Understanding the Hidden Cost of Medications

Why no patient needs a prescription for Epiduo


Medications are approved by the FDA without any consideration of cost. The FDA looks at efficacy and safety. So, when convenient medications come along, it’s tempting to say “I’ll take that, it’s so much easier to take/use!” But at what price is convenience worth it?

Epiduo is a great example of one of these combination drugs. It is a combination of adapalene 0.1% and 2.5% benzoyl peroxide. While on average, Epiduo costs about $438 for a month supply, both of its ingredients can be purchased separately over-the-counter as Differin Gel (under $12 for a one month supply) and Benzoyl Peroxide 2.5% (for less than $10 for a one month supply). Is one product versus two worth an additional $400 per month? And guess what? The drug company which makes Epiduo anticipated that, so they came out with a new formulation EpiDuo Forte, which has 0.3% adapalene.  Fortunately, most patients don’t need the higher concentration of adapalene (which also causes more stinging, drying and sun sensitivity.)

You may be saying to yourself, “over-the-counter products cost me money, but my copay is less.” While you may not directly feel the difference on a monthly basis, we are all paying for this increased cost in the end. Have your insurance premiums gone up year after year more than 10%? Part of the reason is overall cost of care, which includes the money your insurance and/or employer are paying for all of the medications used by all members of your plan.

You may be asking about those coupons your doctor can give you so that you pay next to nothing. Someone is paying the cost of the medication; the drug company is not giving it away for free. This also drives up insurance premiums and costs us all more. More commentary on coupons is available here and here.

For another great example of an unnecessarily expensive combination drug, read more about Vimovo. Alleve + Nexium costs about $40. Alleve/Nexium in a single pill = Vimovo, costs $3,252.

Let’s all be “good stewards of the healthcare dollar” and each do our part to keep rising healthcare costs down. Your dermatologist may not know the pricing of medications. Many times, doctors don’t know how much a medication costs or how much out of pocket expense it will be for you. Let’s work together to pick the right medications for the right reasons and keep cost in mind. So please don’t call and ask us for Epiduo. And if we prescribe a medication that is going to cost you a lot of money, ask your pharmacist if your plan has better coverage for a different medication in the same class and we will work with the pharmacist to change medications when it’s medically appropriate.

A few things you can do to help: know how to access the formulary for your plan and share it with us when we write medications so we can be smart from the start. You should also shop around for the best deal available. Two great websites to use for comparing medications include GoodRx and OneRx. Spend your healthcare dollars as if it’s your own money, because in the end, it is.

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