A CONSUMER’S GUIDE TO DRUG DISCOUNTS
Have you ever had to choose between buying groceries or paying the rent and filling a drug prescription? Have you or has someone you know ever skipped taking medication because of the cost? You’re not alone. Millions of Americans are feeling the burden of increasingly costly prescription drugs, and they’re making choices that could jeopardize their health.
Today, the amount
consumers have to pay out of pocket for prescribed drugs is rapidly escalating,
from about $25 billion in 2000 to a projected $67 billion in 2025. To make
matters worse, more than 8.8 percent of American adults, or roughly 28.5
million people, do not have health insurance and must pay for all prescription
medications themselves.
But there are ways
that you can minimize the effect that the accelerating prescription drug crisis
has on your healthcare. This guide to drug pricing and discounts provides the
answers to common questions and offers practical information that every
consumer needs to know.
Why Are Prescription Drug
Prices So High?
Did you know that
Americans pay the highest costs for prescription medications in the world? You
can partly attribute the exorbitant prices to an intricate and extensive drug
research and development (R&D) and approval process, along with an equally
complex healthcare system.
No doubt, we have
benefited from innovations in the management of diseases for which there were
few or no treatment options before. But opponents of the pharmaceutical
companies argue that just a small percentage of the drug companies’ costs are
used for R&D, with most of the money spent on administration and brand-name
drug marketing.
Drug companies don’t
tell the whole story behind the rising cost of prescriptions. There are
third-party administrators known as pharmacy benefit managers (PBMs), who are
paid to negotiate prices between pharmacies and
large insurers. These PBMs charge pharmacy providers either a percentage or a
flat fee for every prescription filled, which contributes to higher drug
prices.
How Can You Save
Money on Medication?
Consumers have options when it comes to getting the lowest prices on
prescription drugs.
First, if you aren’t
shopping around for medications at local pharmacies, using online coupons, or
joining buyers’ clubs at drugstores, you’re probably paying way too much.
Just because your
pharmacist quotes you a price does not mean that’s the lowest price for that
prescription. Comparison shopping for prescription medications can be as quick
and easy as following the helpful tips below, reviewing a few websites, and
printing some money-saving coupons.
12 Ways You Can Cut
Your Drug Costs
These 12 surefire tips will help you save on prescription medications so that
you can put the extra funds to other important uses.
1. Try Generic Drug
Options
More than 80 percent of all drugs today are generics, which use the same active
ingredients as brand-name medicines and work the same way but tend to cost a
lot less than their pricey brand-name counterparts.
The cost-saving news
is that manufacturers of generic drugs do not have to repeat the animal and
clinical (human) studies that were required of the brand-name medicines to
demonstrate safety and effectiveness. Also, the competition among multiple
companies producing a generic version of a drug helps keep the prices low for
consumers.
According to
the Food
and Drug Administration (FDA), to gain
approval a generic drug must be the same as the brand-name product in the
following ways:
Able to reach the
required level in the bloodstream at the correct time and to the same extent
The manner in which
it is taken (whether inhaler, liquid, or pill)
Strength
Testing standards
Use and effects
Working ingredients
Generics may differ
from brand-name counterparts in terms of other characteristics that don’t
affect the drug’s performance or safety, like flavorings.
What you should do
Talk to your physician and pharmacist about generic equivalents of your
brand-name drugs and consider switching.
2. Search for
Discount Coupons Online
A simple Google search of your prescription drug, over-the-counter medicine, or
healthcare supplies will bring up pages of websites offering money-saving
coupons.
Drug coupons cannot
lower your copay, but your pharmacist may apply the coupon to your drug
purchase to lower the price.
What you should do
Before you head to the pharmacy to fill a prescription, do a quick Google
search to check for money-saving coupons and rebates.
3. Use an App to
Compare Local Drug Prices
There are several websites and mobile applications that can help you find the
best price available for a prescription drug.
One of the most
widely used is GoodRx, which allows you to comparison shop and get coupons
toward medications. GoodRx collects and compares prices and discounts that you
didn’t know existed from more than 70,000 U.S. pharmacies, including CVS, Rite
Aid, and Walgreens. It allows you to print free discounted coupons or send them
to your phone by email or text message. You can then use a GoodRx discount
instead of your health insurance or Medicare Part D or Advantage plan if the
cost is lower than your copay.
When you go to
GoodRx.com, they will ask for the name of the drug, the dosage, the number of
pills, and your zip code. Click the “Find the Lowest Price” button. You will
see what you might pay at different chain pharmacies with a GoodRx discount
coupon or voucher. You can then print or download the generated coupons and
vouchers to your smartphone and show your pharmacist to get savings on your
drug purchase.
Similarly, Blink
Health lets users browse local prices by simply searching for a prescription
drug’s name. It also offers the option of having your medication delivered or
ready for pickup. Another online and mobile service is OneRx, which lists drug
prices in your area and offers discounts to consumers using the OneRx card.
RetailMeNot Rx Saver
is a popular and easy-to-use app and program. Here you can search for prices on
brand-name and generic drugs. Their coupons can be used an unlimited number of
times at retail pharmacies such as Walgreens and CVS.
Other websites and
mobile apps that offer drug coupons and rebates include ScriptSave WellRx, Easy
Drug Card, and Search Rx.
What you should do
Check out these and other no-cost prescription pricing services to see what
pharmacies in your area charge for your medications.
4. Join Your
Pharmacy’s Prescription Club
No insurance or not enough coverage? You can find in-store pharmacy prescription
clubs at many drugstores. These money-saving programs can lower drug and supply
prices.
Also, the in-store
programs provide up to an 85 percent savings on thousands of prescriptions,
including commonly prescribed generic medications for heart health, diabetes,
asthma, mental health issues, women’s health, gastrointestinal health, and
other conditions.
While these savings
clubs are not health insurance, they can save you money at the pharmacy.
What you should do
Compare different in-store pharmacy prescription clubs to get the best prices
when checking out. In-store pharmacies at retailers like Walgreens and Kmart
also offer prescription clubs.
5. Shop Local or a
Preferred Pharmacy Network
Independent pharmacies may beat major chain drugstores, supermarkets, and big
box discounters on price — and by an impressive margin. Independents can also
easily beat membership warehouses and clubs.
In contrast, the
preferred pharmacy network is a group of chain pharmacies that likely give
insurance plans a larger discount than other pharmacies.
The point is that
drugstores have different prices — they can vary by hundreds of dollars — so be
sure to ask ahead before you pick a specific pharmacy.
What you should do
Call your local and preferred retail pharmacies before filling your
prescription to find the lowest prices.
6. Use a Verified
Internet Pharmacy
Verified internet pharmacies are those that have passed stringent reviews by
the National Association of Boards of Pharmacy (NABP). These pharmacies often
include “.pharmacy” in their URLs to show that they are in compliance with the
NABP, although some verified pharmacies are .coms or .orgs. They also carry the
designation VIPPS, for Verified Internet Pharmacy Practice Site.
While verified
internet pharmacies have passed inspection and are deemed safe, be careful not
to use a rogue internet pharmacy that is not verified. Check your internet
pharmacy against the Find a Safe Site list to buy safely.
In a revealing 2018
study, Consumer Reports sent secret shoppers to 150 pharmacies in six cities
across the country to ask for the retail cash prices for a one-month supply of
five commonly prescribed drugs — essentially the prices someone without
insurance might pay. The wide range in prices they uncovered was shocking. While
the five-drug “basket” cost was just $66 at the verified internet pharmacy
HealthWarehouse.com, two national chain retailers had prices closer to $900 for
the five drugs. (7)
What you should do It
pays to shop around, and don’t forget to check internet pharmacies like
HealthWarehouse.com for greater savings.
