As I mentioned in one of my previous posts, medical expenses top our budget. It doesn’t look like we are alone. According to Census.gov, the typical household (including residents of all ages) spent $3,313 on health care in 2011, compared to $2,771 in 2001, after adjusting for inflation.
To make matters worse for us, recently our insurance company separated the drug benefits to a separate part of the insurance program. Now we can’t just go to the drug store and use our insurance card to get prescription drugs. We have to send it to the online pharmacy that is authorized to deal with all their subscribers’ prescriptions. If we want to get it in the local store, we have to pay extra. Most of the specialty drugs are excluded as well. So I decided to shop around and see if I can save money on prescription drugs.
There are several ways to get cheap prescription drugs.
At your doctor’s office
1. Ask them to mark the generic substitution box and educate yourself on generics: FDA requires generics to have the exact same active ingredients, dosage, route of administration and efficacy. Going with generics over brand-name prescription drugs, can mean significant savings. So ask your doctor if it is acceptable to substitute brand-name drugs with generics, when available. Most of the time, they will be ok with it. If your doctor is set on prescribing a brand-name drug, he/she will probably explain the reasoning behind their decision. If you don’t agree with the reasoning, feel free to get a second opinion, if not, stick with the prescription. Also the inactive ingredients in the generics need not be the same as the brand-name drug. Some people might be sensitive to these inactive ingredients. For example, I am not sure what Walmart adds in their generics but they never agree with me. I am fine with Target and Costco $4 generics, but Walmart drugs don’t work for me.
2. Ask for samples: Pharmaceutical reps provide doctors with a lot of sample meds. The doctor might be able to give your first month supply for free.
3. Ask for any coupons: For enticing patients to start on a brand-name drug, the pharmaceutical representatives also provide some coupons to subsidize the first month’s supply. The hope here is that due to the low start-up cost you will start using the drug and be impressed/get used to the brand-name drug and stick with it instead of going with generics. If they have a coupon, you can get the brand-name prescription drug for the first cycle and move on to generics for the refills.
4. Ask for two prescriptions – 30 day supply and a 90 day supply: Whenever I get a new prescription, I need some time to shop around for the best prices and/or it takes time to get them via mail-order. So I use the 30 day prescription to get started immediately and use the 90 day supply to get my maintenance drugs for cheap.
5. Check with your doctor about splitting a pill: I am afraid to put this in as one of the money saving tips because it can be quite dangerous if not done after careful consultation. But for the sake of completeness, I am adding this tip. Sometimes pills of double dosage cost only a little more than regular dosage (for example 30 50mg pills of Zoloft cost $153.38and 30 100mg pills cost $156.41, just a couple of dollars more!). So, if your doctor and pharmacist feel it is safe to split the pill, you can save almost 50% off your prescription cost. But please, please consult your doctor and your pharmacist before doing this. Also, splitting the pill with a knife doesn’t work; you will mess up your dose!!! Get a pill splitter, it is ~$2.
At home after you get the prescription
6. Think more than CVS/Walgreens/Rite-Aid. This was a mistake I made. CVS and Walgreens were the only pharmacies I used during my first few years in the US. I didn’t realize there are still independent pharmacies that provide better service and (sometimes) lower prices. Of course, a lot of the departmental stores now have a pharmacy and provide very competitive prices. I have tried Walmart, Target and Costco. Costco works for the best for me. You can check the price of a drug on the Costco website and their pharmacists are very helpful too. Just give them a call to check the price before you hand over the money to CVS. (Note: You don’t have to be a Costco member to use their pharmacy. Just let the person at the door know that you are going to the pharmacy, they won’t ask for the card. Though, I have found that being a member shaves a few more dollars off the already lower price.)
7. Look for coupons and rebates: The best way to look for coupons is to check the website of the drug manufacturer itself. I have found that a lot of pharmaceutical companies will provide a coupon for free sample that covers anywhere from between a week to a month’s worth of dosage. If nothing is available from the drug manufacturer, try sites like NeedyMeds or GoodRx that list any store specific coupons for your prescription drug. This works well even for OTC drugs.
8. Discount or copay cards from the drug manufacturer: A lot of pharmaceutical companies have supporting resources for people who take their drugs. The resources range from support groups, educational material to discount/copay cards. They want to compete with the generics market, so they offer copay cards for certain drugs that price match (and sometimes even beat) the generic equivalent.
