TODAY   |  April 12, 2013

The high cost of prescription drugs

Patients in the U.S. spend more on prescription drugs than any other country in the world, with an estimated $45 billion spent out-of-pocket by Americans last year. NBC’s Stephanie Gosk reports and Dr. Gail Saltz and CNBC’s Bertha Coombs discuss the cost of our prescription drug dependency.

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This content comes from Closed Captioning that was broadcast along with this program.

>>> up our special series "pill nation" this morning the high price of prescriptions. nbc's stephanie gosk is following the monday. stephanie , good morning.

>> good morning, natalie. patients in the u.s. spend more on prescription drugs than any other country in the world. in most cases it improves their health, keeps them out of the surgery room and out of the hospital but paying for medicine can be the most expensive out-of-pocket health cost for americans . pills, pills, pills. in the next month nearly half of the population in this country will take some kind of prescription drug .

>> next to minority, this is my greatest expense.

>> reporter: single mom sherri thomas has three teenagers, two diagnosed with autism and a.d.d. she says they need their prescriptions to lead normal lives but worries she can't keep up with the payments.

>> i'm one of those people that's paying more than i can afford just to get the basic medication that my kids need.

>> reporter: and sherri is not alone. according to the cdc americans spent a whopping $45 billion out-of-pocket on retail prescription drugs , an estimated $4.5 billion was spent on sleeping medications, $7 billion on drugs to treat adhd and $11 billion on antidepressants. in some cases the enormous costs are linked to brand name drugs but why are they so high? pharmaceutical companies say they have to be because new drugs sore expensive to develop and manufacture.

>> takes about 10 to 15 years from the laboratory benchtop to a pharmacist's shelf and costs on average about $1.2 billion to $1.5 billion.

>> reporter: name brands are then protected by patents to both recoup costs and make a profit. the good news in recent years for consumers is that many of the popular name brands have gone off patent.

>> when a drug comes off patent and a big brand name drugmaker no longer has that exclusivity, usually that means the price goes down, the generic person no longer has to do all that kind of marketing and people will flock to the generic version because the price is cheaper.

>> reporter: still, americans struggle, especially those who are uninsured. over 24% said they did not get prescription drugs due to cost in 2010 versus almost 7% of the insured who say they don't have enough money to pay. adding to the problem, pharmacist alan shnorr says he has seen prices jump in the last year and he's getting stuck with a lot of unclaimed prescriptions.

>> they have two prescriptions and it's $100, it's a lot of money for the working class or any class.

>> reporter: experts fear although unclaimed prescriptions save money in the short term t leads to higher health costs down the road.

>> eventually it's going to price me out and i don't know what i'm going to do. i want my kids to graduate college yet they need this medicine to help them get there as well.

>> the cdc released a new study showing other strategies people use to keep their prescription drug costs down including skipping doses, delaying prescriptions, or turning to alternative medicine , all potentially having an adverse effect on their health. natalie?

>> stephanie gosk, thank you.

>>> dr. gail saltz is a skik psychiatrist and "today" contributor and bertha coombs from cnbc. gail , we've been talking about how overprescribed we are as a nation, people looking for a quick fix. when people are suffering more from anxiety and psychological problems, how do you know when medication is the solution or the right answer for you, when should you seek medical help?

>> i think if you're feeling overwhelmed, you're feeling like you're having stomd you realymptoms you really need to see a mental health professional . they have to look at your history, they have to look at all of your symptoms. they have to look at the entire collection of things to determine do you actually have major depression , and then the question becomes, do you have mild to moderate major depression where medication does no better than placebo and therefore you shouldn't be receiving medication or you have a severe depression which carries a 15% suicide rate, you should be getting medication, so get a proper evaluation and know that therapy and learning coping skills are every bit as important and sometimes better than medication, which really would lower your cost in the long run.

>> and bertha, you have some tips on how people can reduce the cost of their prescription drugs , where do you start in.

>> if it's something you need, generics is where you're going to get the most cost-effective medication and it will be the same as the brand name . if you do have to take a brand name , one of the things you should consider is making your prescription longer, maximize how you get that prescription filled rather than every 30 days where you have to have that $5, maybe $10 copay, do it 90 days , get a 90-day prescription and only paying one copay. also shop around. the different pharmacies have different pricing strategies and in some cases you might want to do mail order through your insurer, and also maybe try to get some sort of lower price as a result of that because it's automatic, and the other thing to do as well is to look at your plans, different plans sometimes cover different types of drugs. if you're married look and see whether your spouse's plan has better coverage than yours and finally to stretch your money is to do one of these pre-tax accounts, a flexible savings account if you get it from your employer or if you buy it yourself, you can also do a health savings account if you have a high deductible. if you're in a 15% tax bracket for example and paying $100 a month you're getting the full $100 worth rather than taking it aftertax and you have to make up that extra 15%.

>> good to put money in those accounts. bertha coombs and dr. gail saltz thank you for great information as always.