Leslie Ramirez, MD
Leslie Ramirez is an internal medicine physician.
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Latest articles
Drugs and prescribing
Two of the biggest -selling prescriptions of all time, Plavix, an anti-platelet medication, and Lipitor, a cholesterol lowering medicine, have been available in generic form since May 2012 and November 2011, respectively. However, most retail pharmacies are still charging patients…
Two of the biggest -selling prescriptions of all time, Plavix, an anti-platelet medication, and Lipitor, a cholesterol lowering medicine, have been available in generic form since May 2012 and November 2011, respectively. However, most retail pharmacies are still charging patients $100-$200 monthly for these medications. Why? And what does this market oddity say about our chances of lowering healthcare costs in the United States?
Patients are used to paying a high …
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Why are some generic drugs so expensive?
Drugs and prescribing
You have insurance and, supposedly, it covers your medicines. However, you still get stuck with a portion of the bill that the insurance company calls a "copay." In some cases these copays can run more than $150/ month per medication…
You have insurance and, supposedly, it covers your medicines. However, you still get stuck with a portion of the bill that the insurance company calls a “copay.” In some cases these copays can run more than $150/ month per medication (e.g. Enbrel). If you are on more than one of these expensive, branded medications the copays can really add up. What are your options?
1. Generic alternative. Always ask your doc if there
…
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Options when your drug copays are too expensive
Patient voices
At LesliesList.org we get many emails asking where an adult can get low cost vaccines. It appears the answer is... nowhere. They don't exist-- unless you are an established patient in one of the county-funded or low-cost clinics in your…
At LesliesList.org we get many emails asking where an adult can get low cost vaccines.
It appears the answer is… nowhere. They don’t exist– unless you are an established patient in one of the county-funded or low-cost clinics in your metropolitan area. However, you can save a little money by comparison shopping. I think your best bet is to try one of the walk-in …
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Where an adult can get low cost vaccines
Drugs and prescribing
As a primary care doc, I have compiled several tips to help patients save money on prescriptions. All the prices quoted in the following examples are from Costco. 1. Patient assistance programs (PAP). Try to get free meds from the…
As a primary care doc, I have compiled several tips to help patients save money on prescriptions.
All the prices quoted in the following examples are from Costco.
1. Patient assistance programs (PAP). Try to get free meds from the pharmaceutical company that manufactures your medication. Most of the time this service is only offered if there is not a generic available for your medicine. I heartily recommend you check out NeedyMeds.org and …
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Tips to help patients save money on prescriptions
Drugs and prescribing
As a primary care doctor, I have figured out many tricks for helping patients save money on prescriptions. Some of them I am sure you have never heard of, and others, well -- you might have, but they bear repeating.…
As a primary care doctor, I have figured out many tricks for helping patients save money on prescriptions. Some of them I am sure you have never heard of, and others, well — you might have, but they bear repeating.
All of the prices quoted here are from Costco, unless otherwise specified.
1. Price compare between pharmacies. Can’t stress enough the potential differences in medicine prices between pharmacies. Generic medicine prices vary more than branded/trademarked …
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Tricks for helping patients save money on prescriptions
Drugs and prescribing
The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply.…
The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply. I found some very surprising results:
Costco: $27
Walgreens (with Saver Card): $325 (without Card): $380
CVS: $361
Walmart: $347
Target: $340
These are not typos. Costco is selling a one-month supply of generic Arimidex for $27, …
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Arimidex price markup at major pharmacy chains
Conditions and diseases
Do you know that the price of a contraceptive pill in Chicago pharmacies varies from $9 (Trinessa, aka generic Tricyclen, at Target pharmacy) to $84 (Loestrin 24 at Kmart pharmacy) a month? That means, over the course of the year,…
Do you know that the price of a contraceptive pill in Chicago pharmacies varies from $9 (Trinessa, aka generic Tricyclen, at Target pharmacy) to $84 (Loestrin 24 at Kmart pharmacy) a month? That means, over the course of the year, depending on what pill you take and where you shop, you could drop as little as $84 or — let me get my calculator here — $1008! These prices are if you pay out …
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Contraceptive pill prices have a huge price range
Health policy
Why don't patients and their doctors talk about healthcare costs? Choose the best answer: A. The doctor doesn't bring it up. B. Patients are too embarrassed to say cost is a concern. C. Patients assume docs can't do anything to…
Why don’t patients and their doctors talk about healthcare costs?
