Consumers get the shaft from Lipitor

If you were counting down the days for generic Lipitor to come out you'll need to add a couple hundred more. Pfizer will get patent rights until November 2011.

But if you read my prior blog about statins then you should have come to the conclusion that Lipitor is a waste of money for the vast majority of people anyway. This is just another reason to knock Lipitor off your formulary a take it out of your medicine cabinet.

Pfizer may be protecting their bottom line, but so can consumer and the health care system. I say fight fire with fire. You can have Lipitor Pfizer, because guess what...we don't need it.

Breathe Easier

The most common question in the pharmacy (at least recently) is allergies. Most often nasal congestion. The are two basic routes to go: orally or in the nose. Let's cover the orals first.

Cheapies:

Pseuoephedrine [Sudafed] (OTC): cheap and effective, need an ID to prove you are not turning it into meth.

Phenylephrine [Sudafed PE] (OTC): cheap and not quite as effective, no ID needed.

Diphenhydramine [Benadryl] (OTC): anti-histamine, most effective-most drowsy. About $2 for a box.

Doxylamine [Unisom] (OTC): about the same as diphenhydramine but it lasts longer.

Loratidine [Claratin] (OTC): anti-histamine, less effective but not drowsy not all. Once a day dosing, about $2 a box.

Certrazine [Zyrtec] (OTC): the "middle of the road" anti-histamine, effective and usually not drowsy. Just went generic so not quite as cheap but coming down fast.

Chlorpheniramine [Chlor-Trimeton] (OTC): effective, can be drowsy, and last a long time. I've gotten #100 tablets for $2.19.

Hydroxyzine: the only prescription one in this category. It get prescribed for sleep, bee stings, and pain. Either way it's about $4.

Rip-offs:

Clarinex: $116/month, about $112 more than Claritin per month. A "patent extender" for Claritin. Thankful I probably see a Rx for this once a month. Unfortunately, I see a Rx for this once a month.

Come back next time to see what you can spray up your nose.

The Pain Hurts, Hopefully the Bill Won't Either

People have pain everyday, it just depends on how much. Arthritis, cancer, injuries, diabetes, taco bell, and heart attacks can be causes. If you are not in pain now, just wait a few days and you will be soon.





Cheapest Non-drug treatment:





ICE! It's localized, effective, and safe. [Cost is about 0.001% of your water bill.]





Rip-off Non-drug treatment:





Going to Urgent Care...





Rip-off drug treatments:

Darvocet:

Your dentist may hand this to you, send it back. It's actually cheap, but not very effective and has toxic metabolites that stick around in your body for weeks.

Celebrex:

$100-400/month
This is the "stomach-friendly" NSAID (non-steroidal anti-inflammatory) that is made by Pfizer. But instead it can cause a better chance of stroke or heart attack. Some would say you get what you pay for, I say rip-off.

Expensive, but maybe worth it:

Fentanyl Patch:
probably $100s-1000s
A patch you leave on for a few days at a time. It is the most potent pain-killer around. If you get prescribed this you probably have cancer, so I would hope you have insurance.

Lyrica:
$100-400/month
Better as a last ditch plan. See gabapentin below.

The Triptans (Imitrex, Max-alt, Frova, Zomig):
$100-300/month
The best thing on the planet if you have migraines.

Cheap Meds: There are so many drugs in this category, but many are DEA controlled because they have some addictive potential. You basically have to increase the dose until it works. The prices will depend on what you need but they all are affordable.

Vicoden, Percocet, etc.: Your basic opiate + Tylenol meds. Very common generally work well, prescribed in the millions.

Oxycodone, regular or Oxycontin: A little more potent, a little more expensive, a little less prescribed.

Gabapentin: Went generic (Neurontin) about a year ago, not as addictive and has a wide spectrum of use.

Tramadol: A misunderstood drug, similar to the other opiates. I've seen addicts using this. Very cheap though.





I hope many pain-free days upon you all.

Done with school, back to business...

I'm all done with regular pharmacy school. I'll be doing rotations for the next year at varying locations...I'll have plenty of stories to tell.

1st stop the VA....

Generic Alert: What was good in April

Here is some good new brand names that went off patient and may save you (or your patient) some $$$.

Top Brand to Generics

1. Aricpet (Pfizer/Eisai), one the biggest Alziemer's treatments is finally off. Teva won the aproval for the generic, donepezil. This will save a ton of cash for people on Medicare Part D.
2. Children's (certrizine) Zyrtec Syrup is now on the OTC shelf. Another allergy option for the public can't hurt.
3. Xopenex Solution: this one always seemed like a rip-off, but now at least the price should come down.

One Class of Meds Where You're Really Screwed

<-"Ok sir, that will be $2, 500. Would you like to pay all up front or our financial department can arrange a payment plan."

None of the effective ED meds are cheap. Plus insurance companies do not like to pay for it, so it comes out of pocket for the poor guys. Let's take a look at what it will cost a guy to have sex 3 times a weeks for a whole year:

Viagra: $1,851.05

Cialis: $2,131.85

Levitra: $1,778.31

Hmm...tough decision: sex all year or a brand new LCD TV with a year-long satellite subscription.

Viagra will probably be available generic in a couple of years. In the meantime let's see what on TV.

