A doctor inexperienced in drug pricing can cost their patients hundreds of extra dollars, while an equivalent medication is often available for just a few dollars.
Often the only difference between the two medications is the expensive drug is still under patent and backed by a multimillion dollar ad campaign as well as employing a salesforce of attractive drug reps delivering lunches to doctors offices around the country. We don’t get many of these visitors, but recent studies have shown that even small paid expenses by drug companies have a dramatic impact on prescribing habits.
So you start with doctors who frequently have limited knowledge about price differences and then the consumer fails to realize how wildly variable prices can be for the same drug at different pharmacies around their town or city. Considering we consume over 300 Billion dollars in prescriptions per year this can really add up. Take this Consumer Reports example of the recent price of Atorvastatin at Walgreens was $150, while the same medication in the same town was only $17 at Costco.