Reducing Medication Costs

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Topic Overview

How can you lower your medicine costs?

Trying to make some changes in your lifestyle might help reduce your need for medicines. Many chronic illnesses, including diabetes, high blood pressure, and low back pain, require fewer medicines if you can increase your activity level, lose weight, and improve your diet. Also, counseling, support groups, and other therapies may help with illnesses such as depression.

How can you save money on prescriptions?

Generic medicines are less expensive copies of brand-name medicines. Ask your doctor or pharmacist if you can take a generic equivalent for the brand-name medicine that you take now. Generic equivalents are made according to the same strict U.S. Food and Drug Administration (FDA) standards as brand-name drugs and therefore have the same quality, strength, purity, and stability as their more expensive counterparts.

Unfortunately, generic equivalents are not available for every brand-name medicine. If there is not an equivalent, ask your doctor if there is a similar medicine in the same class that may be less expensive or that has a generic equivalent. For example, Flomax, which is used to treat an enlarged prostate, is a relatively expensive medicine that does not have a generic equivalent. But another medicine that also is used for enlarged prostate, Hytrin, does have a less expensive generic equivalent.

Always shop around for the best deal on medicines. The retail cost can vary widely from pharmacy to pharmacy. While finding a good deal is important, it's also important that your pharmacist (or pharmacists) knows your medical history, including all the drugs—both prescription and over-the-counter (nonprescription), as well as dietary supplements and herbs—you take, even if they are not dispensed at that particular pharmacy. That way he or she can provide valuable advice about any potential for drug interactions, side effects, or other problems.

Also, compare costs of buying medicines online. Some large drugstore chains have Web sites that offer savings. See a complete list of Web sites on the National Association of Boards of Pharmacy (NABP) site at www.nabp.net/index.html?target=/vipps/consumer/search.asp&. Look for Web sites that display the NABP VIPPS (Verified Internet Pharmacy Practice Sites) seal, which means they have met state and federal requirements.

Pill splitting is another strategy that can help you save money without losing drug effectiveness or safety. Some tablets are available at double the dose and at the same or almost the same cost as lower doses. By splitting the larger dose, you can essentially get two doses for the price of one. But many medicines should not be split, including timed-release pills and capsules. The chart below lists 10 commonly prescribed medicines that researchers have determined can be split safely and effectively with significant cost savings.¹

Ask your doctor or pharmacist if any of your prescription medicines are sold at higher dosages and if it's possible to split them. Talk to your pharmacist about how to split pills with an inexpensive, easy-to-use pill splitter .

Buying prescriptions in bulk can also save you money. Ask your doctor to write a prescription for several months' supply of medicines that you take consistently. Keep in mind that your insurance company may limit the amount of medicine you can get at one time. Sometimes the cash price for a 3-month supply of medicine is less costly than if you were to pay an insurance copay each month for three months. Mail-order services can often save you money on large orders. But make sure to use only trusted, reliable pharmacy Web sites.

If you are trying a medicine for the first time, don't get more than a 30-day supply. In fact, you may want to get only one week's worth of medicine. If the medicine has to be changed later, you will have saved paying for more than you needed.

How can your insurance plan help you save money?

Take time to find out about how your medical insurance or managed health care plan covers medicine costs. Some insurance companies cover only generic medicines if they are available. With some insurance plans, you may have to pay more for medicines that are not on the plan's list of preferred medicines (also known as a formulary). Some insurers cover medicines that are bought only at participating pharmacies. Your insurance company also may not pay for certain medicines such as weight-loss and hair-growth drugs. Ask the customer service representative whether your medicines are covered, whether you need to buy at participating pharmacies, and about your copayment. Many insurance companies also list this information on their Web sites.

If you have a choice between plans, check what your copayment for prescription drugs will be, the maximum amount the plan will pay in a year, and other particulars. Choose the plan that best suits your needs. When buying medicines, find out which payment option will be the least expensive. Some things to consider include whether there is a generic version of a preferred medicine, and whether an over-the-counter equivalent is cheaper than your copayment. Bring a copy of your health care plan's list of preferred prescription drugs to your next doctor appointment, and keep the list with your chart. That way, you and your doctor can see which medicines cost the least on your plan. Remember, having the right information can save you time and money.

