Exploited by the Big Box
My dog broke his toe. It’s sad and painful. Immobilization is impossible. I can only hope it heals to some degree of functionality — amputation being the alternative — and does not forever spoil squirrel chasing for him, that being the activity which precipitated the comminuted fracture. All we can do is keep him quiet, ice it and give him doggie pain-killers and anti-inflammatories.
Which brings me to how a broken dog toe revealed my national-chain, big-box pharmacy has been taking advantage of my trusting nature. Perhaps they’ve been taking advantage of you, too.
My small, rural town used to have three pharmacies, two independent ones and a micro-chain, LaVerdiere’s Super Drug. In 1994, Rite Aid rolled into town, gobbling up LaVerdier’s 72 New England stores into it’s Borg. Resistance was futile.
One local pharmacy, founded in 1893, closed in 1996. The other, of which I was a customer, held out longer. But by the time I was diagnosed with cancer in 2010, Rite Aid, with their vast buying power and longer hours, was the only game in town.
That’s the American way, right? Bigger, better, faster, cheaper. Out-compete the other guy with good deals for customers.
Well, that only works for the customer as long as the competition is still standing. Once they’re down, all bets are off.
Of course, I could have taken my business to an independent pharmacy in the next town. But that would have meant a half-hour round trip, not including pharmacy wait-time. And time — and gas — is money, too. Besides, Rite Aid wasn’t all bad. The pharmacist is the husband of a friend.
I was grateful the medicine prescribed for my particular cancer was, as oncological options go, cheap as dirt. Developed in the 1960s and used to treat cancer since the 1980s, Tamoxifen has been a generic drug since its patent expired in 2002.
For five years my subscription averaged about $25 for a 90-day supply. Then, mysteriously, the price began to climb rapidly. Between the middle of 2015 and the end of that year, the price jumped $12, almost a third more. By the end of the next year, it had jumped another $67. A prescription which had been costing 28 cents per day now cost $1.17. Still not bad in the grand scheme of staying alive, but why?
I put it down to the “we’re all basically fucked when it comes to healthcare” theory of life in these United States.
Suddenly in 2017, the price for a 90-day supply dropped from $105 to $75. Like my $5000-deductible health insurance cost dropping $275 per month (an almost 30% reduction) that same year, I figured it was — thank God — some provision of Obamacare finally clicking in and stabilizing prices.
This January, still reeling from my health insurance premium being jacked up to $930/month, I went Rite Aid to refill my prescription. My friend’s husband grimaced at the price as he looked at the package in his hand. “I can break this prescription down into 30-day portions if you’d like,” he offered. The price had risen to $234 for 90 generic pills. WTF! Three months later it’s up to $268.
I was all, “Curse you, Republican Party!” But it seems my curses were, at least in this particular case, misdirected. Which brings me back to the broken dog toe.
For prescriptions he doesn’t have in stock, my vet likes to call in to our local supermarket (which didn’t have a pharmacy till 2013). Now I know why.
I sat in the little waiting area. My phone’s battery almost dead, I decided reading brochures on shingles would be wiser than expending the last of my juice on Medium. Before long, I’d read all the medical literature they had to offer. I turned to the last handout, Hannaford RX, which proclaimed, “Taking care of your family should be easy. Look inside for our featured generic drug list.”
I wonder if they have a price for Tamoxifen in there … Rats! Nothing under “T”. Wait! What’s this? A “Women’s and Men’s Health” section …
There it was: Tamoxifen, 90-days for $45.
My number was called. Gripping the flier, I hopped to the counter. After paying a grand total of $5 for my dog’s anti-inflammatories, I asked the pharmacist, “Is this still accurate. Do you really sell 90 days of Tamoxifen for $45, because I just paid more than $250 for the same prescription at Rite Aid?”
“Yes,” she said. “What are you doing at Rite Aid?”
A fellow customer turned to me and offered, “I just switched my business from Rite Aid. They’re really good here.”
I wouldn’t feel right switching without letting my friend’s husband know why. I realize he doesn’t set the prices, and I’m sure he can appreciate why I would want to save more than $800 a year. Maybe, just maybe, word of my defection — and, more importantly, the why of it — will find it’s way back to management and changes will be made.
Is there a moral to this story? Caveat emptor for one. It was definitely my bad for not being a more savvy shopper. But this also touches on trust in medical relationships, the lack of transparency in medical pricing, and the importance of competition.
So, do check out what you have been paying for medications. Don’t fall into my trap of letting a combination of convenience, habit and loyalty lead to your exploitation.