9. Drug discount cards: There are several companies that offer a “prescription discount cards”. Some people say they cost the pharmacy too much money. I don’t have enough information or understanding to make that call. What I do know is the discount can be substantial sometimes. ConsumerWorld did a study on pricing a drug using various discount cards. They found savings ranging from 0% – 71% based on the drug and the discount card. These cards are free, so of course, there is a catch – these cards are basically data mining cards, at least most of them are. I am not sure how much of your personal information is captured and how it is used, so if that makes your uncomfortable, skip these cards. If not, they can provide great savings. Some of these discount cards include – NeedyMeds Drug Discount card, AAA Prescription savings, Costco Member Prescription Program, AARP Prescription discounts, National Drug Card and Together Rx Access card.
At the pharmacy
10. Check if your pharmacy will match the discounted price offered by the discount card: As I mentioned earlier, it costs the pharmacy money to process your insurance and discount cards. I came to know about this when a pharmacist at an independent pharmacy explained this to me and offered a discount if I paid cash. He matched what the price would have been + an extra $10 if I just skipped using my card. I cannot think that this will work in a big chain pharmacy, but it might be worth a try at least in the independent pharmacies.
11. Make them bid for your business: I have not used this personally; I read this on Howard Clark’s website – let the pharmacies bid for your business. A site, BidRx.com lets you post the name of your medication and then the independent pharmacies will bid on the price. The site is free to use but you need his referral code to register – “clark”.
12. Shop around locally: Check the price of the prescription in different pharmacies in your area. Visit at least 3 pharmacies; include both chain stores and independent pharmacies. The price will differ based on your coverage but the pharmacy can give a rough estimate based on your insurance. If you are going to be on the prescription for a long time, it is worth it to do this exercise at least every year as the preferred drug (available discounts) for each pharmacy changes a lot.
|30 day supply||90 day supply||Coupon available?||30 day supply||90 day supply||Coupon available?|
13. Shop online
Let me starting with a warning about online pharmacies – most of them are not legit. Of the over 10,000 Internet sites reviewed, NABP (National Association of Boards of Pharmacy) found that 97% of the sites fall in the Not Recommended category because they appear to be operating in conflict with pharmacy laws and practice standards. So be very, very, VERY careful when choosing which pharmacy to order from, don’t just look at the prices. I look for prices in this order –
- My insurance company’s online drug portal/Mail order pharmacy: Most major health insurance companies now have a mail-order or online pharmacy section that provides low rates for 90 day supply (Example: Aetna) or they might have a separate Pharmacy Benefits Manager that administers the prescription drug benefits (Example: BCBS, my previous insurance company used Medco to manage their prescription drug coverage).
- Online prescription filling of major pharmacies: Walgreens, CVS, Rite-Aid, Costco all have mail order services. Most of the time I have found the prices are the same online or in the Brick & Mortar branch of the pharmacy, but it is worth checking to see if they are any cheaper.
- Check for approved online pharmacies: I have used Drugstore.com for some of my prescriptions. Online pharmacies offer very competitive prices but the trick is in identifying which ones are real and which ones are “rogue”. Two sources to check the credibility of an online pharmacy:
I can’t afford my medication, what should I do?
However expensive they might be, we are blessed to be able to still afford my medication. If you need help, there are several programs that provide assistance to make your medication more affordable. There are certain criteria (income and availability of insurance) that have to be met, but they are usually much higher than the poverty level, so you might be surprised at what you can get qualified (For example, the poverty guideline for a family of 4 is $23,050; but to qualify for Merck Patient assistance, a family of 4 should be earning $92,200 or less). Here are the links to some major pharmaceutical company’s prescription assistance programs.
- Merck Patient assistance
- AZ & Me (AstraZeneca’s Prescription Savings program)
- J&J Patience assistance
- Pfizer Helpful Answers
- Lilly TruAssist (Eli Lilly)
- GSK Prescription drug program
I don’t qualify for any Government subsidy so I have not looked up any information on Medicare prescription drug coverage. The National Conference of State Legislation and the Medicare website list all the subsidies and any pharmaceutical assistance programs for uninsured or lower income families and seniors.
Another great resource is NeedyMeds.org, a non-profit that provides a lot of information on the drugs and any assistance available to get them.
Other things to be aware of when bargain shopping for cheap prescription drugs
Pharmacy hopping: Have you ever been asked whether you have any allergies while picking up a prescription? That information goes into the pharmacy’s database. So are the other drugs you are currently taking. If you stick with the same pharmacy, any conflict with the drugs you are taking and the new drug will immediately come up when they try to fill your prescription. That is valuable, so if you find a pharmacy that has most of your drugs for cheap, you might want to stick with them.
Know what is important to you. Some people prefer talking to the pharmacist than following the instructions on the pill box. If you value that consultation, pick a pharmacy that gives you better customer service and has all your health history. There is no point in saving money if you are going to spend more for an ambulance because you overdosed.
There are many ways to save on prescription medication but as the saying goes – An ounce of prevention is worth a pound of cure. It will save a lot more money, time and anxiety if we try to stay as healthy as possible.