Choose the best answer:
A. The doctor doesn’t bring it up.
B. Patients are too embarrassed to say cost is a concern.
C. Patients assume docs can’t do anything to address the cost.
D. Doctors don’t have sufficient knowledge to discuss costs.
E. All of the above
Correct answer: E
Doctors don’t bring up the cost of prescriptions or testing with their patients.
In a study from the Archives …
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Healthcare costs need to be discussed with patients in the exam room
Drugs and prescribing
Many prescription medicines are actually two or more medicines combined into one pill or package. True, this packaging is convenient-- but you can often save money by buying your medicine as its separate components. Let's look at some examples: Lotrel…
Many prescription medicines are actually two or more medicines combined into one pill or package. True, this packaging is convenient– but you can often save money by buying your medicine as its separate components. Let’s look at some examples:
Lotrel blood pressure pills. This is actually a combination of two blood pressure medicines: amlodipine and benazapril. Lotrel, the combo pill, is available in a generic form, as are it’s two individual …
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Combo pills do not save patients money
Drugs and prescribing
As we have established repeatedly on LesliesList.org, prescription prices can vary a lot from one pharmacy to another. But did you know that some pharmacies will actually match a competitor's price? This could save you a ton of cash, but…
As we have established repeatedly on LesliesList.org, prescription prices can vary a lot from one pharmacy to another.
But did you know that some pharmacies will actually match a competitor’s price? This could save you a ton of cash, but you have to know how, and whom, to ask for this service. Pharmacy retail chains all have different policies. I spoke to a pharmacist recently at each of the seven top …
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Ask your pharmacy to price match prescription drugs
Conditions and diseases
Ahhh spring. The lovely blooms unfurling. The trees budding. It's enough to make a girl get tears in her eyes. And sneezes in her nose. And itching on her face. Yes, it's allergy season again -- but what can you…
Ahhh spring.
The lovely blooms unfurling. The trees budding.
It’s enough to make a girl get tears in her eyes.
And sneezes in her nose.
And itching on her face.
Yes, it’s allergy season again — but what can you do to make yourself more comfortable without emptying your wallet?
1. Avoidance. Close the windows. Make someone else cut the grass. Stay inside. (Yes, I hate this one too- let’s move on.)
2. Neti pot or other nasal saline rinsing. LOVE …
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Allergy drug recommendations for patients on a budget
Drugs and prescribing
Free is good, right? If you have to pay out of pocket for medicines, free prescription drug samples from your doctor's office might seem like a godsend. But nine times out of ten, these free samples end up costing you…
Free is good, right? If you have to pay out of pocket for medicines, free prescription drug samples from your doctor’s office might seem like a godsend. But nine times out of ten, these free samples end up costing you more money. Here’s how.
First of all, pharmaceutical reps only get paid to give out brand new medicines that their companies are trying to promote. They are giving out these drugs …
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Free prescription drug samples cost patients more money
Patient voices
Debora T. had a blood pressure of 180/110 during her routine visit in my internal medicine clinic. She was already on every blood pressure medication I could think of, save one -- amlodipine. I prescribed the medicine and asked her…
Debora T. had a blood pressure of 180/110 during her routine visit in my internal medicine clinic. She was already on every blood pressure medication I could think of, save one — amlodipine. I prescribed the medicine and asked her to follow up in a week. I feared her blood pressure was going to cause a stroke if it went up any higher.
At our next visit, her blood pressure was …
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Price transparency will improve patient care
Conditions and diseases
I am often asked how we get the prices for the radiology imaging tests, such as MRI's and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this…
I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.
However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …
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Radiology tests, and how to find their price
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