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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by socialphobic on September 27, 2008, at 8:10:16
I hear a lot of people in the US complaining about the "cost" of medications. How does the system work over there? Do they have a PBS (Pharmaceutical Benefits Scheme) where the government pays a large proportion of the medication?
Here in australia we have the PBS. Under the PBS most antidepressants don't cost more than $30 if you're not on welfare benefits.
However, if you are receiving welfare benefits (either unemployed or pension), then you get a concession card which makes ALL medications only $5. This is what I have, so all meds only cost me $5. Is there such a thing in the US like this?
I feel sorry for all the people I hear saying they can't afford to be on a particular med in the US. Come to australia and go on welfare benefits and you'll get pretty much every medication for only $5 (or $30 if you're not on welfare).
Posted by mav27 on September 27, 2008, at 8:41:19
In reply to Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:10:16
Or pay us Australians to get it cheap for ya :)
ok i will probably get in trouble for saying that... not allowed to export meds bought under pbs subsidised prices
Posted by socialphobic on September 27, 2008, at 8:54:25
In reply to Re: Are medications a lot more expensive in the US?, posted by mav27 on September 27, 2008, at 8:41:19
I've heard in the US you have to have private health insurance for medications to be cheaper? Is that true?
In australia everyone is entitled to the PBS, even if you don't have private health insurance.
Could someone tell me the average price of antidepressants in the US?
Posted by seldomseen on September 27, 2008, at 9:08:38
In reply to Re: Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:54:25
Well, when I first started on Prozac I didn't have insurance. It was $90 a month. Then a generic form of prozac came on the market and the price dropped to $40 a month.
I have insurance now and it is $10 a month.
Posted by socialphobic on September 27, 2008, at 9:09:12
In reply to Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:10:16
One more question, do you guys in the US have "bulk billing" (free) doctors? Some doctors in australia are bulk billing which means the government pays. The doctor I see always bulk bills me, I don't think i've ever had to pay to see a doctor in my life.
Posted by socialphobic on September 27, 2008, at 9:11:55
In reply to Re: Are medications a lot more expensive in the US? » socialphobic, posted by seldomseen on September 27, 2008, at 9:08:38
> Well, when I first started on Prozac I didn't have insurance. It was $90 a month. Then a generic form of prozac came on the market and the price dropped to $40 a month.
>
> I have insurance now and it is $10 a month.Wow $90 a month without insurance??? Crazy. Everyone pays $30 at the most here in australia, even without private insurance.
I guess we're quite lucky in that way. But you guys in the US get new meds a lot sooner than us (usually about 5 years sooner). For example, cymbalta only JUST came out in australia a few months ago, and its been in the US for like 5 years now?
Posted by seldomseen on September 27, 2008, at 9:33:34
In reply to Re: Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 9:11:55
The only 2 drugs I ever had to stop taking because of the price were Provigil (mofandil) and a steroid eye drop prescribed by my eye doctor.
I think the Provigil was $190 for 30 pills, but those eye drops were $240 for one little bottle. I just couldn't afford to even get that prescription filled.
Of course, I called my eye doctor and asked for something cheaper and he called in something that cost $17. I still wonder to this day why he just didn't prescribe the cheaper one to begin with, but whatever.
Seldom
Posted by Phillipa on September 27, 2008, at 11:00:00
In reply to Re: Are medications a lot more expensive in the US? » socialphobic, posted by seldomseen on September 27, 2008, at 9:33:34
Even my generic luvox was $170.00 with medicaire and I pay every doc I see and with medicaire my co-pays are at least $30 just for an office visit and lots of insurance plans limit the docs you can see or the meds they will cover even private. Phillipa
Posted by desolationrower on September 27, 2008, at 11:59:57
In reply to Re: Are medications a lot more expensive in the US?, posted by Phillipa on September 27, 2008, at 11:00:00
The US healthcare system is a disaster (and i'm only going to mention a few of many reasons!). Usually, i have paid 50-150 a month for antidepressants and associated. Plus tests that some of the medications require. Doctor also out of pocket. Fortunately my parents and sister are doing well and could help me out. I was unemployed for 6 months and i don't know how that would have ended otherwise. My current job is classified as 'temp' although i have been there about 5 months, so the only health insurance doesn't cover anything. I buy catastrophic insurance in case something happens, but it doesn't cover 'pre-existing' conditions, ie my depression/anxiety. I did have school coverage until i graduated. I hope once i'm licensed in a few months to find a job with real health insurance, but it is immensely retarded to base an employment search on the health care they offer, instead of on the job itself.
