The “bargain” of mail-order drugs

Mail-order drugs were supposed to save employers and patients money by providing drugs at a much lower price than those old-fashioned brick-and-mortar pharmacies.

Ha, we say. Ha.

It turns out, reports the Wall Street Journal, that mail-order pharmacies — many of which are owned by PBMs, sometimes charge a lot more. We’re talking 35 times more, based on a study commissioned by the good folks at the Washington State Pharmacy Association.

Branded drugs filled by mail were marked up on average three to six times higher than the cost of medicines dispensed by chain and grocery-store pharmacies, and roughly 35 times higher than those filled by independent pharmacies, according to the analysis, which looked at 2.4 million claims by self-insured employers in Washington state from 2020 to 2023.

What do the PBMs say? “Companies’ home-delivery programs save employers on prescription drugs and their convenience helps ensure patients take their medicines,” according to the article, despite the fact that the data proved the opposite.

Oh, and those 2.4 million claims that were analyzed? The PBMs say that was cherry-picked data. Seems like them’s a lot of cherries.

What if we redefined “shortage”?

Medical doctor and Forbes contributor Robert Pearl has an idea for cutting the price of GLP-1 drugs, which he says are “Overpriced By 400-500%” in the U.S.:

Americans pay over $1,300 for a 28-day supply of Wegovy while patients pay far less in countries like Denmark ($186), Germany ($137) and the UK ($92).

That idea: Amend the Food, Drug, and Cosmetic Act to expand the definition of “in shortage” to take into account a drug’s affordability. If a drug is not affordable, he argues, putting it in the shortage category would allow compounding pharmacies to produce it at a reasonable price. In fact, he says, telehealth company Hims & Hers sells compounded semaglutide for $199 per month right now.

“Once market competition brings the price of these drugs under $200 a month (as it is in other nations),” he says, “the ban on compounded production could be reinstated.”

We’re not agreeing or disagreeing with him, but it’s certainly food for thought.

Speaking of compounded semaglutide

Back in May we poked fun at Axios being excited about the stock price of Hims and Hers when the companies started selling compounded semaglutide for a lot less than the brand-name version.

The problem is that it’s not clear what will happen when semaglutide comes out of shortage. Will compounded versions still be allowed? It seems the Wall Street Journal just realized that’s an issue. Aside from being late, though, it’s an excellent piece, especially in how it covers the nuances of compounding.

A ketamine pill?

Ketamine for depression seems to have a lot going for it, but there’s at least one problem: Injections and nasal sprays “can leave people feeling spaced out, sedated, and increases their blood pressure.” That’s how researchers in New Zealand put it, and they set out to find an alternative. What they came up with was an extended-release tablet that — after testing it on 168 adults — they say “showed significant improvement in depressive symptoms.”

“Because most doses of this tablet formulation can be taken at home, this is potentially a much cheaper and convenient option for these patients compared with weekly clinic visits for ketamine injections or nasal sprays.”

CBD and pregnancy

CBD can treat help deal with a bunch of symptoms, and it’s generally considered safe (although opinions are mixed on how effective it is).

But what about for pregnant women? French researchers were curious if CBD might affect the kids of moms who used it. So they tested it on mice, injecting them a low dose of CBD for about two-thirds of their pregnancy.

The kids … well, the kids were different. That’s the scary-sounding result — in fact, the article is titled, “CBD use during pregnancy produces strange behavior in offspring .” But it’s not like the mice are listening to dubstep or watching Canadian football. There were changes to their insular cortexes, though:

“CBD-exposed females tended to move around their new environment more compared to females that didn’t receive CBD during gestation. Furthermore, compared to control mice, both male and female mice treated with CBD established more physical contacts with each other.”

So it’s not bad behavior, it’s just different. What’s the takeaway? Say it with me: More research is needed.

ICYMI: Gesundheit

The next time you sneeze, take a note of how many people say, “Bless you.” Then count your blessings. You could be like the man who eviscerated his bowels after a forceful sneeze.

Fear not: “The man was rushed to hospital for emergency surgery where his bowels were returned to his abdomen.”

(Yes, yes, he was recovering from abdominal surgery. But he still blew out his bowels by sneezing.)

Elsewhere: The Finnish start

Finland is about to become the first country to vaccinate some people against the H5N1 bird flu. Not everyone — just people at risk because they’re exposed to animals, specifically the country’s fur farms. The Finns purchased about 10,000 doses, some to be offered immediately and some to be on hand in case a human case pops up.