The curious incident of the $44,000 prescription
ByCBS NEWS | June 11, 2015, 6:51 PM
When a CBS News employee was recently prescribed a nutritional supplement to boost his energy, he was astonished when he saw the claim the pharmacy submitted — and his insurance approved — for a one month supply: $44,707.
For the cost of a BMW convertible, he got 180 capsules of powdered resveratrol, an antioxidant found in red grapes, available at any local nutrition store.
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In fact, two bottles of another brand of resveratrol contain roughly the same amount as the $44,000 prescription, which raises an even more puzzling question: Why does the over-the-counter resveratrol cost just $157.38?
We wanted to ask Warner West Pharmacy in Los Angeles — the pharmacy that filled the prescription and submitted the claim — why theirs cost so much more, but they declined our repeated requests for an interview.
Last week, a CBS News producer caught up with Brian Sutton, a member of the family who owns Warner West. When the producer asked him to explain the $44,000 price tag for resveratrol, Sutton ignored the question and shut the pharmacy door behind him.
“It’s not the cost of the ingredients, it’s not the cost of formulating them, it’s not the cost of shipping them,” he added. “This is thousands of times more expensive than what you can buy it for anywhere else.”
In fact, you can buy it for thousands less at Warner West, the very same pharmacy that filled the $44,000 prescription.
Wearing hidden cameras, we asked their pharmacist about buying resveratrol without insurance and were quoted a very different price.
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“One capsule, twice daily, that one you’re looking at almost $200,” said the pharmacist. “If your doctor wants to send it over, then we can run it through your insurance, and see if it’s covered and let you know what they’ll pay for.”
At that price the CBS News employee’s prescription would have cost about $600 out of pocket — more than 70 times less than the $44,000 claim approved by CVS/caremark, the prescription benefits manager for CBS News.
We wanted to ask CVS/caremark why they would ever pay that much for a non-FDA approved nutritional supplement, but they refused to discuss it on camera.
As for whether this is legal, there is no indication any law has been broken in this case. A lawyer for Warner West pharmacy told us Warner West submitted a government billing code. He said the insurance company arrived at $44,000 based on the manufacturer’s recommended price associated with that billing code.
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