So I have a toenail...condition. To cure it you have to use a special nail polish with fungicide in it that you have to paint on every day for a year. It has a 17% cure rate. (No, I didn't mistype that. After a year, one in five or so people are cured.) I'm on month 7 (nothing so far!) and got a refill today.
The pharmacist handed it over to me and said, "That'll be $63.99."
I gasped. "Didn't the insurance cover it? They've always covered it before."
He looked at it wonderingly and said, "It didn't go through insurance. That's the cash price." He then pressed the various buttons to get it to go through insurance. "Okay, that'll be five bucks."
"Ah, that's better," I said, paying up.
But that's not the whole story. Because he handed me the "cash price" invoice at first, it had different information on it to the Full Price/Copay slip I usually get. The cash price invoice said,
**Congratulations! By using a generic you've saved $1563.97! Cash price $63.99**
I take that to mean I gasped at the sixty dollar price of Cic******, the generic drug, but the brand name drug, Pe****, had been priced at $1627.96. Since they last about two months, a year's worth is $9767.76.
You have a 17% chance of curing toenail fungus if you spend ten thousand bucks. This is why generic drug manufacturers can jack up their prices - they know brand name drugs are even more expensive. (Though this manufacturer is asking a fair price at around $60.)
I may have missed out a couple of swears in my transcript of the conversation up there.