Tackling Prescription Drug Costs— 5 Steps to Save Money on Medications

I know the struggle. 

I had a period of chronic migraines that became crippling and disruptive to managing day to day life.  I couldn’t go to work for months and I needed a lot of help taking care of my kids. 

 After a brutal trial-and-error process to find a medication to help stop a migraine attack, I finally found some relief.  I picked up the medication at the pharmacy in such a migraine fog that the cost was swiped on my card without much thought.  When it came time to refill, I realized the medication was not affordable, even with my pretty good insurance. 

I felt defeated. 

 With the pain and foggy head from the migraine, I struggled for weeks not wanting to use up this expensive medication.  Eventually when I tried to refill again, the drug store pharmacist leaned in to whisper some advice— “I’m not supposed to tell you this, but check the cost with the mail-order service through your insurance. It will be a lot cheaper.”  

Huh? My insurance has a mail order service? 

This was several years ago and I still don’t understand how I missed the fact that my insurance has a specific mail-order plan with significantly lower costs. I thought mail-order prescription services were something advertised for convenience and cost-savings. I didn’t realize it was the preferred system for my insurance plan with a huge cost difference. I am an RN, educated and attentive to healthcare, and take pride in helping others navigate the healthcare system. These systems are not straightforward for anyone to navigate alone.  I’m grateful to be able to pass along this guidance to you.  And relieved to be paying $50 for three months of my daughter’s medication by mail order rather than $105.29 for one month.  

These 5 cost-saving action steps are provided with empathy for those overwhelmed by medication expense, busy with life, or dealing with a headache. 

1. Call your insurance provider.

This may seem daunting (or maybe obvious) but when I finally called the number on the back of my insurance card, I was pleasantly surprised by the kind human on the other end of the phone that helped navigate my coverage plan.   It’s crucial to know that your prescription coverage can vary greatly based on where you get the medication from. 

2. Communicate cost concerns with your doctor.  

The assumption is made that prescribed medications are what you are taking.  When medications are stopped due to cost barriers, there are significant risks when not transitioned under your doctor’s supervision.  There may be alternatives for a specific medication or an order of priority for the ones you are taking.  Knowing the priority of your medications can help you make safe and informed decisions if you can’t afford them. 

3. Get generic medications 

Generic medications should be ordered unless there is a specific reason for needing a brand name such as an allergy to an ingredient.  They contain the same active ingredients and are usually significantly less expensive. This applies to over-the-counter medications as well.  Next time you need Tylenol, try acetaminophen. If you take Claritin for seasonal allergies, consider loratadine. These simple switches provide the same active ingredients while adding up to significant cost savings over time. 

4. Look for coupons and check prescription savings programs. 

Below are some great resources.  Since finding the right solution for you can be daunting, involving a health advocate or computer-savvy loved one can be helpful with this process.  

Cost Plus Drugs

 This company is designed to provide medications at cost plus a specific fixed percentage. They eliminate the middleman of pharmacy benefit managers which is where the steep markup typically lies. They currently work with very few insurance providers but there can be great cost savings even out of pocket.  They don’t carry all medications, and they only stock the generic version of the ones they do carry. Check their website for your specific medications.  Of note for Medicare beneficiaries, these prices may be lower than your drugstore copay, but it won’t count toward your deductible. You can work with a HICAP Medicare Counselor (https://cahealthadvocates.org/hicap/) to navigate your prescription coverage. 

GoodRx

This company provides savings coupons that can be used at your local pharmacy if the price is better than using your insurance. When you use the coupon instead of your insurance you may or may not be able to apply the cost toward your deductible or be reimbursed for it. Wouldn’t it be nice if insurers could provide a clear rule on this? Until then, here are the reimbursement forms to try for many common insurers.  https://www.goodrx.com/insurance-and-goodrx

Amazon Pharmacy

This online pharmacy can be used with or without insurance. They only supply medications for adults and do not supply controlled substances like narcotic pain medications and stimulant medications. They do provide coupons and offer automatic refills. A potential for savings here is with their RxPass which is $5 per month total, whether you take one or five, for any of the medications you take on their RxPass list. You can find that list here, organized by condition, about halfway down the page.  https://pharmacy.amazon.com/rxpass#tab-tab-body-639

RxAssist

This is a directory of Patient Assistance Programs run by various pharmaceutical companies. There are some eligibility and paperwork requirements, but it’s worth investigating because some drug costs can be covered completely.  This is where to start for a specialty medication that may be a financial burden. Here is where to search for your prescription. https://www.rxassist.org/search

4. Assess the need for each specific medication. 

Reviewing a complete medication list with your primary care provider is not only essential for medication safety, it can potentially lead to cost savings.  Ask your doctor about the continued need for each of your medications.  Challenge yourself to lifestyle shifts that can reduce or eliminate the need for many common medications. Your doctor, healthcare advocate, or nursing consultation can help determine which lifestyle shifts may be most attainable and impactful for you. 

Navigating high prescription drug costs is challenging, but implementing these 5 strategies can help you save money on medications and improve your healthcare experience.  Always consult your doctor before making any changes to your medication regimen. I have cared for too many patients in critical care whose illness or injury was brought on or made worse by thinking they didn’t need a medication anymore or found it too expensive to continue.  Utilize your doctor’s expertise to address any concerns.  

Medication management consultations are available at vallationhealth.com/consultation—  Together we can make your medication regimen safer, more affordable, and easier to manage on a daily basis.

Do you have other resources or suggestions for cost savings? I would love to hear! Comment below or feel free to email me your thoughts or questions to stefanie@vallationhealth.com.