Thursday, June 11, 2009

In Which I Go to the Pharmacy in France to Pick Up My Prescription...

And Am Utterly Gobsmacked by the Price...

I don't know whether to write this as a story or as an open letter to President Obama. Knowing that he already believes we need universal health care, I doubt anything I'm about to say would make a difference or would move him any faster. Perhaps the people I need to be writing to are in Congress, but they're a bunch of useless, bickering schlubs, so I guess I'll just go with the story and hope that maybe, just maybe, we'll acheive univeral coverage for all Americans before the turn of the next century. One can dream, right?

One of the requirements for working at the organization I'm working at is, you have to have a basic physical. I wasn't able to do that before I left the States, so I had to do it here. Fortunately, the org where I work has a fully staffed, on site clinic. So, I made an appointment and had a physical. Part of the process includes meeting with the on site doctor, which I did. Lovely lady whose English wasn't that great, but who spoke French and German. My French sucks (read: is totally non-existent except for a few words like hello, thank you, and wonderful!), but I can do German, so that's what we did.

Anyway--I mentioned to her my history of migraine and told her that I take, as needed, a lovely little pill called Relpax. I told her I had one pill left and wondered if she could write me a script, because I'd left my script at home. She promptly wrote it out and then advised me to pick it up at a pharmacy in France because it would be cheaper than getting it in Switzerland.

Bear in mind two things here. First, I'm self-employed, which means I'm one of the more than 40 million Americans without health insurance. Second, when I have to pick up a prescription, I have to pay for it out-of-pocket. As a result, my medicine is very, very expensive and I'm very careful about when I use it. In the U.S., six tablets of 40 mg Relpax--the standard dispensed dosage--is between US$190 and US$230 a box. That's about US$32-US$38 per pill. Needless to say, I only take one if I absolutely have to, which is further to say that if the two Advil migraine and two regular Advil I take together don't work at the outset of a migraine, I'm reduced to taking one of my very expensive pills.

When the doctor said, "Go to France; it's cheaper," I figured "cheaper" would mean I'd be paying around €110 - €150 (around US$150 - US$210) for the stuff. In preparation for that, I pulled out my Visa card and braced myself. Then, I handed the script to the pharmacist. She went behind the wall, pulled it off the shelf, did a little bit of this and that on the computer, handed it to me and said, "€28,80."

*blink* *blink*

"Pardon? €28,80?" I asked in my best Franglish.

"Oui. €28,80."

I turned to my friend Sue, who comes with me to provide language services when I go to things like pharmacies and grocery stores and the like. "Did she say €28,80? As in two-eight? Twenty-eight euros?"

Sue confirmed that, yes, in fact, the pharmacist said "€28,80."

I think at that point, I had an out-of-body experience. I said, "€28,80?" then looked at the pharmacist and said, "In the United States, I'd pay $200 for these." Now it was her turn for an out-of-body experience. Sue had to translate that to her, despite her good English.

So, here's my question, ladies and gentlemen. Why can I get my migraine medication for US$40.44 in Europe--essentially the price of ONE pill in the States--but it costs me nearly US$200 in the United States for the exact same thing?!

Can someone please explain this inequity to me? Do pharmaceutical companies fleece us like this because they know they can?

Needless to say, I think I'm moving to France. At the very least for my pills, if nothing else. Forget the good butter and the good bread and the access to excellent chocolate, I want my pills.

And now, I'll go away. But before I do, I'm calling the doctor at the clinic and asking her to write me a script for 36 pills. €175 is still cheaper than I'd ever pay in the US.


NG said...

Makes me wonder what it would have cost in Switzerland.

My husband and I both take Relpax and even with our health insurance it's about $80 a box (6 pills). Maybe you could bring back a couple boxes for me? ;)

Gregg Sirrine said...

I just discovered your blog and really enjoyed it. You are such a talented photographer and writer. Please be careful with the Advil, I used to take 4-8 Advil daily for my migraines and permanently damaged my stomach. Now I have to take pills for acid reflex for the rest of my days. Be sure and have some food with the Advil.

