Consumers find it hard to determine how much a drug regimen would cost them

By Steve Luxenberg,

My wife and I don’t want to add to the nation’s financial woes. We understand why it’s important for us to take responsibility for managing our use of the health-care system, why we should limit ourselves to necessary expenses. Not only is it in the country’s economic interest, it’s also in ours: Our health plan is structured so that any medical excesses come out of our own pockets.

Now here’s the $2.5 trillion-a-year question: How can we make wise choices about how much to spend on health care if we can’t easily find out the cost of a simple medical procedure? It shouldn’t require more than a dozen phone calls and hours of time — not to mention a hunting dog’s single-mindedness — to piece together an accurate estimate for a recommended treatment.

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(RONALD CALA FOR THE WASHINGTON POST)

(RONALD CALA FOR THE WASHINGTON POST)

But that’s precisely what happened to us in January and February.

If you work in the White House, on Capitol Hill or anywhere in the health-care industry, which now consumes about 17 percent of the nation’s gross domestic product, perhaps our micro-example brings a little bit of the real world into the debate. Consider it one citizen’s attempt to make a difference.

Our story begins with a diagnosis (osteoporosis) and a choice of what to do about it. Several years ago, a bone scan revealed that my wife, Mary Jo, had lost enough density in her spine and hip areas to suggest that she had a slightly higher risk of fractures than other women of her age (early 60s). It’s a consequence of aging, so she has a lot of company: According to National Institutes of Health estimates, more than 8 million older women and 2 million men have bone-density measurements that qualify as osteoporosis, with millions more heading in that direction. The NIH attributes 1.5 million fractures annually to weakened bones.

For years, Mary Jo had been taking daily calcium supplements and Vitamin D, but our family doctor wanted to do more. She prescribed Fosamax, a once-a-week tablet that can help slow or halt bone loss. It has since become available in its generic form, alendronate sodium.

The current cost to us under our insurance plan’s pharmacy benefits for generic drugs: $80 annually. A bargain, if it worked.

Mary Jo wasn’t keen on signing up to take a medication for the rest of her life. In the end, though, she decided to give it a try.

Mixed results

The regimen for alendronate sodium is trickier than for many other drugs. You not only have to remember to take the pill on the same day each week, but it must be swallowed whole on an empty stomach, first thing in the morning, with at least six to eight ounces of water. For 30 minutes after consumption, no lying down or eating. The worry: damage to tissue in the esophagus on the way down. For the same reason, the pill cannot be chewed.

Not exactly a user-friendly routine for a weekday work morning. Mary Jo chose Sunday as swallowing day, a schedule she kept for the next four years.

Her subsequent bone scans yielded mixed results. At best, the treatment was slowing the decline. At worst, it wasn’t having much effect.

 
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