Are prescription medicines always necessary?

There may be an over-the-counter alternative for your prescription medicine. For example, nonprescription Aleve is a fraction of the cost of the prescription equivalent Naprosyn. (Generic versions of over-the-counter medicines can save you even more money.) Often nonprescription equivalents of prescription medicines come in lower strengths, so get instructions from your doctor or pharmacist on how to take them.

In the case of antibiotics, recent research has found that they are not always needed. For example, up to 80% of ear infections get better without antibiotics.² Likewise, up to two-thirds of people with acute sinusitis improve on their own without antibiotic treatment.³ Your doctor might recommend that you take a wait-and-see approach before buying expensive antibiotics.

Can you save money by purchasing prescription medicines from Canada? Is it safe?

The answer to the first question is "Yes." You can buy most prescription medicines, either over the Internet, by mail order, or in person, for less money from Canadian pharmacies than from their U.S. counterparts. Whether it is legal to do so remains controversial.

The FDA warns that the safety of drugs bought from other countries cannot be ensured. But many doctors acknowledge that Canada also demands safety and efficacy for medicines, and they would rather their patients buy medicines from Canada than have to skip doses because they can't afford their medicines. U.S. citizens have been buying medicines in Canada for years, although officially federal law prohibits the practice. Currently, the U.S. Customs Service allows Americans to bring a 90-day supply of prescription drugs across the Canadian borders for personal use.⁴

Talk to your doctor if you decide to import your medicines, and be sure to buy only from licensed Canadian pharmacies and wholesalers.

How can your doctor help?

To enlist your doctor's help, tell him or her that your prescription medicine bill is a financial burden. Ask for drugs that are less expensive but just as effective. Often, several medicines can be used to treat the same condition, and your doctor may be able to prescribe the one that is the most economical. For example, researchers have found that older, less expensive antibiotics such as amoxicillin work better than newer antibiotics for children who need treatment for middle ear inflammation.⁵

Often, drug companies give doctors medicine samples free of charge. You might ask your doctor if he or she has medicine samples, especially when you are trying out a new medicine to see whether it will work.

What about the Medicare drug program?

The Medicare Part D prescription drug benefit began in January 2006. For the most current information about what the Medicare Part D Act means for you, go to www.medicare.gov or call 1-800-MEDICARE. Your doctor, pharmacist, or social worker may also be able to help you understand your Medicare benefits.

What other resources are available?

See whether the pharmaceutical company that makes your medicine has a patient assistance program. Many pharmaceutical companies offer free or discounted drugs for people who cannot afford them. These companies often require that your doctor contact them first about your case. In any case, your doctor will need to be involved, and the application process can be complex. You may need to provide documentation to verify your income. The nonprofit organization RxAssist provides doctors and other health care providers with the information they need to access these programs. You can find out more at www.rxassist.org. This Web site also lists state programs for seniors and disabled and low-income people.

If you have a rare disease, you may be eligible for the National Organization for Rare Disorders (NORD) medicine assistance program. This program helps people with rare diseases whose income is too high to qualify for Medicaid but too low to pay for their prescribed medicines. For more information, visit www.rarediseases.org/programs/medication.

Most veterans know that the Veterans Administration offers prescription drug coverage for retired veterans. But many people don't know that the same service is available for their families and survivors. Call the VA Health Benefits Service Center toll-free at 1-877-222-VETS (8387), or go to www.va.gov/health.

Some organizations offer special discounts on prescription drugs for their members. For example, AARP and AAA offer savings. Many pharmacies offer some form of a discount plan for seniors. Community health clinics or programs may have low or no cost prescription drugs for those who qualify. Also, some pharmacies now offer one low cash price ($4) for a 30-day supply of certain generic medicines.

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Last updated:	August 16, 2007
Author:	Debby Golonka, MPH
Reviewed By:	Kathleen Romito, MD - Family Medicine, Theresa O'Young, PharmD - Clinical Pharmacist
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman