Anybody price out Doxy lately? If you have Rx ins, no problem, just pay the co-pay and so what. But, if you have to buy it out of your pocket, you are in for a shock.

I remember back in 2001, I choose Doxy because it was cheaper than Larium or Malarone. When I went to pay, they tried to charge me my $20 insurance co-pay. I then asked how much the med was if I paid cash. It was $18 so I told them to give me back my insurance card. I suppose times have changed!

Ask your doctor about minocycline. Same spectrum of activity, lower cost than the new doxycycline cost and fewer side effects - at least in dogs.

if you think that's bad,price some mycoxa flopin or mydixadrupin

In 2012 my Rx for 14 days was $24. They found out we were using it for Malaria, and last May, for the same amount the wanted $280. You can't tell me it coasts 10 times more to make the drug now than it did a year ago.

We are beibg screwed by the pharm. companies. If we can afford to go to Africa we must be rich.

Bob

At the risk of having this topic moved to the political forum - I would venture to say that the cost of the product itself has not increased at all but possibly dealing with continually changing FDA regulations required the companies to raise the price they charge at least a little. I think the bigger issue is that OLDER generics are not very profitable so most companies drop them. So we are down to one supplier of doxycycline and they can charge whatever they want because they are the only game in town. It is happening with cephalexin and phenobarbital too.

not funny,huh?

Buy it when you get here! Certainly in Tz you can get it over the counter and cheap...they always hammer overseas travellers as you can "obviously afford it"!!!

It is a lot cheaper if you buy it in Africa when you arrive.

quote:

Originally posted by DrScott:
At the risk of having this topic moved to the political forum - I would venture to say that the cost of the product itself has not increased at all but possibly dealing with continually changing FDA regulations required the companies to raise the price they charge at least a little. I think the bigger issue is that OLDER generics are not very profitable so most companies drop them. So we are down to one supplier of doxycycline and they can charge whatever they want because they are the only game in town. It is happening with cephalexin and phenobarbital too.

100% spot on

It was the FDA jacking with plants that made some close. Regulations cost!!!...usually the average guy the most.

Yeah, a typical example of how the FDA "helps" us out is the anti-gout drug colchicine. Until the FDA decided that they had to have trials for it, since it had only been in use for a few hundred years, it costs about 10 cents a .6mg pill. Now we, in the US, can't get colchicine anymore, we have to get Colcrys (same thing but the company ran thru the FDA hoops) which costs about $8/pill. Using very rough estimates, I figure that one small "help" from the FDA cost US medical users of the drug at least $2 Billion a year. Fuck the FDA.

I took a Tanzanian hunt in Oct/Nov 3013 and cleverly left my Doxy at home. Bought a 30 day
supply in Dar Es Slaam for $3.00 at the corner chemist. No prescription required. Don

As a pharmacist I wanted to make a few comments:

1. Doxy has gotten more expensive due to shortages and manufacturing problems but the vast majority of patients with insurance are getting it
for reasonable copays.

2. Minocycline is NOT effective against malaria and it is actually more expensive than doxycycline anyway

3. Doxy does have the advantage of being able to be used for tick bite fever. Malarone and Larium do not.

4. I haven't seen shortages of doxy for several months now so it shouldn't be an issue for most people.

5. Waiting to buy doxy in Africa could be a dicey proposition depending on the country. Doxy should be started before entering the malarial area anyway (ie before you leave the US).

spot on. i buy it at Costco. 90 tablets( enough for 2 14day trips) is under $100.

Buy it in Africa. Available over-the counter in almost every country, and the last time I bought some it was like $1.00 for ten tablets.

since it recommended to start taking it 1-2 days before you get to Africa( to develop a high blood level), is it a good idea to start taking it a day AFTER you get there?? granted the time frame is small, but there must be a reason why it is recommended to start prior to arrival. seems the best thing to do if $50-100 is that important to you would be to get a 3 day supply and start prior to leaving, then get more on arrival at a much cheaper price- and hope the quality control on the African drug is the same, as far as potency.

It takes a couple of days for doxy to accumulate in the blood to the point that it is therapeutic. That it is why it is advisable to start taking it 1-2 days before arrival in the malarial area.

Considering that up to 60-70% of the drugs found in sub-Saharan Africa are fakes do you really want to take a chance that you aren't getting genuine doxy? The hunt is costing 15 K or more and you want to skimp on malaria prophalaxis?

I'm sure that most of us who go to Africa have health insurance and that health insurance is going to pay for doxy. It should be a non issue for most of us.

quote:

Considering that up to 60-70% of the drugs found in sub-Saharan Africa are fakes do you really want to take a chance that you aren't getting genuine doxy? The hunt is costing 15 K or more and you want to skimp on malaria prophalaxis?

I'm sure that most of us who go to Africa have health insurance and that health insurance is going to pay for doxy. It should be a non issue for most of us.

Please source your "60-70%" fake figure.

Just because we have or don't have insurance (I self-insure, for one) doesn't mean that high costs for a cheap drug are okay. Such reasoning ("What difference does it make what it costs, insurance will pay for it?") is why the health costs in this country as so significantly higher (with worse results than many) than ALL other developed nations.

This came from a Fox News report in August 2013. "The UN Office on Drugs and Crime (UNODC) warned at a conference last February that counterfeit drugs are a multi-billion dollar business accounting for 30 percent of the pharmaceutical market in parts of Africa."

Even if 30 percent is high it does give one some doubt as to the wisdom of saving money and potentially exposing yourself to malaria by taking counterfeit medications.

Don

Please source your "60-70%" fake figure.

Just because we have or don't have insurance (I self-insure, for one) doesn't mean that high costs for a cheap drug are okay. Such reasoning ("What difference does it make what it costs, insurance will pay for it?") is why the health costs in this country as so significantly higher (with worse results than many) than ALL other developed nations.[/QUOTE]

The source comes from the WHO specifically their findings about counterfeit anti-malarial drugs in Nigeria. They also estimated that up to 100,000 deaths a year occur in Africa due to fake medications. With that being said, I did say "up to 60-70%". I think that across sub Saharan Africa 30% is a likely overall average.

Prescription drugs are a commodity and as such are subject to free market forces. If there is a problem with supply you can expect that prices are going to go up. If you have health insurance that includes prescription drug coverage why wouldn't you use it? That's what it is there for. And no, that mentality isn't the problem with healthcare. If you want to debate outcomes versus expenditures in health care then you can PM me but let's spare the rest of the forum from that discussion.

I prefer public debate. I have nothing to hide and I suspect that many other members might learn something about why they are getting screwed on healthcare and insurance costs. Since you have no source for your previous statement, we seem to have little to discuss. I can and will willingly source my statements about costs vs benefits.

Free markets are not restrained by the FDA, various rules and regulations, the pharmacists demanding prescriptions from doctors, doctors demanding office visits for writing simple prescriptions, etc, etc.

Those are the main reason that Doxy is so much cheaper over there than here, not fake Doxy.

I told you it was from the WHO if you want to read the report here it is:

WHO Report

Every industry is regulated to some degree there is no escaping it.

I really don't feel like butting heads with somebody who thinks they know my business better than I do. I get to deal with people like you every day bitching about the cost of drugs. At work I have to listen to their drivel but here on AR I don't. So lets spare the forum a debate about health care and talk about Africa.

Of course your "business" is pushing pills, etc across a counter. You act like that makes you an expert on the health system. Ummmmm, no.

BULLSHIT. i am a doctor and can thus write my own prescriptions but i am NOT going to take a chance on getting substandard medications in a third world country to prevent a potentially life threatening illness, just to save $100-150. maybe your life is worth that- but mine isn't. even if the third world med is up to standard, you are still waiting at least 1- 2 days to start taking a med you should have started taking 1-2 days before arrival.

I never claimed to be an health care system expert. I do however have a pretty good handle on drug costs and appropriate medication use.

Jdollar nailed it. Why would anybody in their right mind try to source doxy in Africa to try to save a few dollars? I dispense doxycycline every single day and there is no shortage of the stuff. Copays average $10-$25 for people who have insurance. I'm going to go out on a limb and say that it would be pretty damn rare for an individual going on an African safari NOT to have health insurance.

If you want to discuss specific drug choices for malaria prophalaxis I'm game. That might actually benefit the folks on AR. However I don't care to debate health care for the billionth time and put people to sleep.

quote:

BULLSHIT. i am a doctor and can thus write my own prescriptions but i am NOT going to take a chance on getting substandard medications in a third world country to prevent a potentially life threatening illness, just to save $100-150. maybe your life is worth that- but mine isn't. even if the third world med is up to standard, you are still waiting at least 1- 2 days to start taking a med you should have started taking 1-2 days before arrival.

+1
I'm no doctor, but I am a pretty good bullshitter & I am willing to pay more to get the good stuff. I'm not ordering my meds from Mexico or waiting till I get to a 3rd world country to buy something that may or may not be the real thing.
If that's what you want to do, knock yourself out, I'm going for the real thing.

quote:

Originally posted by Gatogordo:
Of course your "business" is pushing pills, etc across a counter. You act like that makes you an expert on the health system. Ummmmm, no.

Just out of curiosity, what makes you an expert?

Gremlin. I will come see you before my next trip,over :-)

Anytime-I'm always happy to talk about Africa!

I go to Africa and I am on Medicare but since I am relative healthy I don't have part D so I pay for the few drugs I use. I paid for my Doxy last year. It ain't cheap but as part of the cost of the hunt is basically peanuts, plain and simple!

quote:

Originally posted by jdollar:

quote:

Originally posted by Gatogordo:
Of course your "business" is pushing pills, etc across a counter. You act like that makes you an expert on the health system. Ummmmm, no.

