Skip to Main Content

Filling Prescriptions: Why Can't I Just Buy Online?

Filling Prescriptions: Why Can't I Just Buy Online?

Video Information

Filling Prescriptions: Why Can't I Just Buy Online?

Dr. Tuckson speaks with David Figg, CEO of Rice's Pharmacy in Beaver Dam, Kentucky.
S15 E18 Length 26:46 Premiere: 3.15.20

Examining the Issue of Rising Prescription Drug Prices

Below are key takeaways from an episode of Kentucky Health focusing on the prescription drug market. Host Dr. Wayne Tuckson welcomed David Figg, CEO of Rice’s Pharmacy in Beaver Dam, Ky., to discuss the costs of prescription drugs and changes in how pharmacies market and sell them.

Navigating Through a Complicated System

“If you think about it, the typical patient, even the typical high-risk patient, will see their primary care provider three and a half times per year – but they will see their pharmacist 33 times per year,” says Figg, whose Rice’s Pharmacy in Beaver Dam in western Kentucky is a small-town business with a mission to serve its community and region.

Many pharmacies are increasingly becoming more involved in attending to their patients’ overall health needs, and Figg says that Rice’s works with several drug manufacturers to help administer labs for patients and also create long-term medication schedules. His pharmacy also tries to help patients who cannot afford their medications, but Figg says that resources to do so are limited.

Most of the patients at Rice’s Pharmacy are elderly folks living in and around Beaver Dam, Figg says, and many of them struggle to pay for their medications. “I had one patient the other day called in crying, can’t afford her medication, lives on a fixed income and gets $1,500 per month, and her drug spend is about $1,000 a month,” he says. “It breaks my heart.”

Figg says that over the years, despite many policy attempts at reform including the Medicare prescription drug act of 2003 and the Affordable Care Act of 2011, customers in America have seen the cost of prescription medications continue to rise. He places a lot of the responsibility for spiraling costs on a business model that has an extra agent on the purchasing side – an insurance company that pays for most of the price of a medication.

“In pharmacy, the oddity is that the one placing the order is still a third person,” he explains. “Doctor writes the prescription, consumer takes the prescription, but then there’s a third party that’s the payer and that’s the insurance company.”

Insurance co-pays exist because of this three-tier system, Figg says. A patient pays a certain percentage of a prescription drug cost, and the insurance company pays the remainder. As a result, the true price of the drug is hidden from the consumer (patient). Coupons offered by drug companies that give a further discount only distort the true cost of a drug, he adds.

“This is an unsustainable system, this broken three-tier system that we have going on…and we’re starting to see the problems with that today,” Figg says. “We see inflating drug costs over and over, it’s a topic all the time.”

Drug companies often argue that high costs of a brand name drug are necessary to fund research and development. But Figg counters that much of the current high prices are for generic drugs, where R&D is not required. He says that once a drug company loses its patent for a particular drug, and generic manufacturers can then produce the same medication, ideally the cost for that drug would decrease. But he notes that many drugs that are now labeled generic are still priced very high.

Furthermore, many drugs, such as the insulin prescribed for diabetes, have been modified by companies through the years, enabling them to maintain control over pricing. “It’s minor differences or a new dosage form, and that’s the new brand name that everybody needs,” he says. “You see those all the time, and (the companies) do a good job at marketing, obviously the marketing is working.”

How Pharmacy Benefit Managers Inflate Drug Costs

Insurance companies may be responsible for paying most medication costs for patients, as noted above, but Figg says that they actually contract that service out to what are known as pharmacy benefit managers (PBMs). The PBM works as a middleman between the insurance company and the pharmacy, and many critics of the U.S. drug marketplace model identify them as prime culprits in elevating drug prices.

According to Figg, recent studies have shown that “there’s a spread in prices” due to this PBM arrangement. “They charge the insurance company or the payer at one rate – at a higher rate – and they reimburse the pharmacy at a lower rate, showing the spread,” he explains. This occurs even within a government-run model such as the state Medicaid program, Figg adds.

