Where Aspirins Cost $15

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It costs 10 euros — about $15 — for a package of 50 aspirins at the local drugstore in Bonn, Germany! What an outrage. Why so expensive? I could get a bottle of generic aspirins at home for well below $5 for 100!

Looking around I also notice, as the photo suggests, a remarkable plethora of pharmacies (apotheken). With few exceptions, those are the only places allowed to sell most drugs, many of which would be over-the-counter in the U.S.

Worse still, so people tell me, each apotheke has a prescribed (no pun intended) area in which no other apotheke can locate. These are classic local monopolies, so it’s not surprising that the prices are astronomical.

Moreover, the geographic restrictions produce clustering at the intersections of territories — just as we often see three or four gas stations on a busy corner.

The solution, in this land where aspirin was invented, is to remove the restrictions on location and on selling most drugs. That is starting to happen, but it probably won’t occur rapidly enough to lessen any of my headaches — especially those induced by ridiculously high aspirin prices!


NM

"I don’t see why Aspirins shouldn’t be OTC."

You mean apart from the risk of death from gastro-intestinal bleeding?

NM

"LOL, you never came into a French pharmacy !!!

You would end up paying 15 € (a mere $22) for 20 aspirins"

BS. I recently bought a pack of 20 ibuprofene (not aspirin but the same class of medication, and there's no reason why it should be cheaper) for €3. And I'm looking right now at a box of 16 Dafalgan 500 (acetaminophen), fixed price of €1.74. Again, it's not acetylsallicilic acid but there's no reason why that would be 10x more expensive. I've never, ever seen aspirin at €15.

A E Pfeiffer

Allowing the manufacture and sale of generic copies of ALL drugs would greatly reduce health care costs and produce wide social benefits, even for those who didn't need the drugs - we'd probably all rather be surrounded by healthy people than sick ones.

What a pity the pharmaceutical companies and their shareholders don't see it that way.

Maria

I'm sure I read an article questioning whether there was Price Fixing going on with Aspirin and other medicines in Germany - the article would either have been in Stern or Der Spiegel magazine from about last Christmas.

Did anyone else hear about this? The article picked up on prices that were identical in a range of different Apotheken. Allegedly, the manufacturer was enforcing a fixed (and artificially high) price across all pharmacies.

I've searched both magazines' websites for the last half an hour, but can't find the article, which I read at college in German -that's what happens when you study both Economics and German at A-level!

jk

Germans colloquialll call expensive stores, restaurants a Apotheke.

For example it would associate "expensive" if you say let's not go this bar it is a Apotheke.

Jim Leitzel

Those Germans invented methadone and heroin, too, and in these cases their restrictive, price-raising laws were more than matched by the rest of the world. What an outrage!

captial L

A few commentators seem to be forgetting that actual Pharmacies in the US do have College-educated, degree -bestowed "Pharmacists." Furthermore, while it can certainly be difficult to establish a rapport with a pharmacist at one of the large chain pharmacies (CVS, Walgreens, et al) or at a pharmacy inside a multi-use store (e.g. Walmart, grocery stores), it is certainly possible. Better still if you are able to frequent a smaller pharmacy (epically if it's a hold-out that still has a lunch counter...). Should you foster such a relationship with your pharmacist, you would likely find that they are perfectly able to offer you useful advice regarding your medications.

MB

I see a definite advantage to aspirin being more expensive; experiments have shown that people trust drugs more if they cost more. Complaining about a few dollars is nothing but cheap populism. I can't believe someone can afford the ticket to Germany, but not the cost of aspirin while there.

People are willing to spend as much as it takes on their own health. If the official drugs are too cheap, they'll just have more money left for all sorts of dubious remedies. Perhaps this is one of the reasons why people are disenchanted with official medicine -- because obtaining it is so trivial and so easy and so cheap; how much does one trust something that one paid 50 cents for? (I am speaking about rich countries here). Between a lawyer who offered advice for $10/hour and one that offered advice for $1000/hour, whom would you trust? And surely health is worth more than legal advice.

Furthermore, making medicine more available only encourages abuse. I think a moderate price (not too cheap, not too expensive) is best.

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MB

Moreover, this complaint seems to me to be the expression of an unhealthy mentality and an unthinking assumption: if one hamburger for $3 is good, then two hamburgers for $4 are even better and five hamburgers for $2 are ideal. What about food poisoning? What about obesity? What if one doesn't need five hamburgers?

