Are You Paying Too Much for Your Drugs? – Aug 2018 – by Renee Fabian
Health care in America is expensive. One of the biggest costs? Your medications.
A recent study from researchers at the University of Southern California highlighted part of this expensive problem. Based on their analysis, 23% of customers overpaid for their prescriptions. Nobody will tell you you’re overpaying, not the pharmacist — who might not be allowed — and certainly not your insurance company.
If you’re one of the nearly 50 percent of Americans who’s taken at least one prescription drug in the last 30 days, it probably won’t surprise you that 16.7 percent of healthcare spending in 2015 was on drugs alone. That’s a total cost of about $457 billion annually, and the prices aren’t going down any time soon.
Here’s how you might be able to save money on your drug costs, even if you’re covered by insurance.
Work With Your Doctor (and Pharmacist!)
Sometimes when clinicians prescribe medication, they have choices about the specific brand or generic they give you that can make or break your budget, depending on the cost.
If your doctor wants to prescribe something that isn’t covered, ask if there’s a similar medication or generic version that is covered.
If you need a medication that is more expensive or not on the formulary list, your insurance company may require you try step therapy before approving your drug of choice.
And buyer beware. Sometimes pharmaceutical companies offer doctors financial incentives to prescribe particular drugs. This may not be in your best medical or financial interest.
If you need help sorting through your option, try asking your local pharmacist. They know just as much, if not more, about drugs as your doctor.
But they know nothing of me, and it’s my personal biochemistry and medical history that usually determines the effectiveness of any particular medication – and the pharmacist has no access to any of that.
Choosing a Generic Medication
n the U.S., drug companies can patent new drugs for 20 years, which means patients prescribed those meds are stuck paying brand prices. This system is partly why your drug costs are so high in the first place.
Once that time period ends, other companies can make a generic version that sells for much less. One of the best ways to save money is to switch to the generic version of a medication.
While there’s been some debate in the media about whether or not generics are as good as the brand, most concerns are unfounded.
I have my doubts about the quality control of generic medications and the equality of different generics.
My experience has been that sometimes when my pharmacy gets their generics from a different vendor, that generic will affect me differently than the previous one I used or the brand name medication.
Generic drugs are regulated by the Food and Drug Administration and must have the same active ingredients as the brand version.
However, one critical difference is that:
The non-active ingredients in a generic don’t need to be the same.
These non-active fillers determine how much and how fast your body can metabolize the medication, so they are a critical component of how the drug works in our individual bodies.
Medication Therapy Management Programs
If you’re on Medicare, you might have heard of a medication therapy management (MTM) program.
An MTM helps you review the medications you use if you have more than one chronic condition. With a pharmacist and/or your doctor, you’ll check to make sure the drugs you’re taking work effectively.
doctors prescribe new drugs each time symptoms occur. Eventually, it’s hard to tell what you’re taking and why. An MTM evaluation can help consolidate prescriptions so they’re more effective and cost-efficient.
If you can’t afford your prescription, you can try reaching out to the drug company directly. Drug manufacturers often offer some version of a prescription assistance program for those can’t afford their medications
Drug company Pfizer, the manufacturer of drugs such as Lyrica, has a RxPathways patient assistance program.
After searching for the medications you take and answering a few personal questions, including your monthly income, you’ll find out if you’re eligible for discount meds.
In the case of Pfizer, if you do meet the income requirements, you can apply to receive free Pfizer-brand drugs at your doctor’s office, home or by using a discount co-pay pharmacy card.
Price Shopping to Get Your Drugs for Less
you can shop around for your medications just like you would any other product.
This means not only checking out a variety of pharmacies or big box and club stores, but also your options available through discount prescription services like ScriptSave WellRx and FamilyWize.
Discount prescription companies negotiate rates directly with drug companies. Often you can get a better rate through one of these services than what you would pay in cash — and sometimes better than your cost with insurance.
You might need to print out a savings card or coupon to present to your pharmacist. Some companies let you order directly online or send medications straight to your house.
Here are six discount prescription services:
Please see the full article for the list and description of each.
How Much Can You Save?
We asked the Mighty community which prescription drugs they have a hard time affording — and more than 500 people shared a variety of costly prescriptions.
Based on the community’s answers, we pulled four common drugs — Abilify, Savella, Remicade and Pristiq — and did a little price shopping.
We compared the average amount you paid, which included brand and generic drugs, with how much you might be able to save (based on calculations in Los Angeles).
Abilify is an antipsychotic used to treat conditions such as schizophrenia, bipolar disorder and depression. Brand and generic versions are available. The brand version can cost as much as nearly 95 percent more than the generic version based on these discount prescription services.
Savella is a nerve pain and antidepressant medication often used to treat fibromyalgia. Currently, only the brand version is available.
Remicade is an immunosuppressive drug used to treat conditions such as rheumatoid arthritis, Crohn’s disease and ulcerative colitis. It is only available as the brand version, though two similar medications, Inflectra and Renflexis, have been approved by the FDA.
Pristiq is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat depression. Currently available in both brand and generic variations. The generic version costs about 20 to 30 percent of what the brand costs based on these discount prescription services.
Author: Renée Fabian is Associate Editor, News & Lifestyle at The Mighty.