Cost disparity

Prescribed problem

Something’s critically ill with a medical system that allows America’s most popular prescription medications to cost her citizens many times more than just across the Canadian border, as well as other industrialized nations.

The Medical Letter, a subscriber-funded nonprofit organization that publishes comparative reviews and appraisals of new prescription drugs, last month revealed eye-popping comparisons between monthly drug costs in the U.S. and Canada. Here’s a smattering of its findings that cry out for serious reform.

Prevacid, widely prescribed for digestive issues, costs $415 in our country versus $63 in Canada.

An “Epipen auto injector” runs U.S. patients $688, but $188 in Canada.

The drug Humira, for treating Crohn’s disease, runs $4,441 in America versus $1,624 in Canada.

Advair for COPD, asthma and bronchitis: U.S. $361 to Canada”s $105.

Finally, the U.S. cost for the blood thinner Eliquis is $388. Canada’s price is $101.

Those are but a few examples of the outrageous differences these two bordering nations charge for exactly the same drugs.

The Medical Letter explained the discrepancy by saying the governments of most industrialized nations regulate their drug prices. That’s where “centralized advisory boards determine the clinical efficacy and cost-effectiveness of a drug. Prices are based in part on … comparison of drug prices in several countries to determine a reference price … . ”

That means fewer payers are involved and in such countries there is only a single public payer. Translation: The government.

The Medical Letter further explains that drug pricing in the U.S. is complicated by multiple factors, including list prices that don’t reflect what is actually paid for a drug, along with the number of middlemen involved in getting a drug from the manufacturer to the suppliers and pharmacies.

All self-serving, pharmaceutical industry-lobbying politics aside, I agree with my friend, the venerable veteran country physician Dr. Tom Whiting of Clifty. This humanitarian (if there ever was one) tells me he’s constantly searching to prescribe the most effective and least expensive drug possible for his patients. “We must find the way to be fair to our patients who need these medications,” he said.

My tuna is ‘meat’

No one at Wal-Mart corporate has sought my advice as a public consultant. It’s understandable since I’m but a frequent customer rather than a business strategist or secret shopper. Yet I might become one if they expressed interest.

Asked how to improve the popular supercenter in my hometown, first thing I’d do is place every grocery item in the aisle compatible with common sense.

I recently wandered the aisles in search of a can of tuna. I finally spotted the little sign that read Canned Meats. But after searching shelves from top to bottom, there was nary a can to be had.

Little did I realize at the time of the debate that surrounds the question of whether tuna is actually considered meat. I only knew it surely seemed like meat to me, even down to the tuna “steaks” offered in meat markets and grocery stores.

So my search continued. I asked the friendly clerk busily stocking another shelf where I might find tuna rather than in canned meats. She pointed me to “the next aisle over,” and returned to her work. After dodging and maneuvering up then down that next aisle over, well, you guessed it, no tuna. Finally, a few minutes later I discovered another little sign designating “seafood” about halfway down another aisle cluttered by carts and shoppers with expressions as dazed as mine.

There I discovered a virtual sea of fish meat, including tuna in oil, tuna in water, albacore tuna, ranch and dill tuna. You name the type of tuna and it was there.

Were this my store to arrange, and I could place canned meat wherever I pleased within reason, I’d offer it in the aisle across from all other types of meat we consume. In that way, all a shopper in my imaginary Mikey-Mart would have to do is turn around and face meat from the ocean.

It makes sense to me, anyway. Next, I’d post notices that encourage shoppers with their metal carts and electrically motorized bumper cars to please stay to the right side in each aisle, thereby leaving the middle open for those trying our darnedest to pass through. Surely a few such notices would be well-received by all the courteous Wal-Mart shoppers. Well, you’re right. It does sound pretty hopeless now that I see it in writing.

The congestion problem we’ve all come to anticipate within the crowded aisles of our favorite Wal-Mart has reached critical mass virtually everywhere. Armies of clerks in their blue vests restocking shelves during busy shopping hours help ensure frustration remains at peak levels.

Experiencing this firsthand, I’d do something radical and return to restocking store shelves in the wee hours of darkness. Yeah, I know, the folks in Bentonville must have some focus-group-tested, cost-effective method to the madness created by continually restocking in conflict with their customers. Still, I’d advocate a return to a less-hectic restocking era where some semblance of peace and order prevailed.