Figg says that there is very little negotiation between pharmacies and PBMs in terms of setting reimbursement rates, and adds that many PBMs own pharmacies as well. “Not only are they dictating how much the community pharmacy is going to get paid, but they’re also dictating how much the patient is going to pay in those pharmacies,” he says. “So that seems to be a bit of a conflict of interest there.”

The current prescription medication market harms many patients, both financially and in leading to poorer health outcomes, Figg says, and landmark legislation enacted in 2003 in 2010 did not stabilize prices. The Medicare Prescription Drug, Improvement, and Modernization Act passed by Congress during the President George W. Bush Administration did increase drug coverage for seniors under what is termed Medicare Part D, but it left a “donut hole” in coverage that kicks in after certain point and can lead to high out-of-pocket costs for a patient if they are on several medications during the course of a year.

Furthermore, the 2003 act did not grant Medicare the authority to negotiate drug prices for its millions of recipients. “This was a highly debated solution when the Part D plan passed,” Figg says. “It was probably the most contentious part. And unfortunately we settled where we are.”

The Affordable Care Act, passed by Congress in 2010 during the President Barack Obama Administration and put into effect over a span of time from 2010 through 2014, did not achieve consistent and stable drug costs in the current North American market either. Attempting to find more affordable options, in recent years many patients have taken it upon themselves to seek out and order medications from other countries via the internet or even driving across the border to Canada.

Figg acknowledges that patients are frustrated with the current domestic drug market but says that obtaining medications from abroad is risky. “I know the steps that the FDA goes through and I know the stringent requirements. I would certainly, if it were my health, want to lean on that,” he cautions. “Any time you’re going out of the country, you’ve just eliminated that. There’s no telling what you’re taking.

“I don’t know how we get out of it, but we’ve got to bring the cost of drugs down,” Figg concludes. “We’ve got to look at all options. If it’s at the pharma level, we’ve got to look at what are our alternatives, whether it be negotiating at the government level, I don’t know. But we’ve got to start looking at it, and taking serious looks at it.”

Program Details

Kentucky Health

About Kentucky Health

Learn how to improve your health through education and increased awareness. Dr. Wayne Tuckson, a colorectal surgeon in Louisville, hosts.

TV Schedules

Jump to Recent Airdates

Upcoming

Microclinic: Simple Solutions for Complex Problems (Part 2) - S15 E13

Dr. Tuckson speaks with Leigh Ann Baker, Bell County facilitator for Microclinic International.

  • Monday August 3, 2020 2:00 pm ET on KET2
  • Monday August 3, 2020 1:00 pm CT on KET2
  • Friday August 7, 2020 1:30 pm ET on KETKY
  • Friday August 7, 2020 12:30 pm CT on KETKY
  • Friday August 7, 2020 6:00 pm ET on KET
  • Friday August 7, 2020 5:00 pm CT on KET
  • Friday August 7, 2020 11:30 pm ET on KET
  • Friday August 7, 2020 10:30 pm CT on KET
  • Sunday August 9, 2020 12:30 am ET on KETKY
  • Saturday August 8, 2020 11:30 pm CT on KETKY
  • Sunday August 9, 2020 7:00 am ET on KET2
  • Sunday August 9, 2020 6:00 am CT on KET2
  • Sunday August 9, 2020 9:00 am ET on KETKY
  • Sunday August 9, 2020 8:00 am CT on KETKY

Rehabilitation: Getting Back to the New Normal - S15 E14

Dr. Tuckson speaks with Dr. Lewis Hargett, a physical medicine and rehabilitation specialist.

  • Sunday August 9, 2020 12:30 pm ET on KET
  • Sunday August 9, 2020 11:30 am CT on KET
  • Sunday August 9, 2020 5:30 pm ET on KETKY
  • Sunday August 9, 2020 4:30 pm CT on KETKY
  • Monday August 10, 2020 2:00 pm ET on KET2
  • Monday August 10, 2020 1:00 pm CT on KET2
  • Friday August 14, 2020 1:30 pm ET on KETKY
  • Friday August 14, 2020 12:30 pm CT on KETKY
  • Friday August 14, 2020 6:00 pm ET on KET
  • Friday August 14, 2020 5:00 pm CT on KET
  • Sunday August 16, 2020 12:30 am ET on KETKY
  • Saturday August 15, 2020 11:30 pm CT on KETKY
  • Sunday August 16, 2020 7:00 am ET on KET2
  • Sunday August 16, 2020 6:00 am CT on KET2
  • Sunday August 16, 2020 9:00 am ET on KETKY
  • Sunday August 16, 2020 8:00 am CT on KETKY

Pediatric Anesthesia: Making Surgery Easier for Kids and Docs - S15 E15

Dr. Tuckson's guest is anesthesiologist Dr. Kapauner Lewis.