7. Use Mail Order for
Medications and Supplies
Many pharmacies offer online ordering for drugs, diabetic supplies,
over-the-counter medicines, hair supplies, and even pet medications. And you
don’t have to have insurance. After placing your order, you will receive the
drugs and supplies in the mail. Make sure the pharmacy is VIPPS accredited and
certified. Your doctor will send the Rx by e-prescription to the proper phone
number.
What you should do
Generally, it will take one to five business days to process your mail-order
prescription, so it’s important to plan ahead.
8. Get Free or
Low-Cost Birth Control Online
Not only can you get great prices on medications online, but several newer
websites also offer free or low-cost birth control to women in many states.
Planned Parenthood Direct, Nurx, Prjkt Ruby, and Maven Clinic offer telehealth
services, virtual clinics, and prescription drugs delivered right to your door
— and no insurance is needed.
What you should do
Explore telehealth services and virtual specialty clinics that can save you
time and money on birth control and other necessary medications.
9. Talk Openly With
Your Doctor
Be vocal with your doctor about any financial issues you may have, and be sure
to try one or more of the following five things at your next office visit:
Ask your doctor for
free samples or coupons. Doctors usually have samples and coupons given to them
by drug reps. It doesn’t hurt to try a free sample pack before filling a pricey
prescription to make sure this drug will work for you.
Ask your doctor for a
90-day supply. This gives you one copay every three months instead of one every
month.
Ask about mail order.
If your drug plan has a mail-order option, you may be able to get the 90-day
supply of medications at an even lower cost.
Ask about
pill-splitting. Your doctor can prescribe a higher dose of medicine at the same
price of the lower dose. You can split the drug in half or fourths to save.
Scored pills are easier to split, but use a pill splitter (usually between $3
and $9 at most pharmacies) to avoid crushing the medication.
Ask for an exception.
If you and your doctor can’t find an affordable option together, speak with
your insurer about making a formulary exception and providing coverage for your
drug. The formulary is a list of prescription drugs covered by a prescription
drug plan or another insurance plan offering prescription drug benefits. Your
doctor will most likely need to submit a supporting statement, detailing that
your drug is medically necessary and that any alternatives would have an
adverse effect.
What you should do Be
open and persistent. If your insurer denies your request for an exception, file
an appeal. This requires that you work with your doctor to submit an
application or letter of appeal.
10. Consider Patient
Assistance Programs
Patient assistance programs (PAPs) are typically offered by pharmaceutical
companies to provide free or low-cost prescription drugs to patients who lack
health insurance or prescription drug coverage. You will need to fill out an
application on the drug company’s website with your financial information. Your
doctor may need to provide information about your prescribed medications.
The drug company will
review the application and tell you if you’re eligible for assistance. If
approved, many companies will ship a supply of the drug to your home or your
doctor’s office. Your doctor will need to place a new order several weeks
before the supply runs out.
What you should do
Check out RxAssist.org, an online database of drug companies offering patient
assistance programs that provide free or affordable drugs and copay assistance.
11. Learn More About
Medicare Part D
If you are 65 years or older and on Medicare Part D or Medicare Advantage, it’s
important to understand how to get discounts on drugs. Medicare Part D is an
optional program to help Medicare beneficiaries pay for prescription drugs.
Medicare Advantage Plan is a type of Medicare health plan offered by a private
company that contracts with Medicare.
The insurer’s
formulary of drugs that they cover can change at any time, so be sure to check
the prescription medications you take on the Medicare.gov site to find the best
Part D plan that works for you.
While some people are
able to use discount coupons with Medicare Part D, most cannot unless they’re
paying cash only. Of course, if you have a coupon for a drug not covered by
your prescription drug plan, you can use this to lower your costs.
What you should do
Take advantage of online education such as the Drugs.com Medicare Support Group
to ask questions, share opinions, and stay up with the latest news. Also, check
the Medicare.gov site for more understanding on how Part D works with other
insurance. Read more..
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