Better Solutions for Healthcare

BLOOMBERG: Patient Drug Prices Can Vary by $50 a Pill Among U.S. Hospitals

By Rebecca Torrence

June 30, 2021

Costs for common generic drugs can vary among hospitals by more than $50 a pill, a study has found, with some health centers ignoring federal regulations designed to make pricing information easily accessible to patients.

GoodRx Holdings Inc., a digital healthcare platform, compared prices for 12 generic drugs at 16 hospitals. Some charged a nearly 6,000% markup on average compared with the pharmacy price for the same drug. Zoloft, used for depression and anxiety, costs $57 a pill at a Las Vegas hospital but just 50 cents a pill at a Tennessee hospital.

The dysfunction has persisted despite federal efforts to increase transparency. As of Jan. 1, a ruling by the Centers for Medicare & Medicaid Services requires hospitals to publicize prices for all drugs and services. But the complicated data sets they use can be difficult for patients to unravel, letting hospitals set prices as they see fit.

“Being able to identify exactly how much you’re going to pay as a consumer is virtually impossible,” said Tori Marsh, director of research at GoodRx.

The Trump administration’s effort to require hospitals to disclose their rates in a “consumer-friendly format” was praised by patients and employers who worried the lack of transparency kept prices high. But GoodRx found the information released is often riddled with errors and complex medical terms.

Meanwhile, the fine for noncompliance is $300 a day, which Marsh said may not be sufficient to force adherence, especially with enforcement lagging in part due to Covid-19. “A lot of hospitals are still not adhering to the CMS regulations,” Marsh said.