Paul J. Campbell

I lived in Germany for two years out of the last eleven, noted the high price of aspirin, and inquired of friends there who are pharmacists. A partial explanation is that aspirin is allowed to be sold only in small quantities and in blister packs; both factors raise the unit price. You have to push--hard---to get each tablet out. The intent of both factors is to avert both accidental aspirin poisoning (esp. by children) and intentional aspirin suicide

The fact that aspirin is available only in pharmacies is another matter, largely one of a continuing professional monopoly by a powerful interest group.

Aristid Breitkreuz

You can check https://www.docmorris.de/de/shop/kategorie/Schmerzen/Kopfschmerzen/1 (well you might have to guess the words) to get an idea of prices. It's absolutely legal to buy there as a German.

50 Aspirin (trademarked): EUR 8.65 (USD 12.74).

50 ass-ratiopharm (generic, but same stuff): EUR 2.95 (USD 4.35).

There's paracetamol, too, of course, but that's not the same substance.

So, it really does matter

(1) if you need the branded variant - most people feel they do, of course.

(2) if you are willing not to buy at your "trusted pharmacist" ("der Apotheker ihres Vertrauens") but rather at a mail-order pharmacy.

Yes, there is still some liberalisation to do, but its supposed lack can't be blamed for everything.

denis bider

I'm afraid that, having read several of Mr. Hammermesh's posts, I get the impression that they have a genuine tendency of being less keenly observed, well-researched and well-informed than some of the other contributors. The WWI-related confiscation of Aspirin's trademark status in the United States is a case in point...

Neil

What a whiny post. There are a lot of benefits to requiring professional, educated, pharmacists to hand out pills. The main one being that you can actually get some advice. Maybe ASA isn't the best approach to your headache. Sometimes cost savings alone aren't the be all and end all of economic policy. Taking a bunch of pills that do you no good is less efficient than paying more for pills that do work.

Some things in Europe are more expensive than North America, some things are cheaper. Just because something is available over the counter in the US doesn't mean it should be available over the counter.

mike

Well, if the German logo for pharmacy is to be believed, you apparently get a martini thrown in. And possibly a snake. Might be behind the high price.

Mike

How is it a local monopoly when there is clustering on a street corner? Sounds like a counter-example to your previous point. The local monopoly would have to be in the center of the territory, no?

Daniel Reeves

@19: "What a whiny post. There are a lot of benefits to requiring professional, educated, pharmacists to hand out pills. The main one being that you can actually get some advice."

Well if it were worth the cost then the free market would solve that problem. Can't see why not.

--

"Just because something is available over the counter in the US doesn’t mean it should be available over the counter."

I don't see why Aspirins shouldn't be OTC.

--

@21: "I simply don’t understand how someone without insurance could ever go to a hospital."

Most don't except in case of emergency. :/

Peter Payne

This is similar to what Japan used to be like. They have these silly vitamin drinks that are just syrup and vitamin B, but you could buy them at a pharmacy because they were like "medicine"! Ooo! Finally the beverage lobby got this removed and now you can buy them in convenience stores. Still, however, nearly all real medicines are sold at licensed pharmacies so if you have a cold, don't go to a supermarket. I've made this mistake, walking in the cold air with a fever, and all they had was Hall's.

Matt

Ian Duncan @ 15 -- That's twice as much as it costs for generic aspirin at many places in the United States. See my post above -- on a recent trip the store I saw 100 aspirin for 99 cents. Given today's exchange rate, you're paying twice as much in the UK.

Sebastian

Hi,

well - the story is more complicated.

a) There is the trademark issue that people mention - but note that the trademark is only for the name, not the drug. I suggest you ask for a generica next time (e.g ask for ass-ratiopharm - ass stands for acetylsalizilsäure (i.e. Aspirin), ratiopharm is the main producer of generica.)

b) the area story is manifestly false, I´ve seen Apotheken next to each other

c) each Apotheke has to be run by a pharmacologist with a university degree in pharmacology. You can rely on getting expert advice to any questions there (as opposed to - I know this all to well - many pharmacies in the US). Ideally, a good ApothekerIn will also monitor the prescription drugs of its regulars to watch out for complications.

d) @ Nr. 4 Mario - Apotheken do have an emergency system and you can always find an Apotheke which is open 24h for emergency medication (emergency broadly speaking - they charge a surcharge for this service, but that never bothered me).

That all said there is a ongoing discussion on deregulating the "Apothekenmonopol" in Germany and for some things that would definitely be a good idea.

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FrenchGuy

LOL, you never came into a French pharmacy !!!

You would end up paying 15 € (a mere $22) for 20 aspirins. Many french people ask their doctor to have it prescribed, as it is reimbursed.

If you don't want to screw the system, you pay the price tag !!! Welcome in monopoly land...