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Sticker Shock at the Pharmacy Counter: Tips to Reduce Prescription Drug Costs

Have you stopped by your pharmacy recently to pick up your prescription medication and been shocked by the price? This trend is happening not only to people without drug coverage, but also for those with insurance. Rising costs at the prescription counter are caused by increases in the price charged by pharmaceutical manufacturers in addition to increases in insurance copay and deductible amounts required by insurance providers.

If you have insurance coverage for prescription drugs, review the details of your coverage at the beginning of each coverage period. You should know the copayment and deductible amounts. An increase in the deductible amount for your plan will increase your prescription costs, especially in the beginning of each new coverage year.

Here are some suggestions to help you reduce the cost of your prescription medications:

Review the drug formulary of your insurance plan. A drug formulary is a listing of specific prescription drugs in different categories that determines how much you will pay for the medication. Medications are usually grouped in tiers or categories of drugs with similar copayment amounts. Certain medications may not be covered or may require special approval. Take this list with you to each doctor’s appointment to help your doctor select an appropriate medication for your condition at the lowest cost for you.

Ask your pharmacist if a generic drug is available. Generic drugs are identical copies of certain brand name drugs that have been on the market for a while. These medications are usually available at a lower cost than the brand name drug and can be substituted by your pharmacist, unless your doctor has indicated otherwise on your prescription.

Consider therapeutic substitutes. Discuss substitutes with your doctor and pharmacist to see if there is a similar medication that is less expensive or has a lower cost based on your insurance plan. Your doctor will need to write a different prescription for this medication.

Look for manufacturer coupons. Drug manufacturers of brand name medications may offer discount coupons on their websites for certain products. Note that there may be a time or refill limit for these programs. Also be sure to read the fine print, as some types of coverage such as Medicare, Medicaid, Tricare, or other federal or state government-funded programs will not allow use of coupons.

Check online for patient assistance programs. Several programs are available to help people with low incomes afford prescription medicines. Check out the following websites with information from each of these organizations: Partnership for Prescription Assistance, RxAssist, and NeedyMeds.

Compare prices at several pharmacies. Prices for prescription medicines may vary from pharmacy to pharmacy. You can call to check the price for your prescription or ask before you have it filled to find out the cost. One note: If you have your prescriptions filled at different pharmacies, be sure to give your pharmacist a list of all of the medications that you are taking so that the pharmacist has a complete record to check for drug interactions or duplication.

Check out store prescription drug plans. Many of the chain drug stores, pharmacies at grocery stores, and big box discount stores may offer savings on a select number of prescription medications through drug-savings programs that you can join for free or at a small cost.

Consider asking for small quantities of new medications. If starting a new medication, ask your doctor to write the prescription for a small amount until you know the medication is right for you. This is especially helpful if you are paying cash or have a large co-pay. In addition, pharmacists can often dispense smaller amounts of the prescription if you ask, although there are a few exceptions based on state laws, drug package size, and insurance restrictions.

Ask your pharmacist for guidance. Pharmacists can be helpful in guiding you through these suggestions and identifying other options if you let them know that you are unable to afford your medication.