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Health Insurance and Prescription Medications [1]
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Date: 2022-12-20
Why are insurance companies so bad at negotiating drug prices?
Is it incompetence? Corruption? My insurance company says medication #1 only costs $39.07 for a 90-day supply. That’s after my deductible, and them paying 75% of the cost of the medication, so they’ve negotiated a price of $156.28. GoodRX says the price, at the same pharmacy, is $17.99 for the same 90 days. 88.5% lower.
Medication #2 was around $90 per month. Then my insurance company said that to serve me better, they were removing it from the formulary, and I could pay the full cost myself, or switch to the name brand medication, at only $279 per month. The GoodRX price for Medication #2 was $33.19; it’s gone up to $43.14. The name brand is still $101.67 via GoodRX and the same pharmacy.
I’m going to ask my representatives to require insurance companies reimburse cash payments at the rate they advertise, and not advertise that they cover 75% of the cost, by marking up the cost 274% to 868% before they “cover” 75% of the marked-up cost. I’m sure there are rebates (I think more like kickbacks) so that the net cost to the insurance company is a lot closer to the GoodRX price than what they claim the price is.
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