  • Sunday August 16, 2020 12:30 pm ET on KET
  • Sunday August 16, 2020 11:30 am CT on KET
  • Sunday August 16, 2020 5:30 pm ET on KETKY
  • Sunday August 16, 2020 4:30 pm CT on KETKY
  • Monday August 17, 2020 2:00 pm ET on KET2
  • Monday August 17, 2020 1:00 pm CT on KET2
  • Friday August 21, 2020 1:30 pm ET on KETKY
  • Friday August 21, 2020 12:30 pm CT on KETKY
  • Friday August 21, 2020 6:00 pm ET on KET
  • Friday August 21, 2020 5:00 pm CT on KET
  • Sunday August 23, 2020 12:30 am ET on KETKY
  • Saturday August 22, 2020 11:30 pm CT on KETKY
  • Sunday August 23, 2020 7:00 am ET on KET2
  • Sunday August 23, 2020 6:00 am CT on KET2
  • Sunday August 23, 2020 9:00 am ET on KETKY
  • Sunday August 23, 2020 8:00 am CT on KETKY

Rural Health Care Practices: It's More Than Just a Doc-in-a-Box - S15 E16

Dr. Tuckson speaks with Barry Martin, chief executive officer, and Dr. John Jones, DO, chief medical officer, of Primary Care Centers of Eastern Kentucky (PCCEK).

  • Sunday August 23, 2020 12:30 pm ET on KET
  • Sunday August 23, 2020 11:30 am CT on KET
  • Sunday August 23, 2020 5:30 pm ET on KETKY
  • Sunday August 23, 2020 4:30 pm CT on KETKY
  • Monday August 24, 2020 2:00 pm ET on KET2
  • Monday August 24, 2020 1:00 pm CT on KET2
  • Friday August 28, 2020 1:30 pm ET on KETKY
  • Friday August 28, 2020 12:30 pm CT on KETKY
  • Friday August 28, 2020 6:00 pm ET on KET
  • Friday August 28, 2020 5:00 pm CT on KET
  • Friday August 28, 2020 11:30 pm ET on KET
  • Friday August 28, 2020 10:30 pm CT on KET
  • Sunday August 30, 2020 12:30 am ET on KETKY
  • Saturday August 29, 2020 11:30 pm CT on KETKY
  • Sunday August 30, 2020 9:00 am ET on KETKY
  • Sunday August 30, 2020 8:00 am CT on KETKY

Taking Care of Patients with Intellectual and Developmental Disabilities - S15 E17

Guests are Dr. Henry Hood, DMD, chief clinical officer, and Dr. Matt Holder, MD, MBA, chief executive officer of Lee Specialty Clinic.

  • Sunday August 30, 2020 5:30 pm ET on KETKY
  • Sunday August 30, 2020 4:30 pm CT on KETKY
  • Monday August 31, 2020 2:00 pm ET on KET2
  • Monday August 31, 2020 1:00 pm CT on KET2
Jump to Upcoming Airdates

Recent

Microclinic: Simple Solutions for Complex Problems (Part 2) - S15 E13

  • Sunday August 2, 2020 5:30 pm ET on KETKY
  • Sunday August 2, 2020 4:30 pm CT on KETKY
  • Sunday August 2, 2020 12:30 pm ET on KET
  • Sunday August 2, 2020 11:30 am CT on KET

