BOSTON (STATE HOUSE) – Consumers looking to comparison-shop on prescription drugs face a challenge in finding the best prices, with different pharmacies charging different amounts for the same medication and accurate information at times hard to obtain, according to a new report.
A Pioneer Institute survey released Thursday found “significant variation among drug stores in the price of generic drugs” — for example, the cholesterol-lowering medication atorvastatin cost $4 at a pharmacy in Lunenburg and around $199 at a Boston pharmacy — and concluded that consumers paying for their own drugs “do not have easy terrain to navigate.”
Some policymakers and health care advocates have suggested that greater pricing transparency from drug manufacturers could help keep health care spending growth in check by shining a light on why medications cost what they do. Authors of the Pioneer Institute survey found that at the retail level, prices are easy to access but not always accurate. They called on pharmacies to better train their workers to communicate about drug discount programs, to make clear when they accept coupons on medications, and to develop consumer-friendly computer systems.
Researchers called 44 drugstores across Massachusetts, described themselves as self-pay customers and asked for a 30-day supply of common doses of five generic and three brand name drugs.
“There are opportunities to save money, but it’s not always a slam dunk, and you have to be aware and savvy,” study author Barbara Anthony told the News Service. She said, “There’s more here that the retail pharmacy industry can do to educate consumers about the fact that there are differences in prices.”
Anthony, a Pioneer Institute fellow and former state undersecretary for consumer affairs and business regulation, said it can be difficult to get reliable price information over the phone. Some pharmacies were unable to provide a price unless a prescription was processed, while others gave price information that did not always include store discounts, she said.
“Consumers can’t be expected to physically go from pharmacy to pharmacy to get an accurate price,” Pioneer executive director Jim Stergios said in a statement.
The Pioneer report focused on consumers who would be paying out-of-pocket for a medication, such as those who are uninsured or have high-deductible plans.
“Although many consumers today have more ‘skin in the game’ than ever before, they still have little access to information that will help them make good decisions about treatment options,” the report said.
High-deductible health plan membership in Massachusetts increased by 14 percent between 2014 and 2015 to nearly 1 million people, or 21 percent of the market membership, according to the Center for Health Information Analysis (CHIA).
Pharmacy spending grew for both public and private payers from 2014 to 2015, CHIA found. Medicaid had the highest increase, rising 14 percent, while MassHealth pharmacy spending grew by 9.1 percent and private commercial insurance by 11.1 percent.
Payers reported spending $8.1 billion on prescription drugs for Massachusetts residents in 2015, a 10.2 percent increase over 2014, according to CHIA.
On Friday, Attorney General Maura Healey released a report that found drug costs continue to grow despite attempts to manage pharmaceutical spending, and that spending on specialty drugs — higher-cost medications that treat chronic, complex conditions like cancer and Hepatitis C — is the “primary driver of total growth in pharmaceutical spending.”
The report analyzed the cost of prescription drugs for major health plans after factoring in discounts and manufacturer rebates, which Healey’s office described as a first-time endeavor in Massachusetts. Healey recommended requiring that “aggregated, standardized information on drug rebates” be reported to CHIA, to allow greater understanding of actual spending on prescription drugs.
The Pioneer study found it is not clear if rebates from drug makers “flow to other retail drug stores” that do not also function as pharmacy benefit managers. Independent pharmacies and the patients who shop there do not appear to “receive the benefit of drug-maker rebates on brand-name drugs,” the study said.
“I’d like to see a more direct connection from rebate to consumer,” Anthony said.
Anthony described health care as the most difficult area for consumers to find pricing information, but said Pioneer’s survey yielded no lengthy wait times and “virtually no” transfers or dropped calls. Callers were treated respectfully, she said.
“You weren’t treated like you were from the moon because you were asking for the price, so that’s good,” Anthony said.
Copyright 2016 State House News Service