Richard Sagall, MD
Richard Sagall, MD, who specializes in family medicine and occupational medicine, Gloucester, Massachusetts. He is founder of NeedyMeds, Inc., a nonprofit that tracks money-saving pharmaceutical programs. NeedyMeds.org
Americans have an expensive drug habit—prescription drugs. Drug costs now average around $1,200 a year per person in this country, and prices are continuing to rise. Health-care costs play a role in more than half a million bankruptcies each year, sometimes because of new cancer drugs that can cost hundreds of thousands of dollars for a course of treatment.
“Everyday drugs” also take a greater chunk out of consumers’ pockets even if they have health insurance or Medicare Part D prescription drug coverage thanks to high deductibles and copays.
You may already know some common ways to save money on prescription drugs—among them, asking for generic versions of drugs…splitting pills in half if the doctor or pharmacist says that’s allowable…and asking a doctor for free samples of a drug. But there are additional ways to cut your costs that you may not know about.
Here are seven strategies that can help lower the cost of your prescriptions…
Shopping Strategies
Comparison-shop multiple pharmacies. The price of a prescription can vary dramatically from pharmacy to pharmacy—sometimes by hundreds of dollars. Drug-price comparison apps and websites offer the best way to find the lowest prices available in your area. Examples: NeedyMed’s Drug Pricing Calculator (www.NeedyMeds.org/drug-pricing)…GoodRx (GoodRx.com, a free app available for Apple or Android).
Traditional pharmacies are not the only sellers. Warehouse clubs such as Costco and Sam’s Club often allow even nonmembers to fill prescriptions at their pharmacies (rules vary by both warehouse club and state). And online pharmacies are an option if you plan ahead or can safely wait for the drugs to be delivered. Just confirm that the online pharmacy has “Verified Internet Pharmacy Practice Site” (VIPPS) accreditation, which ensures that it meets its state’s licensing and inspection requirements as well as National Association of Boards of Pharmacy standards. Warning: Avoid any online pharmacy that says it can provide prescription drugs without a prescription—they are especially likely to provide counterfeit drugs that could be ineffective or dangerous.
Obtain a prescription drug discount card. Dozens of nonprofit organizations, pharmacy chains and other health-care–related companies offer drug discount cards that can provide savings on certain drugs at certain pharmacies. The size of these discounts will vary dramatically depending on the drug, the pharmacy and the card—anywhere from no savings to 80% savings. It depends on how much of a savings the card issuer managed to negotiate on behalf of its cardholders. Or in the case of the pharmacy chain–issued cards, how much of a discount the pharmacy was willing to offer.
These cards cannot be used in conjunction with health insurance/Medicare—you have to use one or the other—but sometimes the total price with the discount card is less than the copay imposed by an insurance or Medicare plan. Before paying for any prescription, ask your pharmacy to compare the price you would pay with your discount card to the amount you would pay out of pocket with your insurance/Medicare. Downside: If you use a discount card to buy a drug, the money you spend will not count toward your annual insurance/Medicare out-of-pocket maximum.
There are many discount cards available. Which ones are best depends on which drugs and pharmacies you use, but pick only those that do not charge any fees. Examples of widely accepted free discount cards: GoodRx (GoodRx.com), NeedyMeds Drug Discount Card (offered by my nonprofit organization, NeedyMeds.org), ScriptRelief (ScriptRelief.com), ScriptSave WellRx (WellRx.com) and SingleCare (SingleCare.com).
Seek a lower-priced drug if there is no way to affordably obtain a drug that you have been prescribed. Ask your pharmacist whether he/she can contact your doctor’s office to check whether a lower-cost drug would be a suitable replacement. For example, there might be an older version of the exact same drug available that’s just as effective but less expensive because it is in a form that is less convenient to take.
Additional Money-Saving Strategies
Request assistance from drugmakers. Perhaps you’ve seen a drug commercial that says that if you can’t afford your medication, the drugmaker might be able to help. Most pharmaceutical companies have “Patient Assistance Programs” that provide free or deeply discounted drugs to patients who could not otherwise afford them. These programs typically are designed to help limited-income patients obtain high-cost drugs, but program rules vary and income limits can be surprisingly high—in many cases $40,000 to $65,000. Details and application forms are available on drug-company websites. They also can be found at www.NeedyMeds.org/pap. If you appear to fall just short of eligibility for the program for a drug you need, file an application anyway—sometimes drugmakers are willing to stretch eligibility rules a little.
Look for drug-company copay rebates/coupons. Drugmakers offer “copay assistance” rebates and coupons for certain drugs—often drugs that have high out-of-pocket costs. The savings can be substantial, in many cases lowering the out-of-pocket price all the way to $0. Unfortunately, these rebates and coupons tend to be available only to people who have commercial insurance, not people who have government-provided health coverage such as Medicare or Tricare. On the plus side, these programs do not have income caps or other need-based eligibility restrictions such as the patient-assistance programs discussed above. These coupons and rebates can be found on pharmaceutical-company websites…or check the list available at www.NeedyMeds.org/coupons. The offers change frequently, so check back every few months.
Examples: Recently the list of drug copay coupon and rebate programs featured thousands of medications, including the chemotherapy drug Abraxane, which has a program that reduces copays to $0 (CelgenePatientSupport.com), and the hypertension treatment Azor, with a coupon that reduces copays to as little as $5 (Azor.com/savings).
Apply to nonprofits associated with your diagnosis for assistance. There are thousands of nonprofit organizations in the US devoted to specific medical problems and topics. Many of these nonprofits offer financial support to people struggling to afford prescription drugs or other treatments. Each program has its own eligibility rules, application forms, deadlines and limits. NeedyMeds maintains a list of nonprofits that have such programs at www.NeedyMeds.org/copay-diseases.
Retry the strategies above every few months. Drug prices, assistance programs and discount-card savings can change. So if you’re taking a drug long-term, it’s worth rechecking whether there are ways to save that were not available when you initially looked.