PodMed TT – Walmart vs. Medicare for Prescription Drug Costs

If you’re a Medicare beneficiary on any of a host of generic drugs for common medical conditions like diabetes or high blood pressure, you may be economically better off buying your medications at Walmart than exercising your prescription drug copay.

That’s according to an Annals of Internal Medicine research paper on the cost differential for cardiovascular drugs Rick and I discuss on PodMed TT this week, and we agree, we’re appalled. The study suggests that someone in the pharmacy-benefits management arena is pocketing the difference between what Walmart charges—that’s $4 per 30-day supply for these generic meds— and the often twice or three times that amount charged under Medicare programs. Even more revolting, the less you pay for your prescription drug benefit, the more you are likely to pay for these medicines, and pharmacists are constrained from advising people they’re better off at Walmart! One possible bright light is that legislation to remove that constraint from pharmacists was introduced this week, but for now, clinicians should advise patients that such a strategy may be prudent.

Other topics this week include a case report of recurrent viremia in a woman infected with Ebola in Lancet Infectious Diseases; two blood tests to assess whether folks with traumatic brain injuries in the ED needed a CT scan in Annals of Internal Medicine; and the low rate of prescribing osteoporosis meds for people who’ve had hip fractures in JAMA Open Access.

Until next week, y’all listen up and make healthy choices.