Keep up the great posts!

Lucy said...

Pharmaceutical companies have been screwing us for ages. And I might add the whole freakin' American medical association. I heard the other day that the only country on the planet that makes health care a profit making monopoly in the US. I believe it. It's not right and needs to be stopped. But my fears are that it will only continue. BTW...perfect description of our 'legistators". They all make me sick. No pun intended.

Jess said...

I wonder about this too. I don't know. Some combination of government subsidies there and no regulations here?

Janet Kincaid said...
This comment has been removed by the author.
j.m. tewkesbury said...

NG: A colleague of mine who takes Zomig and lives in Geneva says she pays about 150 Swiss Francs for six pills. That's about US$170, I think. When I told her should could get Zomig in France for 30 euros, she about fell out of her chair. As for Relpax, if I could managed to finagle a box or two for you, I would gladly do it!

Gregg: Welcome! Thanks for your compliments on the blog. I'm trying to get back into consistent writing here, as well as regular posting of photos to this blog and my photography blog. Thanks also for your advice about Advil. I don't get migraines all that often, so I take my Advil regimen infrequently. That said, though, I need to find a healthier regimen.

Lucy: Why am I not surprised? Let's face it, though, American business is all about the bottom line and making a ginormous profit, regardless of the product. Despite having worked for a pharma company and knowing what it costs to bring a pill into being, I still think it's highway robbery to charge what they charge.

Jess: Probably. Or maybe Americans, who are paying through the nose for prescriptions, are subsidizing EU meds. Ergo, cheap pills in Europe?? Who knows? All I know is, there's something wrong with the price disparity.

foundinidaho said...

Tewkes, I'm a "benefits professional" and Lucy is so right on that it's scary. They can afford to charge less in other countries because they SCREW us. I'm not as hard on the doctors, though the specialists piss me off. The general practicioners, generally speaking, are in the business for the right reasons.

I'm glad you're getting it cheaper while you can! I don't know that Obama, much as I love him, can do much about this one. It's going to be a hard, uphill slog for him.

Anonymous said...

And I want to make sure that we don't forget the health care CEOs -- the middlemen that a one-payer system would eliminate -- in this rant about the state of U.S. medicine. The health care CEOs make millions every year while they refuse to cover all sorts of bodily complaints and medicines. This is millions of dollars that could have been spread out a little to cover people who couldn't afford health insurance. Here is a link to an article that has many other referential links about HMO CEO salaries:,-stay-calm-for-this

I agree -- France is looking good!

JulieAnn said...

I'd like to say I'm shocked. But, notsomuch. Just pissed....

lacochran said...

I believe the pharmaceutical lobby is the strongest one there is. Need I say more?

Glad the trip is providing more dividends than you imagined! :)

Cele said...

OH mi gosh, my Imitrex Rx is like that - 9 pills for I think $211. If I remember correctly - like you I horde them and use only when absolutely necessary. I was schocked at the price reduction of Zytech when it went OTC. From $80 a month, to $25. In one month. Outrageous.

JulieAnn and back me on this comment... talking during brunch one day with a certain Wanker (we were talking his job - bankrupsty lawyer) he asked me,"What is bankruptsy?"

Naively I asked back, "What?"

His straight faced digusted reply, "The American Health System, because no one can afford to get sick." (maybe slightly paraphrased.)

Maya said...

The healthcare system in this country is ridiculous! Now you know why so many people get their pills in other countries...

BTW, you really should get health insurance even though you are self-employed. Just in case!

Debi said...

Being so close to the Mexican border, this isn't a new irritation to me. (Worse than irritation, actually.)

My brother is Diabetic, type I, has been for 31 years. He has no insurance. We recently discovered the Walgreen's program where you can buy your own "prescription card." His insulin went from $60 a bottle (he needs two kinds), to $28, among other things. When you get stateside, maybe you can check that out. Thanks to our congressmen, I'm sure we won't have our health care debacle worked out by then. (Note: THEY have great health insurance. B*st*rds.)