Drug Prices and Manufacturers

In the beginning there was naproxen, and it was good. Along came stomach pain and Esomeprazole was created. (Forgive the timeline breaks. I'm trying to speed up the story.) And it was good. Along came profits and Big Pharma wanted more. And on the seventh day, Vimovo was created. And pharmacists and insurances said #GTFO!

By the Numbers:                         Acquisition Cost (AC)

Naproxen 500mg tablets #100    AC $7.56   

Esomeprazole 20mg caps #30    AC $29.97  

Vimovo 500/20 #60 ct bottle      AC $1409.54      

Will someone please explain to me how this pricing is possible? This would be the same as spending $5.00 on a large jar of Jif Peanut Butter, $4.00 on a large bottle of Strawberry Jelly, and $2.00 on a loaf of bread then charging $200.00 for a single PB&J sandwich. 

I counseled a patient whose insurance, for obvious reasons, did not want to pay for Vimovo. I explained my costs and that she could purchase the "ingredients" individually over the counter and make her own. If she could get her prescriber to write for each of them, she could get her insurance to pay for them. A week after our conversation, the patient returned. We again tried to fill the Vimovo, as the prescriber had assured her they had attempted a prior authorization, only to discover it was not approved. The Sweet Little Patient then told me about her conversation with her prescriber. 

CP: Did you ask her about changing it to its individual components? 

SLS: Yes. 

CP: How did that go? 

SLS: She said "I don't want you to take it that way."

CP: Your doctor said that? 

SLS: Well, she's a nurse practitioner. 

CP: Ah. No excuse for stupidity. Did you ask her to pay your co-pay for you? 

SLS: No. But she refused to write for the individual prescriptions. 

CP: Hmm. I would tell her you'd be happy to take it however she wants as long as she is going to pay for it. Exactly how is this beneficial to you, the patient? 

SLS: It's not. And it's the only thing that's helped my arthritis. 

CP: Your prescriber would rather you take absolutely nothing and suffer than prescribe the medications separately? 

SLS: That's what she said. 

CP: Time to find a new practitioner.