Just out of curiosity, what makes you an expert?

Just out of curiosity, where did I claim to be an expert on medical costs? OTOH, I know a helluva lot more than most people do. If you're so knowledgeable, being a physician, tell me where the roots of the modern medical costs escalation began?

I too am on Medicare, and don't have part D. Just because I mabage to go to Africa doesn't mean I have money to throw away. A few years ago Doxy was cheap, then the Rx companies found out we were using it for Malaria and up the price goes. I can onderstand a reasonable increase, but 1000%? It sure appears to me that the demand has been artificialy inflated to drive the price up.

Bob

venda axe, you think the drug companies just found out people were using Doxy for Malaria and upped the price. Doxy has been used for Malaria for years and years say maybe 60 or 70 years. If you can't afford the upped price for Doxy maybe you should just give up hunting in Africa.

It has been closure of some of the manufacturing plants by FDA that has reduced supply...thus increasing price.

... And the US govt. started using more of it for malaria prophylaxis in the military, finally, after the badness of Larium/mefloquine became so apparent.
The government is involved on both sides of this, knocking down production, and increasing demand at the same time.

Malarone is generic now, and better for malaria prophylaxis.

Lee and RIP,

Where you guys are getting your information? Here is the the info on the shortage and no where does it list plant closures.

ASHP bulletin

The reason I was given last year was a shortage of raw material. To this date I have no new information that would make me discount that explanation.

The military started getting away from Larium in 2009 and started its conversion to doxy at the same time. I don't think caused a shortage in 2013.

I usually get information on potential drug issues ahead of time from various sources including my suppliers.

I would like emphasize that there is not one single anti-malarial that is right for everyone. Multiple factors play a role in deciding which drug is right for an individual and cost is just one of those factors.

And if you want to get even more confused,,, compare dosage strengths according to cost. There is a big difference between 50mg,, 75mg,,, 100mg 150 mg etc. and no 100mg is not twice as much as 50 mg. Malarial prophylaxis dose is 100 mg per day but it could be half as much to take 2 50's in some areas and on some health plans.... As someone dealing with Obama care on a day to day basis and writing pharmaceutical scrips all day long,,,,I give up trying to explain much less understand what is happening to health care in this country

quote:

Originally posted by drwes:
And if you want to get even more confused,,, compare dosage strengths according to cost. There is a big difference between 50mg,, 75mg,,, 100mg 150 mg etc. and no 100mg is not twice as much as 50 mg. Malarial prophylaxis dose is 100 mg per day but it could be half as much to take 2 50's in some areas and on some health plans.... As someone dealing with Obama care on a day to day basis and writing pharmaceutical scrips all day long,,,,I give up trying to explain much less understand what is happening to health care in this country

Exactly and there also can be a price difference between tablets and capsules.

If the price of doxy is an issue for you ask your pharmacist to price out different options. Finally Costco offers very competitive pricing and I would look to them
first. And no I don't work for them.

for sure Costco is the cheapest place i have found. and is $100 or so is a major problem, it seems to me that the cost of African hunting will be a MUCH bigger problem.

quote:

Originally posted by rxgremlin:
Lee and RIP,

Where you guys are getting your information? Here is the the info on the shortage and no where does it list plant closures.

ASHP bulletin

The reason I was given last year was a shortage of raw material. To this date I have no new information that would make me discount that explanation.

The military started getting away from Larium in 2009 and started its conversion to doxy at the same time. I don't think caused a shortage in 2013.

I usually get information on potential drug issues ahead of time from various sources including my suppliers.

I would like emphasize that there is not one single anti-malarial that is right for everyone. Multiple factors play a role in deciding which drug is right for an individual and cost is just one of those factors.

Reason for the Shortage

•Mutual states the reason for the shortage was a raw material shortage.4

-plant producing raw material was not up to FDA code

•Actavis and Heritage state the reason for the shortage is supply and demand.1,7

-why short supply see above

•Teva discontinued their doxycycline presentations in May 2013.6

-because the profit did not exceed the cost up-grade the process to FDA specs

•Major discontinued most doxycycline presentations in February 2013. The company could not provide a reason for the discontinuation.3

-see above for reason

Don't fool yourself into thinking the government is going to put out a bulletin saying oh...by the way...the reason raw material is short and your pharmaceutical is now expensive, when just yesterday it was cheap, is because we are f@(king with the industry.


In veterinary medicine...we use (or did anyway) tons of doxy due to the many tick-borne rickettsial diseases we have in the US. Many of the generic tablet and capsule manufacturers dropped doxy from the production due to the fact that it was not profitable to make anymore due to cost of raw material from the closure of plants by FDA and because some alternative sources were barred from sale to USA markets by FDA.

Maybe all for good reasons...I am not sure. But just like Philip A and others have stated...it is dirt cheap in Africa. I know a few doctors in Africa who treat tick fever all the time with doxy and they have no problems with the efficacy of the product.