-d/r
Posted by bulldog2 on September 27, 2008, at 14:10:26
In reply to Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:10:16
> I hear a lot of people in the US complaining about the "cost" of medications. How does the system work over there? Do they have a PBS (Pharmaceutical Benefits Scheme) where the government pays a large proportion of the medication?
>
> Here in australia we have the PBS. Under the PBS most antidepressants don't cost more than $30 if you're not on welfare benefits.
>
> However, if you are receiving welfare benefits (either unemployed or pension), then you get a concession card which makes ALL medications only $5. This is what I have, so all meds only cost me $5. Is there such a thing in the US like this?
>
> I feel sorry for all the people I hear saying they can't afford to be on a particular med in the US. Come to australia and go on welfare benefits and you'll get pretty much every medication for only $5 (or $30 if you're not on welfare).
>
>If you don't have private health insurance meds are very expensive. Many people can't afford private health insurance and in some cases cannot afford their meds. US phamaceutical companies charge more in the US than in other countries for some reason.
Posted by Nadezda on September 27, 2008, at 14:23:15
In reply to Re: Are medications a lot more expensive in the US?, posted by bulldog2 on September 27, 2008, at 14:10:26
Even if you have insurance, it can be expensive-- although nowhere near as expensive as if you don't-- of ccourse.
Mine is covered and comes to almost $200 a month. And I have a good policy-- other policies won't cover things I can get covered. So it's pretty bad.
They do charge more in the US than other places. It could have partly to do with whether medicare and other government-controlled insurance can bargain for better rates with companies-- among other things. I suspect other governments do a better job bargaining for rates, perhaps. And then, there's all the advertising and selling to doctors-- who then tell you you need something, rather than the older drug that's just like it. Overall, it is a puzzle, though.
Nadezda
Posted by cactus on September 27, 2008, at 16:48:04
In reply to Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:10:16
> I hear a lot of people in the US complaining about the "cost" of medications. How does the system work over there? Do they have a PBS (Pharmaceutical Benefits Scheme) where the government pays a large proportion of the medication?
>
> Here in australia we have the PBS. Under the PBS most antidepressants don't cost more than $30 if you're not on welfare benefits.
>
> However, if you are receiving welfare benefits (either unemployed or pension), then you get a concession card which makes ALL medications only $5. This is what I have, so all meds only cost me $5. Is there such a thing in the US like this?
>
> I feel sorry for all the people I hear saying they can't afford to be on a particular med in the US. Come to australia and go on welfare benefits and you'll get pretty much every medication for only $5 (or $30 if you're not on welfare).
>
>Hey social phobic, not all meds are on that PBS list. I also take modafinil and it's around $450 for 120 tabs which lasts me 2 months, then I found chemist warehouse and it's $352. Even with a healthcare card you would have to pay that price too. This is a strange example though. The distributers of modafinil in Australia, CSL, have no intention of applying to have it added to the PBS either.
I had to pay around $150 for 30, 2mg tabs of repreve/requip for restless leg and my sleep doc wanted to double the dose, so it would have been $300 a month, guess what? Rivotril works for restless leg too. $29 for 100, 2mg tabs. Newer medications are taking longer to go onto the PBS here now, so it's actually becoming more like America which is just a disgusting disgrace for medication and health. The shocking fact is that you too will have to pay full price if it's not on that list, I really hope you never need something that is. Peace C.
