Letters to Editor

Source: Tcpalm.Com

Feb 15, 2015
Tim Ioannides, M.D.,
Vero Beach

A patient of mine came to the office recently in some distress. I had prescribed a medication for her that was generic that I knew to cost around $25. She went to a local pharmacy and was charged over $345 for it.

As most of my patients are, this patient is on Medicare, on a fixed income. It was a hardship for her to buy this at this incredibly exorbitant cost.

There is a website, Goodrx.com, where one can look up the cost of medications and download coupons. If this patient had called my office, we would have printed this coupon for her.

Local pharmacies and pharmacists have a duty to their patients to offer them the lowest cost equivalent medicine. Too often this duty is ignored. Too many of our seniors are being bankrupted by the cost of medications.

I hope that this local pharmacy, as well as others, will do a better job of caring for its patients in the future.

Original Link: http://archive.tcpalm.com/letters-to-the-editor/letter-pharmacy-more-interested-in-profit-than-serving-hard-pressed-seniors-ep-932451432-341130241.html

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Feb 25, 2015
Theresa Tolle,

As the owner of an independent pharmacy that has cared for patients in our community for over 30 years, I am writing in response to Dr. Tim Ioannides’ letter to clarify some points that he raised. Regarding discount cards, while we do occasionally accept these cards, I want to let readers know that they are ‘free,’ and anything that is ‘free’ has a cost! The companies producing these cards become the owners of your private information as soon as you use the card. Although you sometimes get a discount on your prescription with a discount card, they are able to sell your private information.

We care for our patients and regard them as family, and as such, offer very competitive pricing and always protect the privacy of our patients. Dr. Ioannides referenced a product that cost $25 and sold for $345; he did not mention if he checked to see if it could indeed be purchased for $25. Our industry has experienced unprecedented price increases in generic products. Pharmacists unfortunately do not control the prices charged by manufacturers. This has affected many products, dermatological products included. I work every day with my patients and their physicians to find the medications and therapies that best meet their medical and economic needs. I assure Dr. Ioannides and the reader there are many pharmacies and pharmacists in our community who do an outstanding job taking care of patients. I encourage you to have a conversation with your pharmacist, or visit our locally owned, hometown pharmacy to see how we might be able to meet your needs. We all have the same priority – providing access to affordable, quality healthcare services that keep our patients healthy.

Theresa Tolle is a pharmacist and owner of Bay Street Pharmacy in Sebastian

Original Link: http://www.tcpalm.com/opinion/letters-to-the-editor/letter-pharmacy-discount-cards-may-compromise-medical-privacy_06828341

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Mar 1, 2015
John Caprice,

As a 30-year pharmacist, I am concerned that Dr. Tim Ioannides has written a critical letter (Feb. 15) about the cost of a generic prescription at a local pharmacy. The doctor did not indicate the name and quantity of the drug, so I cannot confirm the high cost of this particular medication.

Over the past 20 years, there has been a dramatic increase in the cost of drugs. There are a few reasons for this increase. The increase in price is a result of decreased competition, as manufactures merge their companies. Most, if not all, generic manufacturers have been acquired by larger pharmaceutical companies. I have seen a generic drug’s price rise from $2 per hundred tablets to $25 per hundred tablets, in one week. When competition is eliminated or absorbed, the cost of a product has little or no restriction. There are hundreds of price increases that pharmacists are exposed to on a monthly basis, some are extraordinary. But before we accuse a pharmacy of profiteering, please allow us to check the facts first.

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*At time of posting to our website, this letter has not yet been published.

March 9, 2015

Dear Editor,

I was happy to see that there was some discussion from pharmacists regarding the exorbitant cost of drug prices. But I was surprised by the tone of some of their comments.

One author stated that because I did not name the price and quantity of the drug I was writing about, they could not confirm my facts.

That, in fact, many of the increases in drug costs are related to the monopolies of drug companies, and that “before we accuse a pharmacy of “profiteering” please allow us to check the facts first.”

Let me say clearly: My initial letter never accused any pharmacists of “profiteering.”

Let me also say, I resent that factually inaccurate accusation.

But the writer asked to “please allow us to check the facts first.” So let’s do that.

I printed the screenshots of three commonly used dermatology medicines sold at local pharmacies with some current, estimated cash and coupon prices on the website of my practice (https://www.tcdermatology.com/screenshots/).

As you can see if you look, the prices vary by 300 – 700%. There are the facts for you. These are the exact same medicines sold on the same date at pharmacies that are across the street from each other. I redacted the pharmacies’ names, but anyone can look them up themselves, as I am not trying to pin this on any one institution.

What I mean to say is that one doesn’t have to look very far to find these outrageous examples. Again, there are the facts, please check them out and draw your own conclusions.

I was pleased with the other comment, from an owner of a pharmacy, about the potential loss of privacy with the use of potential discount coupons.

Certainly, there are risks there and they should be discussed.

But the web resource I wrote about, Goodrx.com, specifically states how they treat the personally identifying information they receive (you can read about it on their website at: http://www.goodrx.com/privacy-policy). Also, I receive nothing of any value from Goodrx.com for recommending them.

The owner of that pharmacy even has a web page that has a link to a site that asks for personal information like a patient’s name, address and phone number (for a site called healthyheartclub.com). I think that this shows that even someone who might be a bit of a skeptic about the collection of personal information realizes that there may be some benefit to her customers.

I applaud her for her open mindedness about this important issue.

The majority of my patients though, are of Medicare age. They didn’t get to be senior citizens without realizing that there is no free lunch. But I think that given the option to be offered huge savings in the cost of their medicines, that choice might be worth it to some of them.

They deserve to be given that choice.

And that, finally, is the point of my initial letter. I never accused anyone of anything. These price discrepancies are NOT the fault of pharmacists, but they are in a unique position to help patients navigate these difficulties.

I just wanted to help our patients out.

Doctors, pharmacists, nurse practitioners, nurses, and physician assistants can all try to help relieve the burden of excessive drug costs with some outside-the-box thinking. We try to do this in our office every day.

Lastly, I might be misreading it, but it seems from the tone of some of the comments I have read, that I am condemning and singling out pharmacists on this issue.

I want to publicly say, nothing could be farther from the truth.

When I was in medical school, and in my residency, pharmacists would often go on rounds and see patients with the medical students, nurses and doctors. Working together, I saw, first hand, how important the integration of their knowledge with the entire medical team could benefit our patients.

I remember those lessons to this day.

Frequently, before taking a medication, the pharmacist is the last person on the medical team that a patient will see. This is an incredibly important and personal position from a health care perspective.

I am glad to see pharmacists be given the ability to directly give vaccinations to our patients, and their expanding role in healthcare. I anticipate that the importance of the role of the pharmacist will only increase.

I consider pharmacists my colleagues and hold them in the highest esteem. We all depend on pharmacists to help take care of us and our loved ones.

And so, like I saw in years past, let’s all of us (patients included) continue to work together to give our patients every advantage to have productive, healthy and long lives in an economically viable way.

They deserve it.

Warmest regards,
Tim Ioannides, MD