If you were in chronic pain and needed oxycodone, how much would you be willing to spend for a vial of the painkiller?
A hundred and forty dollars? Eight hundred? How about $1,250?
Those were the prices offered to a 50-year-old Florida man — not by drug dealers lurking in some dark alley — but by licensed pharmacists who may be profiteering from people with pain.
Scott, who asked that we not use his last name, wasn’t treated as a patient with crippling pain when he tried to fill his prescription. He was treated as a common junkie and a criminal.
Scott’s story is not unique. Millions of Americans in chronic pain are finding it harder and more expensive to get their prescriptions for opioids filled. The problem is particularly acute in Florida, where state regulators and law enforcement agencies have shutdown hundreds of pill mills, pain clinics and pharmacies to combat prescription drug abuse and the diversion of opioids.
Faced with the very real prospect of being audited or even prosecuted, many Florida pharmacists are reluctant to accept new customers needing opioid medicines. Some won’t fill prescriptions for patients who live outside their geographic area. Others refuse to accept insurance payments and will only take cash. And some, apparently, are only in it for the money.
Scott’s Pharmacy Crawl
Last September, Scott’s drunken neighbor smashed his shotgun into Scott’s knee during an argument. He immediately went to a hospital emergency room but received inadequate treatment. Scott obtained a referral to a pain clinic, but walked away when the clinic demanded $800 (lowered from $1,200 because he had no insurance) to see the doctor.
Unable to find a physician locally, Scott made an appointment with a physician recommended by a friend. This required a 200 mile round trip to West Palm Beach, but Scott was so desperate for pain relief he made the appointment.
The doctor prescribed oxycodone – 120 pills in 30 mg tablets. Scott was told by the doctor to break each tab into four pieces so the prescription would last for three months. I imagine this was recommended to save Scott the physical discomfort and financial burden of the monthly round trip.
Scott tried to fill his prescription in his hometown but was repeatedly turned away by pharmacists. One told him they no longer carried oxycodone; but if they did, they’d charge him $140. At two other large chain pharmacies Scott was also turned down – after being quoted prices of $158 and $180.
Scott tried a local discount pharmacy that didn’t accept insurance and was told he’d be charged $1,250 for the oxycodone – but only if he supplied them with his medical records. When Scott disputed their need for his records the pharmacist told him, “Get the f**k out of our store.”
“Go to your drug dealer”
The following day Scott went to the last remaining local pharmacy, where the woman behind the counter laughed at him and said that the medicine would cost $800 in cash, no insurance.
“Why don’t you try a street vendor?” she said.
“What?” Scott asked incredulously.
“Go to your drug dealer,” she advised. “But if you come back with the $800, we’ll take care of you.”
Scott, wondering who the real drug dealers were, wisely left.
This went on for weeks with Scott simply having to bear the increasing agony. At home taking care of his invalid father, Scott had to climb 14 stairs several times a day to assist him. Scott would sometimes cry from the pain in his knee as he ascended the stairs.
The pain was so bad Scott went three or four days at a time without sleeping. His misery worsened and a viscous circle set in.
He told his physician at his next appointment that “I’m in sheer agony. I can’t sleep or sit. I’m screwed no matter what I do.”
The doctor gave him a new prescription – the time for only ten 30 mg. tablets. He was told he could only fill the script at pharmacies within five miles of his provider. Within that radius, Scott went to and was rejected by all 11 pharmacies.
“I got to the point where I wanted to shoot myself or cut off my leg.”
In one last attempt, Scott went to a chain pharmacy where he was told, “Your type of person won’t get anything filled here.”
Scott has long hair and tattoos and believes he was constantly profiled by the pharmacies and found wanting. He felt defeated.
“I never got the chance to see if the oxycodone would have worked for me,” Scott said.
By December, the pain in Scott’s knee began to subside, but it didn’t erase the three months of torture inflicted on him by a distorted health care system.
The real cost of oxycodone
After talking to Scott I contacted a CVS pharmacy in centra lFlorida and asked what they charged for one 30 mg. tablet of oxycodone. I was told they couldn’t supply that information. I obtained no response from their headquarters either.
The cost of oxycodone varies from state to state and many pharmacies are reluctant to discuss what they charge patients. But Vermonthas a law that requires pharmaceutical companies to publicly disclose their wholesale prices. According to this report, the wholesale cost of a vial of 120 30 mg oxycodone tablets would be anywhere from $172 to $294.
Obviously, that’s not anywhere near the $800 or $1,250 that Scott was quoted.
Price gouging and other problems are so widespread among people with pain in Florida, one wonders when the state pharmacy board and legislators will acknowledge that the war on drugs has turned into a war on patients. They need to write regulations forbidding pharmacies from turning down legitimate pain patients with perfectly legal prescriptions and prevent those pharmacies from financially gouging the least powerful among us. Lastly, they should be required to accept patient’s insurance.
It’s time to declare a truce in the war on patients.
Mark Maginn lives in the east bay of San Francisco where he is a poet, writer and social justice activist. Mark suffers from chronic pain and was a longtime volunteer with the American Pain Foundation. His blog can be found here.
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(10) Readers Comments
November 12, 2012
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Oh boy...Your right we hate to hear this. You know why people in pain
Doesn't the 1.5 billion is spent a year give credence to its possitive
Many MS drugs cause PML and deaths too these drugs all need t
I knew him when he was breaking in at a couple of Los Angeles TV stati
Saying there is a 'twist' is the worst type of spoile