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Wednesday, June 15, 2011

Irrational Price Expectations

Nothing makes me giggle like a schoolgirl more than the thought of having to discuss pricing issues with patients.  I get so excited I almost wet myself in anticipation.  My rather cynical approach to most pricing questions is "why are people so irrational when it comes to medications and prices?"  Here are a few of my ??? moments from my past to set the stage.

1.  Crabs--A guy came to me asking for an OTC remedy.  I showed him our Nix and Rid products and he balked at the $10 price.  Seriously?  You Have Crabs!  He asked for something cheaper and I asked if he owned hair clippers and he gave me a funny look.  I patiently explained that a bear can't hide in the forest if there ain't no trees, nudge nudge, wink, wink.  He caught my drift, but again balked at the thought of something sharp nestling near his twig and berries.  As he walked away he said "I guess I'll just go home and get a match and lighter fluid".  Seriously.  I shit you not.  I wonder if he won a Darwin Award?

2.  STD--A guy came in asking for our price on Flagyl.  Not to assume anything, but one look and I guessed his diagnosis (he was hunched over holding his junk with one hand and offering the Rx with the other).  The hospital discharge sheet confirmed it.  I quoted him $10 and he started swearing up a storm at my counter.  "WTF? $10 f-ing dollars?  That's some bullsh!t right there."  Okay, really?  Apparently his limit is under $10 which explains why he didn't buy the condoms in the first place.

3.  Brand-Names--A woman asked for an OTC steroid cream for itching/hives/bags under her eyes.  I put the House-Brand Hydrocortisone in her hand.  She picked up the Brand-Name product, looked at who made it and said "well I want this one because I own stock in that company and it will help them".  Not really one bit.  The extra two dollars you could have saved would have been better spent on a lottery ticket; better odds.

4.  Copays--A guy complained about the $30 he had to pay for the 5 medications he was about to receive saying he didn't have any money.  He stormed out, only to return 10 minutes later with cash.  He said he put $20 in the lottery machine and won $50.  He was actually bragging that he "hit the jackpot".  Wow, so where did the $20 come from in the first place?  Apparently his priorities are 1. gambling, 2. medications?  Go away, now!

5.  Dumb Price Dialogue #1--"How much will this cost?" I don't know.  I have to process it on your insurance first.  "Well how do I know I want it here?" Well, correct me if I'm wrong, but you are standing here, right?

6.  Dumb Dialogue #2--"Hi, I'd like a price on my blood pressure and Parkinson's medications because I would like to transfer them here from my other pharmacy."  Okay, what are they called?  "I don't know."  Well I cannot give you a price unless I know what I am to price.  He got angry and left.  It's like asking AAA for directions from Point A to Point B, not knowing either Point, then getting mad at me and storming out like a bratty 3 year old.  Yes, he really was pissed that I would not help him, said this is why he never comes to us, and actually left in a huff.

All of this and people still amaze me that they readily buy drugs from Canada, continue to pay for expensive brands, yet without any hesitation will buy drugs over the internet.  If brand is so important, how do you know what you're getting online?

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