Posted by azalea on September 27, 2008, at 20:07:08
In reply to Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:10:16
Some generic medications are quite reasonably priced here in the US. Kroger, Walmart, and Target all have an extensive list of meds that cost $4 a month without insurance. Quite the contrast to Emsam which is $500 a month out of pocket.
> I hear a lot of people in the US complaining about the "cost" of medications. How does the system work over there? Do they have a PBS (Pharmaceutical Benefits Scheme) where the government pays a large proportion of the medication?
>
> Here in australia we have the PBS. Under the PBS most antidepressants don't cost more than $30 if you're not on welfare benefits.
>
> However, if you are receiving welfare benefits (either unemployed or pension), then you get a concession card which makes ALL medications only $5. This is what I have, so all meds only cost me $5. Is there such a thing in the US like this?
>
> I feel sorry for all the people I hear saying they can't afford to be on a particular med in the US. Come to australia and go on welfare benefits and you'll get pretty much every medication for only $5 (or $30 if you're not on welfare).
>
>
Posted by socialphobic on September 27, 2008, at 20:07:42
In reply to Re: Are medications a lot more expensive in the US, posted by cactus on September 27, 2008, at 16:48:04
Yes there are a few medications not covered by the PBS, but not many. We are still much better off than the US. The only one i've encountered not on the PBS is klonopin, but that is only like $30 anyway.
It sounds like if you're unemployed in the US then you simply cannot afford medications because you can't afford health insurance? That is not a good system. At least here in australia we only have to pay $5 for medications while on welfare, so it makes it affordable.
Posted by azalea on September 27, 2008, at 20:25:24
In reply to Re: Are medications a lot more expensive in the US, posted by socialphobic on September 27, 2008, at 20:07:42
That's exactly the problem--Health insurance is generally through your employer here in the US. If you're unemployed, you can get an individual health insurance plan but the monthly premiums are quite expensive. Without health insurance, most medication is not affordable (except for the $4 generics which there are many). But you still need a prescription from a doctor and then you're paying out of pocket for the visit to the doctor. Healthcare reform is a big issue in the presidential election so hopefully things will be changing and there will be universal health care coverage for all in the US soon!
> Yes there are a few medications not covered by the PBS, but not many. We are still much better off than the US. The only one i've encountered not on the PBS is klonopin, but that is only like $30 anyway.
>
> It sounds like if you're unemployed in the US then you simply cannot afford medications because you can't afford health insurance? That is not a good system. At least here in australia we only have to pay $5 for medications while on welfare, so it makes it affordable.
>
>
Posted by mav27 on September 27, 2008, at 23:23:05
In reply to Re: Are medications a lot more expensive in the US, posted by socialphobic on September 27, 2008, at 20:07:42
> Yes there are a few medications not covered by the PBS, but not many. We are still much better off than the US. The only one i've encountered not on the PBS is klonopin, but that is only like $30 anyway.
>
> It sounds like if you're unemployed in the US then you simply cannot afford medications because you can't afford health insurance? That is not a good system. At least here in australia we only have to pay $5 for medications while on welfare, so it makes it affordable.
>
>Bupropion is another one not covered except for 6 months to stop smoking, i tried it out and it cost me about $60 a fortnight or $90 for the brand name version.. thankfully MBF gave me about $50 back on each script.
America also has other programs in place to help people that can't afford their meds, they can apply to the drug company to get cheap or free meds off them for eg.
Posted by bulldog2 on September 28, 2008, at 7:48:54
In reply to Re: Are medications a lot more expensive in the US » socialphobic, posted by mav27 on September 27, 2008, at 23:23:05
> > Yes there are a few medications not covered by the PBS, but not many. We are still much better off than the US. The only one i've encountered not on the PBS is klonopin, but that is only like $30 anyway.
> >
> > It sounds like if you're unemployed in the US then you simply cannot afford medications because you can't afford health insurance? That is not a good system. At least here in australia we only have to pay $5 for medications while on welfare, so it makes it affordable.