Microclinic: Simple Solutions for Complex Problems (Part 1) - S15 E12

  • Sunday August 2, 2020 9:00 am ET on KETKY
  • Sunday August 2, 2020 8:00 am CT on KETKY
  • Sunday August 2, 2020 7:00 am ET on KET2
  • Sunday August 2, 2020 6:00 am CT on KET2
  • Sunday August 2, 2020 12:30 am ET on KETKY
  • Saturday August 1, 2020 11:30 pm CT on KETKY
  • Friday July 31, 2020 11:30 pm ET on KET
  • Friday July 31, 2020 10:30 pm CT on KET
  • Friday July 31, 2020 6:00 pm ET on KET
  • Friday July 31, 2020 5:00 pm CT on KET
  • Friday July 31, 2020 1:30 pm ET on KETKY
  • Friday July 31, 2020 12:30 pm CT on KETKY
  • Monday July 27, 2020 2:00 pm ET on KET2
  • Monday July 27, 2020 1:00 pm CT on KET2
  • Sunday July 26, 2020 5:30 pm ET on KETKY
  • Sunday July 26, 2020 4:30 pm CT on KETKY

Changing Curriculum to Meet Unique Patient Needs - S15 E11

  • Sunday July 26, 2020 9:00 am ET on KETKY
  • Sunday July 26, 2020 8:00 am CT on KETKY
  • Sunday July 26, 2020 7:00 am ET on KET2
  • Sunday July 26, 2020 6:00 am CT on KET2
  • Sunday July 26, 2020 12:30 am ET on KETKY
  • Saturday July 25, 2020 11:30 pm CT on KETKY
  • Friday July 24, 2020 11:30 pm ET on KET
  • Friday July 24, 2020 10:30 pm CT on KET
  • Friday July 24, 2020 6:00 pm ET on KET
  • Friday July 24, 2020 5:00 pm CT on KET
  • Friday July 24, 2020 1:30 pm ET on KETKY
  • Friday July 24, 2020 12:30 pm CT on KETKY
  • Monday July 20, 2020 2:00 pm ET on KET2
  • Monday July 20, 2020 1:00 pm CT on KET2
  • Sunday July 19, 2020 5:30 pm ET on KETKY
  • Sunday July 19, 2020 4:30 pm CT on KETKY
  • Sunday July 19, 2020 12:30 pm ET on KET
  • Sunday July 19, 2020 11:30 am CT on KET

Colon Cancer: Can We Prevent Unnecessary Deaths? - S15 E10

  • Sunday July 19, 2020 9:00 am ET on KETKY
  • Sunday July 19, 2020 8:00 am CT on KETKY
  • Sunday July 19, 2020 7:00 am ET on KET2
  • Sunday July 19, 2020 6:00 am CT on KET2
  • Sunday July 19, 2020 12:30 am ET on KETKY
  • Saturday July 18, 2020 11:30 pm CT on KETKY
  • Friday July 17, 2020 6:00 pm ET on KET
  • Friday July 17, 2020 5:00 pm CT on KET
  • Friday July 17, 2020 1:30 pm ET on KETKY
  • Friday July 17, 2020 12:30 pm CT on KETKY
  • Monday July 13, 2020 2:00 pm ET on KET2
  • Monday July 13, 2020 1:00 pm CT on KET2
  • Sunday July 12, 2020 5:30 pm ET on KETKY
  • Sunday July 12, 2020 4:30 pm CT on KETKY
  • Sunday July 12, 2020 12:30 pm ET on KET
  • Sunday July 12, 2020 11:30 am CT on KET

Infections and Other Urinary Tract Problems - S15 E9

  • Sunday July 12, 2020 9:00 am ET on KETKY
  • Sunday July 12, 2020 8:00 am CT on KETKY
  • Sunday July 12, 2020 7:00 am ET on KET2
  • Sunday July 12, 2020 6:00 am CT on KET2
  • Sunday July 12, 2020 12:30 am ET on KETKY
  • Saturday July 11, 2020 11:30 pm CT on KETKY
  • Friday July 10, 2020 11:30 pm ET on KET
  • Friday July 10, 2020 10:30 pm CT on KET
  • Friday July 10, 2020 6:00 pm ET on KET
  • Friday July 10, 2020 5:00 pm CT on KET
  • Friday July 10, 2020 1:30 pm ET on KETKY
  • Friday July 10, 2020 12:30 pm CT on KETKY
  • Monday July 6, 2020 2:00 pm ET on KET2
  • Monday July 6, 2020 1:00 pm CT on KET2
  • Sunday July 5, 2020 5:30 pm ET on KETKY
  • Sunday July 5, 2020 4:30 pm CT on KETKY
  • Sunday July 5, 2020 12:30 pm ET on KET
  • Sunday July 5, 2020 11:30 am CT on KET

