What‘s happening with drug pricing is highly complex. It is much more than the price setting by big pharma, much more than the price fixing and access limiting of the highly profitable PBMs(prescription benefit managers) such as insurance company wholly controlled intermediaries like Optum, much greater than the “vertical” mergers of pharmacies and PBMs and so control requires pressures at so many points it is almost hard to imagine success. In Dermatology, where the most extreme exaggerations of drug pricing have occurred, partly because there are so many options to accomplish the same treatment endpoint and partly because the hue and cry of patients is not so great in non-life-threatening circumstances that we have seen the most successful “end arounds.”
Prescribed Solutions is a company that utilizes pure product carefully quantified and without known preservatives or irritants at an extremely well price point allowing dermatologists to sell for a trivial product and make available at the time of appointment, and effective and inexpensive solution. For patients who have Medicare and are subject to the worst of abusive pricing some of which we have calculated at 50 fold increase in three years, this is A gift. For patients who are unable to get prescriptions that are in their best interests but utilize prescriptions that nonetheless work it is also a great gift. The amount of time it takes to prescribe medications, figure out what is on formulary, accept “second-best“ and reply to ever-changing formularies with lengthy, always refused requests for drug coverage it is undoubtedly time saving and in this unprecedented demand on financial resources of practices it is practice saving. At Kline Dermatology we estimated that 1.2 full-time equivalent staff members were required just to manage medications due to the constant changing and rejections of the simplest of medications. This cost of $100,000 annually has been reduced by 80% simply through delivering medications to our patients inexpensively at the time of visit. There is much more to say but for now we have been able to improve the quality of prescribing the timeliness and the cost to our patients.