The High Cost of Cheap Medicare Prescription Drugs

There’s a lot of talk in Washington DC about what will happen with Medicare. Many elderly people rely on Medicare to pay for their health care needs.

Lots of lobbying groups are pressuring the government:

“More than 100 diverse groups representing providers, health plans, community organizations and more are urging President Donald Trump and his administration to protect and strengthen Medicare Advantage for seniors, in a new letter submitted Thursday to the Centers for Medicare & Medicaid Services.”

Of course ‘protect and strengthen’ usually means one thing. They are calling for the government to spend more money on Medicare.

Up until the Trump administration, it seemed like that’s what politicians would do. The same thing politicians always do. Things may be changing now. Regardless of your political affiliation, I think we can all agree that President Trump, mostly through Elon Musk, is going through a lot of government departments and looking for waste.

Your opinion of ‘waste’ may differ from Elon’s. I’m not here to judge.

One of my definitions of waste is spending way too much for an item compared to what other people are spending.

The military is well known for doing so.

Medicare just doesn’t publicize that they do it as much.

Check this video out from an independent pharmacist:

He talks about a medication called dimethyl fumerate. It is a prescription medication for adults with multiple sclerosis.

Medicare pays $3,800/prescription for it. He charges customers $65/prescription on a cash pay basis.

Medicare paid for 155,000 prescriptions last year for a total cost of $590 million. If Medicare had bought all those prescriptions from his pharmacy, the total would have been $10 million total.

Seems like a wast of $580 million. ON ONE DRUG!

He has a lot of other videos with examples of these drugs on his YouTube channel.

So I looked up which drugs receive the most Medicare dollars. The most recent data I could find was from 2021:

Here’s what the top 5 drugs treat:

• Eliquis - a blood thinner used to avoid blood clots after surgery or for people with atrial fibrillation

• Revlimid - slows cancer growth and block blood vessel growth in tumors

• Xarelto - Also used to prevent blood clots

• Trulicity - Helps lower blood sugar in Type 2 diabetics

• Januvia - Helps lower blood sugar for Type 2 diabetes as well

Even the 6th highest drug, Jardiance, is for Type 2 diabetes. And I’m sure Ozempic has probably made a run to move into a higher spot between 2021 and now. Officially Ozempic is for diabetes.

Atrial fibrillation, cancer, and blood clotting risks increase due to insulin resistance. And of course diabetes and insulin resistance go hand in hand.

During my years in manufacturing companies we were always told to look for the root cause in problems.

I don’t think the root cause is just poor negotiation skills by the government. Imagine how much money we could save (not to mention lives saved) if we focused more on insulin resistance and less on making drug companies wealthy.