Health Insurance for All: What Does It Mean? - S15 E8

  • Sunday July 5, 2020 9:00 am ET on KETKY
  • Sunday July 5, 2020 8:00 am CT on KETKY
  • Sunday July 5, 2020 7:00 am ET on KET2
  • Sunday July 5, 2020 6:00 am CT on KET2
  • Sunday July 5, 2020 12:30 am ET on KETKY
  • Saturday July 4, 2020 11:30 pm CT on KETKY
  • Friday July 3, 2020 11:30 pm ET on KET
  • Friday July 3, 2020 10:30 pm CT on KET
  • Friday July 3, 2020 6:00 pm ET on KET
  • Friday July 3, 2020 5:00 pm CT on KET
  • Friday July 3, 2020 1:30 pm ET on KETKY
  • Friday July 3, 2020 12:30 pm CT on KETKY
Top

Season 15

Catching My Breath: Lung Diseases and Their Causes

S15 E24 Length 27:25 Premiere Date 5.24.20

Pain Management and Treatment of Addiction

S15 E23 Length 26:55 Premiere Date 5.17.20

Intestinal Microbiome: Care and Feeding for Your Health

S15 E21 Length 25:51 Premiere Date 5.3.20

Health Care Networks

S15 E20 Length 27:11 Premiere Date 3.29.20

Diabetes: It's More Than Just Sugar

S15 E19 Length 26:56 Premiere Date 3.22.20

Filling Prescriptions: Why Can't I Just Buy Online?

S15 E18 Length 26:46 Premiere Date 3.15.20

Caring for Patients with Developmental Disabilities

S15 E17 Length 27:03 Premiere Date 2.23.20

Rural Health Care Practices: Serving a Region In Need

S15 E16 Length 28:46 Premiere Date 2.15.20

Pediatric Anesthesia: Making Surgery Easier for Kids

S15 E15 Length 26:54 Premiere Date 2.9.20

Rehabilitation: Getting Back to the New Normal

S15 E14 Length 27:26 Premiere Date 2.2.20

Microclinic: Simple Solutions for Complex Problems, Part 2

S15 E13 Length 27:35 Premiere Date 1.26.20

Microclinic: Simple Solutions for Complex Problems, Part 1

S15 E12 Length 27:26 Premiere Date 1.19.20

Changing Curriculum to Meet Unique Patient Needs

S15 E11 Length 27:14 Premiere Date 1.12.20

Colon Cancer: Can We Prevent Unnecessary Deaths?

S15 E10 Length 26:56 Premiere Date 1.5.20

Infections and Other Urinary Tract Problems

S15 E9 Length 27:02 Premiere Date 12.15.19

Health Insurance for All: What Does It Mean?

S15 E8 Length 27:50 Premiere Date 11.24.19

Huntington's Disease

S15 E7 Length 28:42 Premiere Date 11.17.19

Natural Approaches to Health and Nutrition

S15 E6 Length 26:52 Premiere Date 11.10.19

Vaping, E-Cigarettes and Kids: Not a Good Mix

S15 E5 Length 27:37 Premiere Date 11.3.19

Breast Cancer: Determining Your Risk

S15 E4 Length 27:36 Premiere Date 10.27.19

Cystic Fibrosis: Improvements in Outcomes

S15 E3 Length 26:53 Premiere Date 10.20.19

Rhinoplasty: Looking Good, Breathing Better

S15 E2 Length 27:42 Premiere Date 10.13.19

Child Psychiatry

S15 E1 Length 27:15 Premiere Date 10.6.19

Explore KET