One of the frequent questions that I get from friends is requests to help them find more affordable prescriptions – either for themselves or for their parents. After answering it so many times, I’ve decided to put together this list of all of the different programs and possibilities of saving money on prescriptions in the hopes that it can help other.
A couple of basic pointers before we delve into the different options – please note that you can combine any of these options for maximum effect…
1) Take generics whenever possible. When the patent for a brand-name drug expires then generic versions of the drug can be offered for sale if approved by the FDA. Generic drugs are usually cheaper than brand-name drugs.
2) Check your drug formulary. A formulary is a listing of prescription medications which are covered by a Health Plan (aka – Your Insurance Company). The list is subject to periodic review and modification by the Health Plan and may change with zero notice to you. If a drug that your doctor prescribes is not on the formulary, your insurance will not cover it at all. Additionally, most formularies have different amounts that you have to pay for different classifications of drugs so you always want to check to see what “tier” of coverage your drugs will fall into.
3) Different pharmacies charge different amounts. Prices for the exact same dose of the exact same drug vary by pharmacy. If you are paying out of pocket, it is worth trying to find a pharmacy that has the lowest price. Since the internet is a wonderful place, there are free tools for looking up drug prices. Goodrx is a pretty decent tool for looking up costs and you can also find coupons for some drugs.
4) If there is not a generic there may be something called a “therapeutic alternative” or “therapeutic interchange”. Basically, there might be 5 different drugs that treat a condition like depression or high cholesterol and they are chemically different from each other but they are all used to treat the condition. It’s like trying Advil instead of Aleve or Tylenol. The AARP (in conjunction with Consumer Reports) has put together a Drug Saving Tool that lets you put in the name of your prescription and provides you with approximate cost as well as a list of other alternatives used to treat the same condition for you to take and discuss with your doctor. The major caveat with therapeutic alternatives is that they absolutely require a conversation with your doctor and will not always be available or make sense for your condition.
5) Consider Pill Splitting. Drug pricing doesn’t always make sense – you may pay 2x the price for a 50mg prescription that you take twice a day rather than a 100mg pill that you split with a pill splitter. So do a little research on the prescriptions that you take and see if you can get double the dose for less than you pay for your current dose (i.e. – see how much 100mg costs vs 50mg). Then talk to your doctor and see if you can split the pill you are taking and get a new prescription for the higher dose. Please be aware that anything with controlled release, extended release, etc cannot be split – ever. So make sure that if you plan on splitting pills that you verify with your doctor or pharmacist that the pill can indeed be split.
6) Think about mail order. Most insurance plans will offer you a 90 day supply of your prescription for the price equivalent of a 60 day supply if you get the prescription through their mail order pharmacy. Depending on your copay this can save you between ~$60-$200/year.
Money Saving Programs
Walmart, Kroger, and Target all have a list of $4 generic drugs that they offer. It is worth the time to see if any of your prescriptions have a generic alternative that you can get for significantly less money.
Coupons are frequently available for all sorts of both pharmacy dispensed and over the counter drugs. One of my favorite places to look before I go to buy any medicine is on NeedyMed’s coupon pages. You can also find coupons at DrugCoupons.com (brand name drugs only), RxVouchers (brand, generic, and over the counter drugs). As a potential downside Consumer Reports has an article about how coupons don’t always provide the best deal that you should read.
Many brand name prescription drugs have rebate programs to help offset the cost of a prescription drug. Often, many of these programs do not require the individual to be financially needy to qualify. The programs are often referred to as Patient Assistance Programs and are offered by the drug manufacturer for certain high cost medications.
One of the best sites to get information on any programs that might be available is NeedyMeds.org. There are links on the left of the page to look up any brand or generic medications as well as links to coupons or other programs that might provide assistance. I had an employee taking a monthly medication that required a $150/month copayment. Using this site, we were able to get the employee some assistance and reduce his monthly payment to $35/month saving him ~$1300/year.
There are also often rebate programs available for certain prescriptions that can be found at various sites such as fromyourdoctor.com.
Prescription discount cards give you a printable card that you can use at certain pharmacies to get discounts on your prescriptions. RxAssist offers this – you need to click on the link at the top that says ‘Locate a participating pharmacy…’ and you’ll need to input both your zip code and the prescriptions that you take but then you can click on the ‘Print Card’ option at the top (or just cheat and click here and print off the card) NeedyMeds offers a discount card as do PharmacyCard and MedicationDiscountCard.
Need Based Discount Cards
There are also discount cards specifically available for those without insurance. For example TogetherRxAccess will provide you with a discount card if you do not have insurance and do not qualify for Medicare. It’s sponsored by the drug companies so most brand name prescriptions are subsidized and it’s accepted at most major pharmacies.
Need Based Programs
There are also just regular need based programs that offer more than just a discount. Partnership For Prescription Assistance can help you find all sorts of programs including Medicare/Medicaid programs, state based programs, children’s programs, rebate programs, and discount cards. NeedyMeds also provides links to all sorts of need based programs on their website.
Did I miss anything else? If so, please leave a note in the comments and I’ll add it to the list!