The U.S. has a vibrant and highly competitive market for prescription drugs, with over 50% of prescriptions going to generic brands. On top of that, U.S. generics are the least expensive in the world, which means that where generics are available and appropriate, American consumers can find better bargains at home than they could in Europe or Canada.
Still, as this article from Consumer Reports describes, prices for generic drugs can vary widely, and consumers should comparison shop to find the best values.
Consumer Reports asked 132 pharmacies about the prices of five common prescription generic drugs and found striking differences. For a family paying outofpocket for all five, the difference between the highest and lowest prices could total nearly $2,200 a year. That's on top of the substantial savings the family would gain by choosing generic rather than brand-name versions of those medications in the first place.
When a drug first goes generic, the maker's suggested retail price might be 70 percent of the branded version. As competition among generic manufacturers heats up, that price generally falls to 20 to 50 percent of the brandname equivalent. People with drug insurance or a safetynet program pay only a copayment or a negotiated price. But if you have no such coverage, you're on your own.
Some generic drugs cost pharmacies pennies per pill, but they can sell them to people who lack coverage for as much as they want. Some pharmacies will charge far more than others, as we found in our survey of five drugs: fluoxetine for depression, lisinopril for hypertension, lovastatin for high cholesterol, metformin for type 2 diabetes, and warfarin for preventing dangerous blood clots.
Prices for a 30-day supply of those five varied sharply, from $43 at a Costco in Sacramento, Calif., to $296 at an independent pharmacy in Clayton, Mo. Costco stores nationwide were generally the least expensive, with a median price less than half that of the two closest competitors, WalMart and Target. And Costco pharmacy customers don't have to pay Costco's $50 annual membership fee.
The Washington Post reports that the federal Bioshield Project has experienced yet another setback in its efforts to develop a stockpile of counterterrorism drugs and vaccines.
Federal drug regulators halted plans by a California biotechnology firm to begin human testing of an anthrax vaccine this month, throwing the fate of the troubled program into doubt.
VaxGen Inc. officials said yesterday that it was unclear how long it would take to address Food and Drug Administration concerns about the vaccine's reliability. The delay prompted the Department of Health and Human Services to warn the company that it might terminate work potentially worth nearly $1 billion.
The anthrax vaccine effort, already years behind schedule, is by far the largest component of the Bush administration's Project BioShield, a $5.6 billion effort to counter bioterrorism threats. The military has used an anthrax vaccine produced by Emergent BioSolutions Inc. of Gaithersburg for years, but the government sought to produce another version with VaxGen. The firm has run into several technical problems, including a failed test on humans.
FDA officials declined to comment, but the company said the agency's questions centered on the vaccine's "stability," or the rate at which it would deteriorate while stockpiled.
"We were encouraged by the improvements we've made to the vaccine and the stability data we have compiled, and we felt it supported reentry into the clinic," James P. Panek, VaxGen's executive vice president, said in a conference call with analysts. "Unfortunately the FDA disagreed, citing remaining concerns about the vaccine's stability."
VaxGen officials said they hoped to hold a teleconference with the FDA next week and an inperson meeting within 30 days, but acknowledged that the FDA controls the timetable. "We're anxious to have that meeting to get a better sense of the FDA's concern and more importantly to try to find a path forward," Lance K. Gordon, president and chief executive, said during the conference call.
Addressing the FDA's doubts could require VaxGen to generate new data on the current vaccine formula or make more improvements to it, Gordon said.
Not to cast aspersions on the FDA, but this is an enormous problem. The more companies see the bureaucratic nightmare that Bioshield Project has become, the more they will be inclined to avoid the biodefense sector entirely.
The government and the private sector need to get their respective houses in order and find better ways to expedite programs like this one and to make the process more transparent and predictable. Otherwise, in the event of a large scale bioterrorist attack there will be plenty of finger pointing, but no real treatments.