A physician colleague's insurance will not cover her anti-nausea medicine (Zofran/ondansetron) for her CHEMO. It is $280.40 cash for 30 pills at Walgreen's. I logged into a physician/hospital medical supply company and can buy 30 pills for $3.30. That's an 8500% markup. 1/
It is easy to be angry at the insurance company bc Zofran is a well-known therapy for chemo-induced nausea and it should absolutely be covered. However, I'm sure Walgreen's buys in bulk and gets it for even less than $3.30. Add in labor, plastic bottle and charge $25. 2/
Retail pharmacies make an absolute killing, especially on cash-pay patients. Some pharmacies will offer a cash discount. However, in some states, pharmacists are not allowed to tell patients if the cash price is lower than their insurance co-pay. This is absolutely criminal. 3/
Medicaid negotiates with drug companies. For example, if you had asthma prior to 2016, Medicaid would cover brand-name Xopenex inhalers but not generic albuterol. So, we would have to write prescriptions for an expensive drug the patient didn't need so it would be free. 4/
How are emergency room physicians supposed to remember what drugs are on Medicaid's formulary, let alone all of private insurance? But how frustrating to be a patient and take in a prescription your doctor thinks you need only to find out it isn't affordable. 5/