Drugs and Money…

“Send lawyers, guns, and money” — Warren Zevon

I was with a client today taking him to the food pantry and he showed me a receipt he had for meds and I darn near died!  He gets 800 milligrams of a drug called Seroquel twice a day and he got a months supply. He paid $3.00 co-pay and they actually cost (drum roll, please…) $381.00!!!  And he gets more than one med every month!  So, yes, our government pays $378.00 for one bottle of pills every month.  Times 12, that equals $4536.00 for just him for one med per year. As he used to sell drugs, he informed me that 23 grams equals an ounce and we started figuring…

His drug costs, for a little over 2 ounces =381.00, or  $183.17 per ounce.  We weren’t sure of the price of gold, and I looked it up.  It costs waaayyyy more than Seroquel. But, the silver (yes, the precious metal, silver) is trading at 23.66 per ounce.  So one ounce of my clients’ one med is worth seven ounces of silver!  Oil is trading at about $82. per barrel.  My clients one bottle of pills is worth two barrels of oil, plus some!

Now before people go blaming the government for only giving him a 3.00 co-pay, note that the man is disabled, so he can’t afford more than that. And he can’t not take his meds — they are for mental health purposes and some meds, if you stop them abruptly, cause psychosis. I don’t know if Seroquel is one of them, but that’s not the point.

Here’s the point: a man has a mental illness and he has to buy meds or his   his mental health deteriorates (you wouldn’t like him if that happened, I suspect) and his meds cost the same as 5 ounces of silver or two barrels of crude oil every month. I don’t know what they put in this stuff, but I’ll bet it’s not 5 ounces of silver.  In fact, it probably costs them less than, what?, ten dollars to make?

If 100 clients at my agency use this med (and many do), our government pays $436,000 per year for 100 residents of the town I work in. Nearly a half a million dollars for 1 med for 100 people per year!  Let’s see if I can figure out where our budget money goes… Let’s see… medications!!!

My friends that complained that health insurance reform wasn’t helpful as long as medical costs remained high were vindicated when I found this out.

I knew it, but without his health insurance, my guy doesn’t get his meds! So we’ve sort of solved a problem, but not fixed the actual problem — the problem of greed — simple, straightforward greed.  There is no ethical way that these meds should cost this much . Remember that whole “greatest healthcare system in the world” thing? Here’s another example of “the greatest healthcare system in the world, if you can afford it“, which is the one we’ve got.

Speaking of money and drugs, I’ve long wanted to put this one in print: A bag of heroin — in Hartford, apparently costs $5. In Springfield, I hear that it’s $10. I have met plenty of addicts who use 20 bags per day! That’s $100 to $200 per day that heroin addicts have to come up with every day.  But, if you’re a heroin addict, you don’t have time or energy (or brain cells) to get and keep a job.

So what do they do? They steal. They steal everything from lawn mowers and car parts to credit cards to the family silver. That’s what addicts, with a never ending supply of costs and continually dwindling amounts of income, do. It’s as simple as that.  In addition to the financial cost, there’s the emotional costs — therapy, crime, destruction of property, insurance claims, police hours, illness, death… The list goes on. Agencies involved can range from DSS to the FBI, all because of heroin addicts.

When your average heroin addict goes in to detox, insurance, or the state, or the center pays for only 5 days of medically necessary treatment. Which would be fine, if that’s how long it took to fix.  The problem is that junkies get dopesick (have cravings and a flu-like illness if they don’t use) for a full two weeks.  We treat you for 5 days of a two week illness and we send you home because “it’s cheaper this way”. Since many addicts go to detox 5 to 8 times before they get clean, we create this revolving door where we spend five or eight times more of the amount fixing it.  Plus, all the secondary costs — years of therapy because an addict traumatized someone, hours of police time and money for every break-in, homelessness because mommy-or-daddy addict didn’t pay the rent last month.  The list goes on.

Couldn’t we do it right the first time and save all that money?  Note here that I’m not saying whether the insurance companies or the government should do the paying, but the fact is addiction treatment for heroin is a pay-me-now-or-pay-me-later kind of deal. You can pay once and get it all done or you can pay five times and get it done. It behooves whoever is paying to get it done right the first time. As they say in carpentry, “Measure twice, cut once or Measure once, cut twice”.  We already know how long the symptom of dope-sickness lasts. Why would we set people up to fail.  Is it “because they should know better than to use drugs in the first place”?  Maybe they should, but we pay the price for “teaching them” that lesson.  If we’re going to pay anyway, why not spend it on good things — like treatment, before the fact — rather than on painful things like police and therapists, after the fact? Particularly if we’re going to have to pay for treatment again, on top of it?

So here are two concrete suggestions to help fix our budget:  1) Don’t let drug companies charge outrageous prices for their product and 2) Cure the medical symptoms of heroin addiction all the way before you send people home — give them a fighting chance.

With these two, you could save billions and billions of dollars. Isn’t it worth a shot? (no pun intended : ) )

Peace,

 

John

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4 thoughts on “Drugs and Money…

  1. as an employee at a biotech, I can assure you that creating a drug takes many many years and is very expensive. So when a drug costs an outrageous amount of money, it’s because it costs an outrageous amount of money to create it in the first place. Also, I’m sure the real payer is not paying full price, be it gov’t or insurance companies. They all negotiate lower prices, another reason the “street value” is very high. And drug companies also have a lot of incentives they give to people who can’t afford the meds. A poor analogy but it’s kind of like MSRP on a car – nobody pays that. But all that aside, it would be nice to see an improvement for first-time treatments. And as you know, there are other factors besides the physical addictions – the abuser’s social circle, their desire to get themselves better, their outlook on life, etc.

    Only a little off topic but I know of an older man who was just diagnosed with lung cancer. He tried to stop smoking 15 years ago but his wife would never quit, and thus he was never successful at quitting. Even now, with the big C diagnosis, his wife is still smoking. Seriously? The point is that some people either do not understand or do not care how their actions affect others, and some people do not understand or do not care what damage they may be doing to their own bodies, or of those around them.

    • Derek: Wow. Nice reply. Some good points. There are some economic things I just don’t get, though. I don’t understand why auto dealers would create an MSRP that wasn’t real, or drug companies would have a price like that. I believe you, but I don’t understand it. I know it costs alot to create one, but at some point, is it even viable to put it on the market if no one can really afford it?

      Addicts’ lives are complicated — you’re correct. Still, I’ll have to think about it. Thanks for thinking about it with me.

      Peace,

      John

  2. You forgot one all important part..

    as the song goes..

    it’s LAWYERS, Drugs and Money..

    wait that was Lawyers, Guns and Money.. well you get my drift…

    • Rob: Ever the detail man! I don’t know enough lawyers to say anything, but the song was too fun to leave out!
      Peace, John

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