LAYERS BETWEEN THE DRUG MAKER AND THE CONSUMER? WE INVESTIGATE TO HELP YOU SAVE MONEY. >> Reporter: FOR THE LAST DECADE, PRESCRIPTION DRUG PRICES HAVE GONE IN ONE DIRECTION. UP. A GALLUP POLL RELEASED IN 2021 FOUND ABOUT 18 MILLION U.S. ADULTS CAN'T AFFORD TO BUY THE DRUGS THEY NEED. ONE PHARMACIST FOUND A WAY TO LOWER THOSE COSTS. JUST OUTSIDE COLUMBUS, OHIO, NATE RUNS PICKERINGTON PHARMACY WHERE CUSTOMERS RELY ON INSURANCE TO PAY FOR THEIR MEDS. >> IT'S A TRADITIONAL PHARMACY. >> Reporter: BUT NEXT DOOR, HE OPENED A SECOND BUSINESS. >> SO, THIS IS FREEDOM PHARMACY. >> Reporter: IT'S A SELF-PAY PHARMACY WHERE CUSTOMERS PAY OUT OF POCKET AND CAN SAVE HUNDREDS ON COMMON MEDS LIKE THOSE FOR CHOLESTEROL AND ARTHRITIS WITHOUT INSURANCE. >> 85% OF THE MEDICINE THAT WE HAVE HERE IN THE UNITED STATES ARE GENERICS, AND THEY'RE NOT EXPENSIVE.
>> Reporter: FOR MOST PEOPLE, A PHARMACY BENEFIT MANAGER NEGOTIATES HOW MUCH YOU PAY AT THE REGISTER, AND HOW MUCH THE PHARMACIST GETS REIMBURSED, AND THAT CAN VARY WIDELY. >> GENERIC CELEBREX, FOR INSTANCE, FOR ONE INSURANCE COMPANY, IT WOULD BE $141 CO-PAY FOR A 90-DAY SUPPLY. ANOTHER, IT WILL COME BACK $10 CO-PAY. >> Reporter: AND YOU SEE THAT EVERY DAY? >> EVERY DAY. >> Reporter: BUT AT FREEDOM PHARMACY, HE CUT OUT THE MIDDLEMAN, SELLING MEDICATIONS AT COST, PLUS A SMALL MARK-UP TO COVER HIS OVERHEAD. >> MOST PEOPLE WALK INTO A PHARMACY AND THEY HAVE NO IDEA IF IT'S GOING TO BE $5 OR $500. AT FREEDOM, I CAN IMMEDIATELY TELL YOU WHAT THE PRICE IS GOING TO BE. >> Reporter: WHY CAN'T YOU OFFER THE SAME PRICES AT PICKERINGTON? >> WE NEED THE HIGH PRICES TO COVER A LOT OF THE OVERHEAD THAT COMES ALONG WITH DOING BUSINESS WITH INSURANCE COMPANIES.
>> WE HAVE TWO FREE TODAY. >> Reporter: LAST YEAR, RETIRED NURSE SHARON KITCHEN SAVED $500 ON HER PRESCRIPTIONS BY NOT USING HER INSURANCE. >> THANK YOU VERY MUCH. >> THANK YOU. >> Reporter: SHIRLEY CUT HER COSTS IN HALF. >> I THOUGHT IT WAS WRONG. >> Reporter: YOU THOUGHT HE UNDERCHARGED YOU. >> YEAH, I THOUGHT HE WAS CHEATING HIMSELF. >> I'VE SEEN SOME PATIENTS SAVE AS MUCH AS $4,000 ON A SINGLE PRESCRIPTION AT A CASH PHARMACY. THE SYSTEM IS COMPLETELY UPSIDE DOWN AND IN DESPERATE NEED OF AN OVERHAUL. >> Reporter: ANTONIO RUNS A DRUG PRICING DATA FIRM. HE SAYS WITH SO MANY MIDDLEMEN BETWEEN DRUG MAKERS AND PATIENTS, LIST PRICES AT PHARMACIES INFLATE, AND PEOPLE WITH HIGH DEDUCTIBLE PLANS GET THE SHORT END OF THE STICK.