Wal-Mart offers more cheap meds

Those blue-vested bastards. They've now made a $10/90 day list, and a $9 list. The $9 list has some good women's health meds. Breast cancer, hormone replacement therapy, birth control, osteoperosis prevention (aka Fosamax).

A link to the list.

Financial Disclosure: I'm Broke!

I get tired of thinking about drugs all day and night. Time to bring some diversity here. Just wanted to let everyone know that when I talk positive or negatively about a medication it is not because I have any financial interest in it for the following reasons:

1. Not enough people look at this site to make a dent in any sales. (Maybe someday.)
2. My job performance is not based upon sales in $$$'s.
3. I don't have any significant amount of money to invest in a pharmaceutical company.
4. I don't think any of the big Pharma companies stocks are good investment right now. (Come back for more discussion.)
5. If anything I talk more negatively about big Pharma companies than positive, but it depends on the topic of course.

Bottom line: I'm all about full disclosure. At least from me you don't have to worry about kickbacks from Pfizer.

Anti-Whatever, anxiety, depression...It can be cheap!

The brain is probably the most complex ever known. Neurons, neurotransmitters, synapses, neural networks, and grand mal seizures. Surely the two most common problems regarding this organ, anxiety and depression, must need really fancy, sophisticated medication(aka expensive), right? No...for better or worse little has changes pharmacologically in this arena for a few decades. But two goods things come from this...clinical experience and cheap meds!!



I'm starting a new categorization system. Let's see how it goes:



(I use drugstore.com for prices, except when I know they are on a $4-5 list at Wal-mart, Kmart, or Target. Prices based upon a month supply)



Rip-Off Meds:



Lexapro: $86



A legal way to make more money from the same drug, from your friends at Forest Labs.



Luvox(fluvoxamine): $63+

Might have had a chance, but then Columbine happened.



Expensive, but maybe worth it:
These two work slightly different so maybe have a higher value.


Cymbalta: $120



I just love the look of the capsules!! A pharmacologic fashion icon.








Effexor XR: $126-400+
Effexor-regular(generic): $60-100+

The regular Effexor might be cheaper, but patients hate taking things more than once a day, and three times...forget about it!



CHEAP MEDS:


Prozac(fluoxetine): $4

I heard that it free if you drink tap water, too!

Celexa(citalopram): $4

Once a great product for Forest Labs, then forgotten about when sexy-looking, high-margin Lexapro came knocking.

Zoloft(sertraline): $16

Whatever happened to those commercials with the happy and sad eggs?

Trazodone: $4

A huge off-label market for no-sleepiness(insomnia), seems like its destiny.




That should wrap it up, feel free to comment on the new categorization. Or just comment about anything since nobody has left any comments yet anyways.

ZZ out.

The Cholesterol-Lowering Statins (Lipitor, Zocor, Crestor, Pravachol)

This category is really easy to save on and many people are on these meds. Let's look at the top 200 drugs (by total sales) of 2006:

#1: Lipitor ($8.7 Billion)
#7: Zocor ($3.2 Billion)

There is a very good chance your doctor will prescribe one of these in your lifetime. And guess what...you'll probably stay on it for the rest of your life. The evidence and the guidelines clearly show why.

Ok so you got your prescription for Lipitor, you're happy, you're doctor is happy, because they think they making you healthy. But you get to the pharmacy wait for 30 minutes and the pharmacist says "Sorry...your insurance company doesn't cover this medication."

What?!! Does the insurance company not care about me? Don't they want me to have the medicine the doctor wanted me to be on? Turns out no...they don't. But there is a method to the madness. The guidelines do NOT specify between statins, and the cost is huge. I've complied the list below based upon drugstore.com's prices for a 1 month prescription of said statin...

Lipitor 10mg: $85.99
Zocor 20mg
(Simvastatin):$27.99 (even less, about $5 at K-mart)
Lovastatin 20mg: $22.99 ($4 at some Targets)
Crestor 5 mg: $108.99
Pravastatin 20 mg: $17.99

Your cost per year on these meds can range from $48-$1308. A 96% difference in price!!!!

Here the price difference is not from the quality of the medication, but basically how long it has been on the market. From my point of view the longer something is on the market, the more confidence I have in it, not less. The health care community has more experience with it.

The bottom line is....

If your doctor writes you a prescription for a statin look at what you're paying, you could save over $1000/year for a medication that works just as well and has been out longer...

Sources:
drugstore.com
American Heart Association
ATP III guidelines
K-mart
Target website

This is a great site from the American Heart Association.

Let Me Introduce Myself...

My name is Zach Z. I am in the last stage of a PharmD (Doctor of Pharmacy) degree at the University of Minnesota. I started this blog and my website, savemoneyonprescriptions.googlepages.com, to help people save money on their prescriptions drugs. As we all know, the costs of prescriptions in our country have been rising every year and consumers are paying a higher percentage of the total cost. And here lies the problem...

We rely so much (and rightly so I would argue) on drugs to keep us alive and healthy, yet few people know how much they costs and what options are available to them. When a doctor writes your prescription they are usually not aware of the price. They maybe picking a drug based on their personal experience, what drug rep. saw them last, or what name they can remember easiest. Hopefully your insurance will cover it...but if its expensive they probably won't, or charge you a higher co-pay. But it's what the doctor ordered, right? There are many cheaper options for the majority of prescriptions, but how can you tell? That's what I want this blog and website to be about. So...let's get started....