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Paying more out of pocket for prescription drugs? Here’s what you need to know

BR Proud


You may have noticed the price of prescription drugs rising, leaving you to pay more out of pocket.


Louisiana Independent Pharmacies Association (LIPA) President Randal Johnson said the increase in prescription drug costs is preventing some people from affording their treatment.

“It’s a shame, that when we look at those rebates, that drugs shouldn’t cost what they cost,” he expressed.

He experienced this firsthand when getting flu medicine.


“So, think about that, the difference between $11.56 and $45.60 for exactly the same drug 48 hours apart using exactly the same health insurance plan,” said Johnson.


America’s Agenda Executive Director Mark Blum said middlemen called Pharmacy Benefit Managers negotiate contracts between manufacturers and healthcare providers. He said this is likely the cause of higher drug prices.


“He’s just negotiating with the manufacturers, negotiating with the wholesales, then he negotiates with the pharmacists. The pharmacist is going out and buying the drugs, but can only sell for those drugs what the health plan allows. So, he’s in the middle of all these transactions,” said Blum.


This year laws passed in the state to increase transparency and make prescriptions more affordable.


“That allows the pharmacist to provide the patient with the information of the price of their prescription drugs,” said Johnson.


One law introduced by Senator Fred Mills allows middlemen to compete for better prices based on the state’s calculation for the price of a drug.


“It allows the state to create a competitive marketplace. What it does is that it uses big data analytics, to take PBM offers for thousands of drugs, calculate out what the price state will be for those offers, and show the price of the offers to the other PBM’s and get them competing against each other,” Blum explained. “When you know the price of various suppliers, you go for the good you want for the cheapest price you can get it for.”


Johnson encouraged you to talk with your local pharmacist to make sure you get the best price possible.


“When you know how much something is costing, and you’re able to ask, ‘should it cost that much?’ We’ve seen that transparency actually brings a reduction to that cost,” said Johnson.

According to a report from the Kaiser Family Foundation, nearly one in three adults failed to take their medication in the past year because of the price tag.