Personal health: Sticker shock at pharmacy

My recent sinus infection came on suddenly and painfully. After diagnosing it, my physician e-prescribed me an antibiotic.


This is tricky territory for me. I’m sensitive to some antibiotics. Years ago, I took a couple of varieties to treat similar infections, and wound up with oral thrush in one case and C. difficile in another. Both were 100 times worse than the original ailment.

My physician knew this history. He prescribed a two-week supply of doxycyline hyclate, a dependable antibiotic that he felt I could tolerate well, partly because I had handled it well in the past.

So I headed to my pharmacy to pick up the “doxy.”

“It’s one seventeen,’’ said the clerk, in an oddly sheepish way.

I pulled a dollar from my wallet and extracted some change from my pants pocket.

She looked at the money and said, “No. It’s a hundred and seventeen dollars.’’

“Whoa,’’ I said. “$117?”

Andy Miller

My regular pharmacist stood nearby. Not many firms manufacture doxycycline, he told me apologetically, so the ones that do “can charge what they want.”

(And I had good health insurance, with typically low co-pays for drugs.)

Then I recalled a story GHN did on the same drug last year. That’s when Fran Beall, a nurse practitioner in Athens, told me she prescribed for a patient a seven-day supply of doxycycline, which had long been generic and inexpensive.

Pharmacists told her it was between $135 and $157, due to a shortage of doxycycline.

Those high prices for doxycycline hyclate stunned Beall, who has been a nurse practitioner for 38 years. She told GHN that for a long time, the drug was easily available and typically cost $4 or $5. In fact, she said, “just a year ago it was even free at the local Publix pharmacy.”

There appears to be a question about the current supply of the drug. The FDA a year ago said the shortage had been resolved.

The Poughkeepsie (N.Y.) Journal this summer, though, reported that the price of doxycycline had skyrocketed.

The FDA said in the article that it continues to hear from manufacturers of doxycycline that the drug is in good supply.

The newspaper reported that U.S. Sen. Charles Schumer (D-N.Y.) had asked the federal agency to encourage pharmaceutical companies to produce more doxycycline, which can be the first line of treatment in Lyme disease cases.

An FDA spokesman added that pricing is outside the agency’s purview, and that it doesn’t have the authority to require manufacturers to lower prices.

Yet the American Society of Health-System Pharmacists lists doxycycline hyclate as a shortage drug.

“Off and on, [doxycycline] has been a problem,’’ said ASHP spokesman Joseph Hill on Thursday. He added that more supplies were expected by the end of the year or the first quarter of 2015.

Back to my sinus infection. The bottom line is that I didn’t want to risk complications from other antibiotics, so I paid the $117. I could handle it, even if I was not happy about it.

But it makes me wonder how people who live month to month financially can deal with such prices, for drugs or other medical treatments.

Some perspective: It could be worse.

There’s the breakthrough hepatitis C drug, at $84,000 a treatment cycle. While the manufacturer is thriving, what’s happening to the health costs of the employer, the insurer – and the hepatitis C patient?

By comparison, $117 seems like chump change.