Ruth,

The consumer would save lots if they only paid the actual price of the drug;
ie, what the Tylenol actually costs.  No, the rep doesn't "drop off" the
Tylenol in those little packages; they are unit dose packages, and the
hospital does pay for them.  (Ask my husband who pays the pharmacy bills at
his hospital!!)  However, the reason an aspirin costs the consumer $4.00 (or
whatever), is because of the costs involved delivering said drug to the
patient.  The pharmacists salary comes out of the drug budget, as does the
pharmacy tech, as does the buyer, the secretary, and the stock clerk.  The
nurse who gives the drug to the patient needs to be paid, as does the ward
secretary who transcribes the order to begin with, as does the medical
records clerk who files the chart, as does the housekeeper who cleans the
room, and the dietary aide who brings the lunch tray, as does the cook who
makes the lunch.  There are revenue producing departments in a hospital
(pharmacy is one of them), and non-revenue departments
(nursing/housekeeping/dietary) etc.  The revenue producing departments have
to pay for the non-revenue producing departments which are often bigger and
more costly.  One of the reasons the first departments to be downsized is
nursing is because it is the biggest and is non-revenue producing.

Now, if the drug companies would only charge hospitals for the drugs and not
the advertising, free luncheons and all the rest of it, health care costs
could drop dramatically.

Jan B., who learned more about this sort of stuff than she ever wanted to
know when she was head nurse of a birthing center who was trying to break
even.....