of 65; one in five are children.one in five are children.

Some insurance companies charge a percentage co-pay Some insurance companies charge a percentage co-pay instead of the flat-fee co-pay that many enjoy;instead of the flat-fee co-pay that many enjoy;

Medicare Part D helps seniors, but they can save by Medicare Part D helps seniors, but they can save by comparison shopping.comparison shopping.

* Report commissioned by Governor Granholm

22

MEDICARE PART D “DONUT HOLE”MEDICARE PART D “DONUT HOLE”

1: You pay 100% of the first $250 prescription drug costs;1: You pay 100% of the first $250 prescription drug costs;

2: You pay 25% of the next $2,000 prescription drug costs;2: You pay 25% of the next $2,000 prescription drug costs;

3: You pay 100% of the next $2,850 prescription drug costs;3: You pay 100% of the next $2,850 prescription drug costs;

4: You pay 5% of anything over $5,100 for the rest of the year.4: You pay 5% of anything over $5,100 for the rest of the year.

$250 + $500 + $2,850 = $250 + $500 + $2,850 = $3,600$3,600 that you pay that you pay before receiving catastrophic coverage.before receiving catastrophic coverage.

1 2 3 4$0 $250 $2,250 $5,100

100% 25% 100% 5%

33

AG WEBSITE (HB 4559) vs. DCH WEBSITEAG WEBSITE (HB 4559) vs. DCH WEBSITE

AG:AG:

LOCALLOCAL Usual & Customary Usual & Customary (retail) price of 25 most (retail) price of 25 most commonly prescribed drugs commonly prescribed drugs

CUSTOMIZED SEARCHCUSTOMIZED SEARCH by by consumer and sorted by pharmacy consumer and sorted by pharmacy or zip codeor zip code

DOSAGE & QUANTITY DOSAGE & QUANTITY specific per drugspecific per drug

DCH:DCH:

Statewide Usual & Customary Statewide Usual & Customary (retail) price of 25 most (retail) price of 25 most commonly prescribed drugscommonly prescribed drugs

No searchNo search

No quantityNo quantity

44

55

66

77

88

DRUGS SURVEYEDDRUGS SURVEYEDDrug Name Dosage Quantity Common Use

Acetaminophen w/ Codeine

300 mg 60 pills Narcotic pain medication used to treat moderate pain and coughs

Albuterol 90 MCG 1 inhaler Inhaler used to treat or prevent symptoms of asthma, emphysema, and other breathing problems

Fosamax 70 mg 4 pills Prevention and treatment of osteoporosis

Lexapro 10 mg 30 pills Treats depression and generalized anxiety disorder

Nasonex 50 MCG 1 inhaler Inhaler used to prevent and treat seasonal and perennial allergies

Norvasc 10 mg 30 pills Controls high blood pressure and chest pain

Plavix 75 mg 30 pills Reduces risk of stroke or heart attack

Prevacid 15 mg 30 pills Treats ulcers, gastro esophageal reflux, and ulcers caused by long-term use of certain pain medications

Singulair 10 mg 30 pills Prevents and treats asthma and allergy symptoms

Zoloft 100 mg 30 pills Treats depression, panic disorder, obsessive-compulsive disorder, severe PMS

99

Pharmacies SurveyedPharmacies Surveyed

Randomly selected 20 or more pharmacies in the Randomly selected 20 or more pharmacies in the following communities:following communities:

1. Detroit1. Detroit 7. Saginaw7. Saginaw

2. Grand Rapids2. Grand Rapids 8. St Joseph/Benton8. St Joseph/Benton

3. Lansing3. Lansing Harbor Area Harbor Area

4. Livonia4. Livonia 9. Sterling Heights9. Sterling Heights

5. Monroe5. Monroe 10. Traverse City10. Traverse City

6. Royal Oak6. Royal Oak

1010

Consumers have a right to know the price of Consumers have a right to know the price of prescription drugs when they ask in person or by prescription drugs when they ask in person or by phone (MCL 333.17757).phone (MCL 333.17757).

Pharmacies must conspicuously display written Pharmacies must conspicuously display written notice at each drug counter the consumers’ right to notice at each drug counter the consumers’ right to ask for drug prices.ask for drug prices.

12% of the pharmacies contacted during my survey 12% of the pharmacies contacted during my survey broke the law by refusing to give drug prices and broke the law by refusing to give drug prices and some even hung up on my surveyors.some even hung up on my surveyors.

Report violations to the Bureau of Health Professions Report violations to the Bureau of Health Professions at the Michigan Department of Community Health by at the Michigan Department of Community Health by calling (517) 373-4972.calling (517) 373-4972.

Consumers’ Right to Know

1111

SURVEY RESULTSSURVEY RESULTSGrand Rapids ~ Albuterol* Grand Rapids ~ Albuterol* ((asthma inhalerasthma inhaler))

$28.33$26.99

$5.59$0.00

$5.00

$10.00

$15.00

$20.00

$25.00

$30.00

Retail Price

DCH

High

Low

* At $28.33, the DCH Usual & Customary price is higher than the highest price charged by any pharmacy in Grand Rapids (at $26.99) for Albuterol.

