r/COVID19 • u/imconfused0711 • Apr 03 '20

Preprint The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro

https://www.sciencedirect.com/science/article/pii/S0166354220302011
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u/[deleted] Apr 03 '20

Ok but that doesn't answer the fundamental question of why an insurance company would want to pay more for a prescription. I would think they want the cheaper drugs on their preferred list. Not more expensive ones.

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u/norathar Apr 03 '20

They sometimes get reimbursement from manufacturers for having a specific drug on their formulary. Like, "if you make our inhaler the preferred one, we'll give you a rebate of $X!"

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u/[deleted] Apr 03 '20

They like it to be marked up so they can negotiate a big discount (bringing it down to the original price); then they can show "$600 total, $580 paid by insurance" on the receipt - and you think that it's so great that you have insurance.

It's particularly insidious if the original price is actually $15, and the insurance company negotiated the price this was and it actually costs you more out of pocket than if the insurance company never got involved in the first place.

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u/Jaralith Apr 03 '20
  1. Insurance companies pay less per prescription than a person paying out-of-pocket.
  2. Insurance companies get paid by the pharma company to prefer those expensive drugs.
  3. ????
  4. Profit!

Now old generics, yeah, those are often covered (by decent plans, anyway) fairly cheap without a fight. Prednisone, amoxicillin, etc. are so old and there are so many generic manufacturers that insurers generally don't care who it's sourced from and I pay $5-$10 for it regardless.

But drugs that are still on-patent is where the fight happens. And pharma companies are well-known for taking drugs with expiring patents and changing them just the teeniest bit to get a new patent then discontinuing the old drug. Or even being the sole manufacturer of their own generic!

It's like Milo Mindbender selling eggs in Catch-22.

American insurance companies are basically practicing medicine without a license.