From our discussions to Wal-Mart's new initiatives for $4 per 30-day supply of commonly prescribed dosages of generic drugs, I am curious to see the coverage of the 300 generic drugs offered and as to where, likely offshore countries, the active ingredients to these generic drugs are being chemically synthesized. The impact of product quality of generic drugs is uncertain as prescription substitutes for physicians with FDA approval requirements. Therefore, physicians tend to prescribe brand name prescription drugs even at the county and VA hospitals where I rotated as a medical student. Patients and families with low income receive medical coverage under Medicaid, and I would realistically anticipate that this population would not utilize Wal-Mart's policy based on existing medical assistance programs direct with the hospitals that they receive care. Prescriptions at the VA hospital for veterans and their families are subsidized almost completely for their medical expenses. The Medicare program also has its prescription coverage for the population age 65 and older and some under age 65 that are disabled or in end-stage renal disease.
Wal-Mart likely targets the income bracket of working families above what Medicaid covers. Given the extremely low cost of producing general active ingredients for these prescriptions and economies of scale for such production at Wal-Mart and Costco, this program is still hugely profitable for Wal-Mart. I've attached below some information published by the Department of Commerce to show a few benchmarks although most of these brand name prescriptions are what is prescribed by physicians and generics would likely not cover these medications.
Celebrex: 100 mg Consumer price (100 tablets): $130.27 Cost of general active ingredients: $0.60 Percent markup: 21,712%
Claritin: 10 mg Consumer Price (100 tablets): $215.17 Cost of general active ingredients: $0.71 Percent markup: 30,306%
Keflex: 250 mg Consumer Price (100 tablets): $157.39 Cost of general active ingredients: $1.88 Percent markup: 8,372%
Lipitor: 20 mg Consumer Price (100 tablets): $272.37 Cost of general active ingredients: $5.80 Percent markup: 4,696%
Norvasc: 10 mg Consumer price (100 tablets): $188.29 Cost of general active ingredients: $0.14 Percent markup: 134,493%
Paxil: 20 mg Consumer price (100 tablets): $220.27 Cost of general active ingredients: $7.60 Percent markup: 2,898%
Prevacid: 30 mg Consumer price (100 tablets): $44.77 Cost of general active ingredients: $1.01 Percent markup: 34,136%
Prilosec : 20 mg Consumer price (100 tablets): $360.97 Cost of general active ingredients $0.52 Percent markup: 69,417%
Prozac: 20 mg Consumer price (100 tablets) : $247.47 Cost of general active ingredients: $0.11 Percent markup: 224,973%
Tenormin: 50 mg Consumer price (100 tablets): $104.47 Cost of general active ingredients: $0.13 Percent markup: 80,362%
Vasotec: 10 mg Consumer price (100 tablets): $102.37 Cost of general active ingredients: $0.20 Percent markup: 51,185%
Xanax: 1 mg Consumer price (100 tablets) : $136.79 Cost of general active ingredients: $0.024 Percent markup: 569,958%
Zestril: 20 mg Consumer price (100 tablets) $89.89 Cost of general active ingredients $3.20 Percent markup: 2,809
Zithromax: 600 mg Consumer price (100 tablets): $1,482.19 Cost of general active ingredients: $18.78 Percent markup: 7,892%
Zocor: 40 mg Consumer price (100 tablets): $350.27 Cost of general active ingredients: $8.63 Percent markup: 4,059%
Zoloft: 50 mg Consumer price: $206.87 Cost of general active ingredients: $1.75 Percent markup: 11,821%
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By the way, I was at Ralphs the other day and noticed that they are starting to do a similar program with prescriptions. As much as I don't always like Walmart, I have to say that if they have the power to make other companies start following their initiatives, regardless of their original motives, it's a pretty great program!!!
Similarly, I was in East LA on Saturday and saw a billboard for $4 prescriptions at CVS. I did a quick search online and it appears Target, Hannaford, etc. are all following suit. Since they are using the same $4 price point, it seems Walmart has provoked a strong competite response. Hopefully this will benefit consumers!
Very interesting data Jules. I've always wondered about these markups.
I wonder if there is room for certified generics - generic brands that undergo quality control testing by a reputable source. This may add a few dollars to the cost, but a physician trusts the drug and prescribes it, and lower the overall amount spent on drugs per patient.
I think the same in true in regard to the minute clinics. I found a link online that shows an interview with some of the nurses at a clinic. It seems the majority of clients thus far are not necessarily low-income or on Medicaid/Medicare. This is not to say that the program is bad or unsuccessful, only that it may not be serving those "most in need" as some articles suggest. At the moment, the main constituency is working-class families with time constraints and possible lapses in medical coverage.
Just FYI, i drove by a CVS on Westwood with abig sign outside advertising its Minute Clinic.
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