A Patient Price Guide for Prescription Medication
Authors: Robin Feldman, Natalie Feldman, Enrique Seoane-Vazquez
Journal: Annals of Internal Medicine (2022)

Ideas and OpinionsJune 2022A Patient Price Guide for Prescription MedicationRobin Feldman, JD, Natalie Feldman, MD, and Enrique Seoane-Vazquez, PhDRobin Feldman, JDUniversity of California, Hastings College of the Law, San Francisco, California (R.F.)Search for more papers by this author, Natalie Feldman, MDBrigham and Women's Hospital Psychiatry Department and Harvard Medical School, Boston, Massachusetts (N.F.)Search for more papers by this author, and Enrique Seoane-Vazquez, PhDChapman University, School of Pharmacy and Economics Science Institute, Irvine, California (E.S.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-4755 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A physician prescribes one 450-mg pill of Wellbutrin (bupropion) once a day for a patient with depression. The patient returns a month later, having not taken the medication and now more depressed. When the physician asks why, the patient replies that the medication is not covered by insurance. The physician then calls the patient's pharmacy and asks the pharmacist to put in a test claim for three 150-mg pills a day. That prescription is fully covered. The patient is so frustrated that the physician agrees to ask the pharmacist to test claims for other antidepressants. Test claims for Effexor (venlafaxine) ...References1. Iosifescu A, Halm EA, McGinn T, et al. Beliefs about generic drugs among elderly adults in hospital-based primary care practices. Patient Educ Couns. 2008;73:377-83. [PMID: 18706784] doi:10.1016/j.pec.2008.07.012 CrossrefMedlineGoogle Scholar2. Ornstein C, Thomas K. Take the generic, patients are told. Until they are not. The New York Times. 6 August 2017. Accessed at www.nytimes.com/2017/08/06/health/prescription-drugs-brand-name-generic.html on 6 December 2021. Google Scholar3. Feldman R. Perverse incentives: why everyone prefers high drug prices—except for those who pay the bills. Harvard J Legis. 2020;57:303-76. doi:10.2139/ssrn.3162432 CrossrefGoogle Scholar4. Feldman R. May your drug price be evergreen. J Law Biosci. 2018;5:590-647. [PMID: 31143456] doi:10.1093/jlb/lsy022 CrossrefMedlineGoogle Scholar5. Galewitz P. Doctors Slow to Adopt Tech Tools That Might Save Patients Money on Drugs. National Public Radio. 5 July 2019. Accessed at www.npr.org/sections/health-shots/2019/07/05/738283044/doctors-slow-to-adopt-tech-tools-that-might-save-patients-money-on-drugs on 25 January 2022. Google Scholar6. Feldman R, Graves CT. Naked price and pharmaceutical trade secret overreach. Yale Journal of Law & Technology. 2020;22:61-128. Google Scholar7. Nutrition Labeling and Education Act of 1990, Pub. L. No. 101-535, 104 Stat. 2353 (8 November 1990). Google Scholar8. National Institute of Standards and Technology. A Guide to U.S. Retail Pricing Laws and Regulations. 27 April 2020. Accessed at www.nist.gov/pml/weights-and-measures/laws-and-regulations/retail-and-unit-pricing-laws on 6 December 2021. Google Scholar9. Kaiser Family Foundation. An Overview of the Medicare Part D Prescription Drug Benefit. 13 October 2021. Accessed at www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-prescription-drug-benefit on 6 December 2021. Google Scholar10. Centers for Medicare & Medicaid Services. Changes to Medicare Advantage and Part D Will Provide Better Coverage, More Access and Improved Transparency for Medicare Beneficiaries. 15 January 2021. Accessed at www.cms.gov/newsroom/press-releases/changes-medicare-advantage-and-part-d-will-provide-better-coverage-more-access-and-improved on 6 December 2021. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of California, Hastings College of the Law, San Francisco, California (R.F.)Brigham and Women's Hospital Psychiatry Department and Harvard Medical School, Boston, Massachusetts (N.F.)Chapman University, School of Pharmacy and Economics Science Institute, Irvine, California (E.S.).Acknowledgment: The authors thank Gideon Schor and Nathan Brown for providing research support.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4755.Corresponding Author: Robin Feldman, JD, University of California, Hastings College of the Law, 200 McAllister Street, San Francisco, CA 94102; e-mail, [email protected]edu.Author Contributions: Conception and design: R. Feldman, N. Feldman.Analysis and interpretation of the data: R. Feldman, E. Seoane-Vazquez.Drafting of the article: R. Feldman, N. Feldman.Critical revision for important intellectual content: R. Feldman, N. Feldman, E. Seoane-Vazquez.Final approval of the article: R. Feldman, N. Feldman, E. Seoane-Vazquez.Collection and assembly of data: R. Feldman, E. Seoane-Vazquez.This article was published at Annals.org on 22 March 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA Proposal to Increase Value and Equity in the Development and Distribution of New Pharmaceuticals June 2022Volume 175, Issue 6Page: 885-887KeywordsDrug informationDrug pricesDrugsInformation technologyMedicarePharmacists ePublished: 22 March 2022 Issue Published: June 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...