> >
> >
>
> Bupropion is another one not covered except for 6 months to stop smoking, i tried it out and it cost me about $60 a fortnight or $90 for the brand name version.. thankfully MBF gave me about $50 back on each script.
>
> America also has other programs in place to help people that can't afford their meds, they can apply to the drug company to get cheap or free meds off them for eg.I personally know several people who cannot afford their meds.
Posted by mav27 on September 28, 2008, at 8:01:31
In reply to Re: Are medications a lot more expensive in the US, posted by bulldog2 on September 28, 2008, at 7:48:54
A day trip down to mexico will get ya some cheaper meds as well :)
Posted by yxibow on September 29, 2008, at 1:49:01
In reply to Re: Are medications a lot more expensive in the US, posted by mav27 on September 28, 2008, at 8:01:31
> A day trip down to mexico will get ya some cheaper meds as well :)
And some possibly dangerous ones depending on the city, I won't make broad prejudicial statements.
Basically in the US every new medication is like $3 a pill at the minimum, at the uncovered level, and some like the 5HT3 blockades are $25 a pill (ondansetron, etc), laboratories [blood draws, etc] (unpaid) are typically $100+ each, unless they are the most common, which makes Clozaril at the last figure $9,000 a year and probably much more.
If you don't get health insurance through work, you have to pay it privately, that is if you can get it without "pre-existing conditions", the nasty bean-counter way of excluding everyone from insurance because of every possible disorder.
I forget how it works but COBRA under dependent college students (?) up to 26(?) is an extension, but I believe there isn't a particular limit to a fee. I'm not sure. Fortunately there is HIPAA which extends COBRA. Of course, the insurance company can charge what they want, typically in the $300+ per month, with deductibles, all sorts of things.
People who have insurance are lucky to get their prescriptions at $20 and $40 levels. [My unnamed insurance] charges most any level of Seroquel a fair over $100 per month.
The health care system is disastrous in this country -- I don't know how we are going to insure 307 million people, the ones who don't already have insurance, stop-gap, all sorts of schemes, but mm... that gets into politics so I shall stop here before I go on my rant that the US long ago should have had public health care coverage.
But while Canada was leaning towards that direction up to its decision to create Medicaire, we were immersed in the cold war and any social services were "communist".
Now it isn't all rosy in Canada -- there is triage, some Canadians have to take out American insurance and have cross-border procedures because they are on a long waiting list for a necessary procedure. Still, prescription medication is covered much better. Some medications are not approved in Canada and vice versa for here.
Its sort of my view that Australia tends to regulate controlled substances more strongly, but that you would know.
Similarly, in the UK, there is triage -- from what I've heard about it, medication on approval lists tends to use the less expensive and older medications when newer ones may have less side effects and of course cost NHS more. There is a bit of stagnation I think, but maybe I'm generalizing; and I'm sure there is triage for a population at least double the size of Canada.
Ultimately any social health care will have triage, just as an emergency room has triage, but some people just may never get a procedure done.
Still speaking of emergency rooms, Federal law bans turning away anybody from any ER who has a genuine emergency or is a woman in labor regardless whether they can pay or not. This of course contributes to hospitals absorbing the cost of health care to individuals who can't afford health insurance and often use hospitals for disorders that could have been avoided by preventative checkups paid by some sort of stopgap system.
Now this doesn't cover the problem with mental health care.
The Mental Health Parity Act of 1996 has loopholes in it and rarely covers to its full extent personal insurance or employee self-funded plans. Although in theory the act was supposed to place on par the doctor visit lifetime cap for mental health at the same level as emergency and other regular medical visits, it fails.
As a result, people who can, have to have private visits.
Hundreds of millions if not billions of dollars are lost every year in industry to time lost to mental (biological) disorders because there is no effective coverage.
The stigma of mental illness and the nature that it is just as medically related as any other serious medical illness such as MS, diabetes, heart conditions, etc, needs to go.