>> THOSE WHO HAVE THE MOST LEVERAGE IN SOPHISTICATION ARE THE ONES GETTING THE BEST PRICES, AND THOSE THAT DON'T, END UP GETTING RIPPED OFF. >> Reporter: IN A STATEMENT, A TRADE GROUP FOR THE PHARMA INDUSTRY SAID PHARMACY BENEFIT MANAGERS AND INSURANCE COMPANIES "EXTRACT TENS OF BILLIONS OF DOLLARS IN REBATES FROM DRUG MAKERS AND THAT THESE SAVINGS ARE NOT SHARED WITH PATIENTS AT THE PHARMACY." JC SCOTT, WHO REPRESENTS PHARMACY BENEFIT MANAGERS, HAD A DIFFERENT TAKE. >> DRUG COMPANIES ALONE HAVE THE ABILITY TO SET PRICES. >> EVERYONE SAYING SOMEONE ELSE IS TO BLAME FOR HIGH DRUG PRICES. WHAT IS THE FIX? >> I THINK THE BEGINNING OF THE FIX IS TO ADDRESS THE ROOT CAUSE, WHICH IS THE PRICES WHEN THEY ARE INITIALLY SET BY DRUG COMPANIES.
BUT I WILL SAY, EVERY STAKEHOLDER IN THE PRESCRIPTION DRUG SUPPLY CHAIN NEEDS TO FIGURE OUT HOW WE CAN DO A BETTER JOB IN SERVING PATIENTS. >> Reporter: IN THE MEANTIME, YOU NEED TO DO THE LEGWORK TO SAVE MONEY. EXPERTS SAY, DON'T ASSUME INSURANCE IS CHEAPEST. ASK WHAT IT WOULD COST OUT OF POCKET AND SEE IF THERE'S A SELF-PAY PHARMACY IN YOUR AREA. USE APPS LIKE GOOD RX, BLINK HEALTH, SINGLE CARE, WELL RX, AND NEEDY MEDS, AND ALWAYS ASK THE PHARMACIST, IS THIS THE BEST PRICE FOR MY MEDICINE? IS THERE A GENERIC OR LOWER COST OPTION? YOU REALLY HAVE TO BE YOUR OWN ADVOCATE AND EXPERTS SAY IF YOU WORK FOR A BIG COMPANY AND YOU HAVE GREAT INSURANCE WHERE YOU USUALLY PAY VERY LITTLE AT THE PHARMACY COUNTER, SELF-PAY PHARMACIES ARE PROBABLY NOT FOR YOU.
BUT IF YOU'RE ONE OF THE GROWING NUMBER OF PEOPLE IN THIS COUNTRY WHO'S ON A HIGH DEDUCTIBLE PLAN, IT MIGHT BE WORTH PAYING OUT-OF-POCKET AND ALSO THINK ABOUT BUYING IN BULK. OPT FOR YOUR MEDS TO COME IN A 90-DAY SUPPLY BY MAIL AND ALSO YOU MAY WANT TO CONTACT YOUR DRUG MAKER DIRECTLY. YOU CAN ASK ABOUT DISCOUNTED MEDS. BUT YOU SEE HOW MUCH YOU HAVE TO DO ON YOUR OWN. >> YES, YES. >> IT'S NOT EASY. HOPEFULLY THIS HELPED MAKE IT A LITTLE BIT EASIER TO UNDERSTAND ALL THE OPTIONS FOR YOU. BUT YEAH, YOU HAVE — YOU'RE ON YOUR OWN. >> THAT'S SUCH A GOOD STORY, AND THERE ARE SENIORS — NOT JUST SENIORS BUT PEOPLE WHO TAKE FIVE, SIX, SEVEN, EIGHT THINGS. >> THAT IS WHY IT'S IMPORTANT TO GET YOUR MEDS FROM ONE P
