Rising medication costs are at the forefront of news reports, as drastic increases are creating roadblocks for patients to receive proper health care treatment. Even with prescription insurance assistance, patients are bearing more of the cost-sharing burden, which results in prescriptions not being filled, and in turn, conditions and illness going untreated.
As frustrating and as defeating as this can be, UnityPoint Health pharmacist, Amanda Ketterer, Pharm.D., shares strategies to consider with your provider and pharmacist that may make your medications more affordable and accessible.
1. Generic Medications
Using generic medications can provide significant cost savings and are nearly always preferred by prescription insurance plans. Be assured that generics have been proven to be equally as effective and safe as the original, brand name medication. While the inactive ingredients may vary, the active drug has met the same requirements and standards for production as the original product and will treat your condition in the same manner. Ask your provider or pharmacist if there is a generic treatment option available and if it is appropriate for you.
2. Different Medication Choice
Oftentimes, there is more than one medication option to treat the same condition. When your provider is deciding what to prescribe, he/she doesn’t always know the cost of medications and just how variable the costs can be. If you get to the pharmacy and it seems your cost is high, ask your pharmacist if there are any alternatives you can suggest to your provider and/or insurance company. Insurance companies use something called drug formularies, which specify medications they prefer in order to keep costs down. Sometimes, it is as easy as switching from one drug to an equally-effective drug on your insurance formulary, resulting in hundreds of dollars in savings to you each month. This won't always be the case, but it certainly doesn't hurt to inquire with your pharmacist, your provider or your insurance company’s customer service phone line. Don't be afraid to ask questions - your provider wants to prescribe the best option for you, but sometimes, there is more than one - and it may be worth it to ask.
3. Different Pharmacies
With the changing health care system, we are seeing more high-deductible insurance plans, as well as more patients who decline prescription coverage with their plan. In these cases, the out-of-pocket costs of medications are very important to know. It may shock you how much the cost of the very same medication can differ between pharmacies. For example, with no insurance savings, the out-of-pocket cost for Atorvastatin, the generic version of Lipitor, a common cholesterol medication, may be $4.50 at one pharmacy and $140 at another just down the street. And, best price may not be the pharmacy you think – sometimes, the smallest pharmacies are able to offer medications at a much more reduced rate than the larger retailers. While I do not suggest jumping between pharmacies, it can certainly pay to speak to different pharmacies to see if they can aid with reducing your out-of-pocket costs. Call the pharmacy, and ask if you can set up a time for you to go through your medication list and see if their out-of-pocket costs may save you significantly each month.
4. Coupon Savings
If the medication you need is only available as an expensive brand name, then there may be an opportunity for coupon savings directly through the drug manufacturer. If you have a commercial prescription insurance plan, such as one through an employer or private insurer, you may be eligible for substantial reductions on your monthly copays with these coupons savings programs. Many drug manufacturers realize their medications have higher copays for patients, and in order to keep their medications competitive and accessible, they may offer these coupons to make your copay comparable to the less expensive options your insurance prefers. If you have a federal or state-funded prescription plan, you probably do not qualify for monthly savings, but the company may offer a one-time free trial coupon, so you can try the product without spending a substantial amount of money. The most reliable way to find these coupons for brand-name medications is through the manufacturer's website.
Generic medications do not have the same manufacturer based savings programs, but there are many discount programs you can find online that may provide cost savings compared to the out-of-pocket prices. There are a number of websites out there, but ask your pharmacy if they know of any specific discount programs they have seen to be worthwhile for patients. CommunityCaresRX.com, WellRX.com, and GoodRX.com are a few that I have found useful. They allow you to search for a specific medication and compare pharmacies within your area. The prices are not always exact (sometimes they're even less than listed!), but they can give you a general idea of which pharmacy may have the best price for you. These websites also offer apps for your phone, so you can get an estimate before you even leave your provider’s office.
5. Patient Assistance Plans
Even if you do not qualify for coupon savings programs from the manufacturer, many of the brand name drug manufacturers offer Patient Assistance Programs for uninsured or low-income patients. To find out if these programs are available, use either the manufacturer's website, or search for the drug name at RXAssist.org, a nationally-recognized resource for finding reliable patient assistance program information and criteria.
For generic medications, RXOutreach.com is a respectable, non-profit, mail-order pharmacy that offers generic medications at a discounted rate to qualifying patients with a household income at or below 300 percent of the federal poverty level. You may qualify for their services, even if you already have a prescription drug plan (including the federal plans), and may find the medications are even less expensive than using your insurance.
6. Don’t Skip Important Medications
The most important thing you can do for your health is to stay on track with your necessary medications. While it is tempting to skip doses, or just forego filling a prescription altogether, this will often result in worsening your illness or condition. Ultimately, going untreated or under-treated can lead to far more serious and expensive health care outcomes, such as hospitalizations, more prescription medications, missed work days and an overall lack of well-being. Keep up with your daily medications, and always ask your provider before stopping medications. Take advantage of preventive appointments and annual well-check appointments. Communicate with your pharmacist and provider to make sure you understand why you are taking each medication. We want you to have the best possible health outcomes. Be an advocate for your own health by working with your pharmacist and provider to find the most affordable and effective solutions together.
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