But that's my soapbox.
-- Jay
Posted by Zyprexa on September 30, 2008, at 2:09:54
In reply to Re: Healthcare in the US, posted by yxibow on September 29, 2008, at 1:49:01
You can go to wallmart and pay $4/month for some of the different genarics. Or costco and pay $10/100pills. Go some where else and Some of these meds are charging your insurance like $70/month?
Posted by brot on October 1, 2008, at 8:41:21
In reply to Re: Are medications a lot more expensive in the US?, posted by Phillipa on September 27, 2008, at 11:00:00
> Even my generic luvox was $170.00 with medicaire and I pay every doc I see and with medicaire my co-pays are at least $30 just for an office visit and lots of insurance plans limit the docs you can see or the meds they will cover even private. Phillipa
well. in europe luvox (brand) 100mg 30 pills costs ~30 USD. without any insurance. thats the actual price of the drug if you would buy it yourself.
Prices are generally more enxpensive in us than anywhere else.
and most european countries have a proper social/health care system. for expample, I have a 100% cover of prescription drugs here. if I would have more money it would be ~5 uds per prescriprion drug.... but i am retired due to my illness and pay nothing. and yoou always get insurance and cover of your costs. whether your condition was pre-existing or not...
good for the ill, bad for those who earn much and have to pay much tax...greets
Posted by Mickapoo on October 3, 2008, at 10:21:08
In reply to Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:10:16
>Do they have a PBS (Pharmaceutical Benefits Scheme) where the government pays a large proportion of the medication?
>Nope, the only thing we have similar to that in the U.S. would be a "Medicaid" program, which is sort of a welfare program, but you have to be extremely low income with very little assets (cars, money in bank, etc...) to qualify.
Posted by Mickapoo on October 3, 2008, at 10:24:09
In reply to Re: Are medications a lot more expensive in the US?, posted by socialphobic on September 27, 2008, at 8:54:25
> I've heard in the US you have to have private health insurance for medications to be cheaper? Is that true?
>Yes, that is true.
> Could someone tell me the average price of antidepressants in the US?
It depends on whether there is a generic available, or if you have to buy the name brand. Before Lamictal was available as a generic, it was almost $300/month.
But if you're buying a generic version of Prozac, for instance, there are retail stores that sell that for $4 for a 30 day supply.
So as you can see, it really varies.
Posted by azalea on October 3, 2008, at 13:49:27
In reply to Re: Are medications a lot more expensive in the US?, posted by brot on October 1, 2008, at 8:41:21
For comparison, fluvoxamine (generic for Luvox) 100mg 30 pills costs $24 if you're paying out of pocket. In this case, prices are quite comparable.
Philipa, perhaps you could call around and a lower price for your generic Luvox. Sam's Club and Costco usually have the best prices and you don't have to be a member to get a presciption from the pharmacy.
> > Even my generic luvox was $170.00 with medicaire and I pay every doc I see and with medicaire my co-pays are at least $30 just for an office visit and lots of insurance plans limit the docs you can see or the meds they will cover even private. Phillipa
>
> well. in europe luvox (brand) 100mg 30 pills costs ~30 USD. without any insurance. thats the actual price of the drug if you would buy it yourself.
>
> Prices are generally more enxpensive in us than anywhere else.
>
> and most european countries have a proper social/health care system. for expample, I have a 100% cover of prescription drugs here. if I would have more money it would be ~5 uds per prescriprion drug.... but i am retired due to my illness and pay nothing. and yoou always get insurance and cover of your costs. whether your condition was pre-existing or not...
> good for the ill, bad for those who earn much and have to pay much tax...
>
> greets
Posted by desolationrower on October 3, 2008, at 14:04:40
In reply to Re: Are medications a lot more expensive in the US » brot, posted by azalea on October 3, 2008, at 13:49:27
I would check at the local pharmacies too. The big chains both charged over 100$ for a months worth of bupropion when i took that, while the local-owned high street shop charged 30$ something.
-d/r
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