Every cloud has a silver lining.
While prices of brand-name prescription drugs have doubled or tripled in recent years, making them unaffordable even for some people who have insurance, generic drugs are cheaper than ever.
On Monday, Wal-Mart announced an expansion of its discount prescription drug program. The world’s largest retailer already shook up the pharmacy market in 2006, when it began offering some common generics at $4 for a 30-day supply.
Other stores, such as Target and Kroger, soon followed with similar programs. Publix even began giving out basic antibiotics for free.
Wal-Mart and its sister chain, Sam’s Club, now have added a greater variety of drugs to the discount list, for a total of about 350 generic medications. And they’ve sweetened the deal. While a 30-day supply is still $4, customers can get a 90-day supply for just $10.
The company also has enhanced its women’s health initiative, charging $9 a month for certain female-specific medications, including the breast-cancer drug tamoxifen and a generic version of Fosamax for osteoporosis.Laird Miller, owner of Medical Park Pharmacy, an independent store in Gainesville, said Wal-Mart doesn’t lose money on the program because cheap drugs are what’s known in the industry as a "loss leader."
"They know that once you come into the store to fill your $4 prescription, you’re going to buy more than $60 worth of other stuff while you’re there, so they come out ahead," he said.
Miller added that if you are unfortunate enough to require a brand-name drug, Wal-Mart doesn’t give you a break on price. "They charge the same as everyone else," he said.
Still, the majority of consumers can benefit from discount programs such as Wal-Mart’s.
"If you can get at least some of your medicines for $4, then maybe you’ll have more money to pay for the ones that are not on the list," said Cheryl Christian, executive director of Good News Clinics in Gainesville.
The clinic serves people who have no insurance and very little income. Medical and dental care is provided at no charge, and the clinic has its own pharmacy, where medicines are also free.
But Christian said many patients "graduate" from Good News when they are able to get a job. Then, she said, they often turn to Wal-Mart or other discount pharmacy programs for their medicines.
"It does help tremendously for people who are on a tight budget," she said. "Even if they are able to get insurance through their job, it may have a high deductible. And so many insurance plans now are not offering a drug plan, or it’s very limited."
The bottom line, Christian said, is that it doesn’t matter how patients get their medicine, as long as their health problem is being addressed.
"Why see a doctor and do the lab work if you can’t pay for the medicine that’s needed to treat what’s wrong with you?" she said.
When uninsured patients are sick and don’t know where else to go, they typically end up in the emergency room. Hospitals are required by law to examine each patient and determine what their condition is.
But emergency departments don’t dole out prescription drugs. Patients usually leave the hospital with a written prescription in hand, and they can go wherever they want to fill it.
But many people still don’t know that discount programs exist. They may go to a pharmacy, only to find out the medication costs more than they can afford to pay.
Rhiannon Brewer, spokeswoman for Northeast Georgia Medical Center, said hospitals are trying to get the word out about the lower-priced options.
"The (ER) doctors have become very familiar with those (discount) lists," she said. "Case management gets involved (when patients are uninsured) and does refer patients to those $4 programs."
At the Hall County Health Department’s primary care clinic, a limited number of basic medications are available on site, according to District 2 Public Health spokesman Dave Palmer.
"But they are not free," he said. "Patients are charged based on income."
Palmer said he didn’t know whether health department patients are given information about local discount programs.
Elizabeth Pyron, coordinator of the Georgia Cares program at Legacy Link, the Area Agency on Aging in Gainesville, said seniors do seem to be savvy about which stores have discount prescriptions.
"Some of them are using these programs, if they are able to take a generic," she said.
Most insurance plans charge at least a $10 co-pay for a generic drug. So if a patient needs a medication that’s on Wal-Mart’s $4 list, they’re better off just paying for it rather than using their prescription card.
When Wal-Mart first introduced its discount list in 2006, the program was criticized for including only certain categories of drugs, mainly short-term treatments such as antibiotics. The company responded by adding many more drugs for chronic conditions such as heart disease and diabetes.
There are still gaps on the list. Wal-Mart doesn’t have much to offer patients with neurological conditions such as epilepsy and migraines. And patients with autoimmune diseases such as rheumatoid arthritis and multiple sclerosis will still pay hundreds of dollars for their medications, no matter which pharmacy they go to.
But Christian said the discounts do help the vast majority of patients who have more common ailments.
"I think the $4 program really is a service to the community," she said.