1212

SURVEY RESULTSSURVEY RESULTSLansing ~ Albuterol* Lansing ~ Albuterol* ((asthma inhalerasthma inhaler))

$28.33$26.49

$6.16

$0.00

$5.00

$10.00

$15.00

$20.00

$25.00

$30.00

Retail Price

DCH

High

Low

* At $28.33, the DCH Usual & Customary price is higher than the highest price charged by any pharmacy in Lansing (at $26.99) for Albuterol.

1313

SURVEY RESULTSSURVEY RESULTSDetroit ~ Lexapro Detroit ~ Lexapro ((antidepressantantidepressant))

$99.39

$69.00

$0.00

$20.00

$40.00

$60.00

$80.00

$100.00

Retail Price

High

Low

1414

SURVEY RESULTSSURVEY RESULTSLivonia ~ Singulair Livonia ~ Singulair ((treats asthmatreats asthma))

$117.27

$84.99

$0.00

$20.00

$40.00

$60.00

$80.00

$100.00

$120.00

Retail Price

High

Low

1515

SURVEY RESULTSSURVEY RESULTSMonroe ~ Acetaminophen Monroe ~ Acetaminophen

w/ Codeine w/ Codeine ((pain relieverpain reliever))

$28.99

$8.95

$0.00

$5.00

$10.00

$15.00

$20.00

$25.00

$30.00

Retail Price

High

Low

1616

SURVEY RESULTSSURVEY RESULTSRoyal Oak ~ Nasonex Royal Oak ~ Nasonex ((allergy inhalerallergy inhaler))

$130.00

$74.00

$0.00

$20.00

$40.00

$60.00

$80.00

$100.00

$120.00

$140.00

Retail Price

High

Low

1717

SURVEY RESULTSSURVEY RESULTSSaginaw ~ Plavix Saginaw ~ Plavix ((reduces risk of stroke or heart attackreduces risk of stroke or heart attack))

$179.25

$133.38

$0.00$20.00$40.00$60.00$80.00

$100.00$120.00$140.00$160.00$180.00

Retail Price

High

Low

1818

SURVEY RESULTSSURVEY RESULTSSt. Joseph/Benton Harbor Area ~ St. Joseph/Benton Harbor Area ~

Zoloft Zoloft (antidepressant(antidepressant))

$107.99

$66.99

$0.00

$20.00

$40.00

$60.00

$80.00

$100.00

$120.00

Retail Price

High

Low

1919

SURVEY RESULTSSURVEY RESULTSSterling Heights ~ Albuterol Sterling Heights ~ Albuterol ((asthma inhalerasthma inhaler))

$49.00

$13.99

$0.00

$10.00

$20.00

$30.00

$40.00

$50.00

Retail Price

High

Low

2020

SURVEY RESULTSSURVEY RESULTSTraverse City ~ Prevacid Traverse City ~ Prevacid ((controls acid refluxcontrols acid reflux))

$157.95

$137.04

$125.00

$130.00

$135.00

$140.00

$145.00

$150.00

$155.00

$160.00

Retail Price

High

Low

2121

A local Prescription Drug Finder Web site is important and here’s a good example why:

Highest: $49.00

Lowest: $5.59

DCH Usual & Customary Price:

$28.33

  ALBUTEROL

          

  HIGHEST LOWEST

Detroit $30.40 $12.00

Grand Rapids $26.99 $5.59

Lansing $26.49 $6.16

Livonia $26.99 $9.99

Monroe $32.99 $8.44

Royal Oak $26.99 $9.95

Saginaw $32.99 $10.25

St Joseph/Benton Harbor Area

$38.31 $8.44

Sterling Heights $49.00 $13.99

Traverse City $26.99 $13.85

Price Difference 877%

2222

What is your Attorney General doing as a What is your Attorney General doing as a result of the Drug Survey?result of the Drug Survey?

1.1. Notifying all 26 pharmacies of their allegedly illegal Notifying all 26 pharmacies of their allegedly illegal conduct in refusing to provide price information over conduct in refusing to provide price information over the phone;the phone;

2.2. Demanding a written explanation of how pharmacies Demanding a written explanation of how pharmacies will ensure consumers who call will be provided price will ensure consumers who call will be provided price information;information;

3.3. Alerting the Bureau of Health Professions to Alerting the Bureau of Health Professions to pharmacies that refused to provide prices;pharmacies that refused to provide prices;

4.4. Price gouging investigations of 17 pharmacies;Price gouging investigations of 17 pharmacies;5.5. Educating the public by releasing a consumer alert;Educating the public by releasing a consumer alert;6.6. Making all survey information available at: Making all survey information available at:

www.michigan.gov/ag.www.michigan.gov/ag.

2323

RecommendationsRecommendations

Governor and Department of Community HealthGovernor and Department of Community Health

should take drug price information that theyshould take drug price information that they

already have and make it available on a drug already have and make it available on a drug

price Web site, including:price Web site, including:1.1. All communities (searchable by city and zip All communities (searchable by city and zip

code);code);

2.2. All drugs;All drugs;

3.3. Monthly updates.Monthly updates.