14 June 2020

    I have a long list of television commercials that I despise, but here’s a summary of what I think may be the most despicable: A woman, obviously distraught, holding on to a little child (we suspect the child badly needs medicine, but it might be the woman), rushes in to a drug store. She asks for a prescription. The druggist rings up the sale: $60. Clearly, the woman can’t pay $60, and sadly turns to walk away. The druggist calls after her to wait, pulls out her trusty smart phone, and shows the woman that she can get the same drug for under $10. The woman is ecstatic, pays the lower price, and walks away with her prescription. Thanks to the druggist’s “app,” she (or her child) may live another month.

   Since this commercial aired, a couple of other prescription “apps” have shown up. In the new ads, the customers are generally savvier than the poor lady in the original. They just whip out their phones, show the druggist a list of ten different prices for the same prescription, and say “give me that one.” The druggist smiles (or maybe it’s a grimace), says “cool,” and fills their order. Everybody is happy.

   In the original commercial, I was amazed that the druggist was going to charge the full price of the name-brand pills when she knew that there were generics available. Generics are not knock-off drugs of lower quality than the original; they are identical formulations. (Originators of a drug are able by law to charge exorbitant prices for a few years, then the product becomes available on the open market.) I’ve never had a druggist who didn’t tell me when a generic was available; it seems unethical to hold back that information, particularly when the difference in cost is extreme, as in the commercial (something like $60 versus $6, as I recall).

   Leaving out the high cost of the original, why does the “app” show a half-dozen or so different prices for the generic, with as much as $10 difference in price? If that looks okay to you, then your explanation is that it’s the “American way” to barter for the best price available for anything we want. It’s true; healthcare – to our shame – has long been treated as a commodity in the United States, something to sell for whatever the market will allow. But in dismissing the extra effort needed to “research” the price of a necessary – maybe, vital – drug, we forget that prescriptions are perhaps most important to two classes of people: (1) oldsters like me who didn’t grow up with “apps” on the internet (and, remember, the Computer Age didn’t begin for most people until the late 1990s), and who may get flustered by operations that are old-hat to 21st century folks; and (2) people with young children, who want the best for their kids, but have too many immediate worries and too much in general on their plate to “shop around” for something that may be vital.

   Going into a drugstore these days reminds of how – before “apps” on the internet – it used to be to buy a car. You went to a show room, where you were taken in hand by a salesperson who worked strictly on commission – meaning no pay unless a car deal was closed. You started with the asking price of the car, and offered a lower figure. The salesperson excused himself or herself to go “talk to the boss” about it. Back from “the boss,” you found that they couldn’t meet your price, but instead they could do something in the middle. You might haggle back and forth for a while, until you reached some kind of agreement. It was undoubtedly less than the original price quote – which was good – but it was hard to walk away without feeling that you probably could have done better. You got the car, but you’re pretty sure you got screwed, as well.

   It doesn’t seem like it should feel that way in the pharmacy.




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