A pharmacy hardly seems like the place to see people break down and cry. But it happened at a neighborhood pharmacy here in Salt Lake.

(("IT WAS JUST A TOTAL FIASCO IN THERE."))

Shanna Richmond, was one of many caught off guard after insurance co-payments on prescription drugs took a dramatic turn for the worse. Science specialist Ed Yeates has more. Ed, what happened?

On that day, the pharmacy was full. Each pharmacist was taking time to talk to each customer about some dramatic hikes in their insurance co-payments.

Shanna Richmond is already getting financial help from her Bishop and other agencies, so this was yet another hard pill to swallow.

((SHANNA RICHMOND, PATIENT: "THERE WERE PEOPLE IN THERE WHO WERE CRYING. I WAS ONE OF THEM. IT WAS JUST OVERWHELMING. MY HEART JUST FELT LIKE IT WAS GOING TO COME RIGHT OUT OF MY CHEST."))

And for Shanna on a fixed income, who has to take a number of medications, there was good reason to cry. Her co-payment on drugs through Pacifcare jumped 400 to 800 percent. For example: Each vial of insulin - from $5 to $20. An asthmatic inhaler - from $5 to $40.

(("TO HAVE IT RAISE THAT MUCH, I'M GOING TO HAVE TO CHOOSE SOMEWHERE ALONG THE LINE WHAT IS MORE IMPORTANT."))

In Shanna's case, does she buy the insulin or pay her home mortgage?

(("I THINK THERE IS GOING TO BE TIMES TO PAY MY HOMEOWNERS MORTGAGE INSTEAD OF BUYING MY INSULIN. AND THAT REALLY FRIGHTENS ME."))

Granted, Pacificare which took over FHP is selling its Utah insurance operation and trying to cut losses. So this incident may be unique. But it's not just Pacificare or Shanna. It's something much bigger which could affect all of us.

Insurance carriers are taking a long hard look at what's to come. The University of Utah says some 400 to 500 new genetically engineered drugs are in the FDA pipeline, waiting to hit the market. They're more complicated to make and more effective for treating illnesses. But the pricetags are staggering!

Pharmaceuticals now make up about 5% of a hospital's operating cost. The new drugs will boost that to a whopping 30% Increases you could see on your bill.

Dr James Jorgensen says some of the bigger universities are already there.

((JAMES JORGENSON, DIR., U OF U PHARMACY SERVICES: "FOR A 400 BED HOSPITAL, THEIR DRUG BUDGET IS OVER 75-MILLION DOLLARS."))

This new Neupogen increases a patient's white blood cell count so cancers can be attacked more agressively. But the cost - $125 per single dose.

(("IT'S INCREASED OUR DRUG EXPENSES BY ALMOST A MILLION DOLLARS."))

How about another new drug, TPA, for victims of heart attacks - imagine two thousand 200 dollars per single dose.

A new drug for treating a strain of septic shock, an unbelievable four thousand dollars per single dose.

Most patients are elderly, on Medicare, with an insurance max for this disease capped off at $55-hundred dollars.

(("ONE DOSE OF THAT AGENT WOULD ESSENTIALLY EAT UP THE ENTIRE REIMBURSEMENT FOR THAT."))

(("GIVEN FREE REIGN WITH THESE DRUGS, YOU CAN REALLY DESTROY A BUDGET IN A QUICK AMOUNT OF TIME."))

What to do? Pharmacists say they must change their role. They'll do more counselling and less dispensing in the 21st Century, evaluating how and who should use these new drugs.

Jorgensen says researchers also need to look at long-term outcomes for patients. Will some of new blockbuster drugs, used once only, improve health and decrease costs over the long-haul. If they do, insurance companies may have to begin formulating their compensations on a long-term basis, not short-term.