High prescription drug prices are among the top reasons why nearly one in three Americans can’t take their prescribed medicines. This is alarming since not taking their prescribed medicines can lead to serious health consequences and longer-term harm.
Even worse, many individuals are unaware of the practical ways to get prescribed medicines at the lowest prices or even for free. If you’re one of them or would like to know more, here are seven ways to cope with high medicine costs in the United States.
1. Coupon Savings
Drug manufacturers may offer coupon-saving opportunities, especially for medicines that are only available as costly brand names. These are called manufacturer-based coupon savings programs. Manufacturers offer such programs to make consumers’ copay comparable to the more affordable options an insurer prefers. In this way, they can keep their medications accessible and competitive.
Such coupon savings programs may provide substantial reductions on consumers’ monthly copays. However, they’re typically available only if the consumers have private or employee-sponsored commercial prescription insurance plans.
The good news is that many drug companies still offer one-time free trial coupons for brand-name medications. These enable consumers with federal or state-funded insurance plans to try their medicines at low cost. Note that the most reliable way to find these coupons is through a manufacturer’s website.
Generic medications, on the other hand, typically don’t have similar manufacturer-based coupon savings programs. Fortunately, many websites like BuzzRX offer discount programs that can help consumers reduce their drug costs compared to out-of-pocket prices.
Besides the cost savings, such websites enable consumers to search for specific medicines easily and compare pharmacies within an area. These online platforms also have apps, allowing consumers to get estimates over the phone before leaving their provider’s office. While the drug prices may not always be exact, they can still help consumers get a general idea of which brand and pharmacy may have the best price for them.
2. Patient Assistance Programs
Another alternative solution for those who aren’t eligible for manufacturer-based coupon savings programs is patient assistance programs (PAPs), also called drug assistance programs. They can be in the form of free or low-cost medicines or discount cards. They’re particularly offered to uninsured or low-income patients, typically based on their income and health needs, by brand-name drug manufacturers.
PAPs are often available on the manufacturers’ websites. Alternatively, you can find them on the following:
- RXAssist.org. It’s a nationally recognized online comprehensive medication resource center to help healthcare providers, patient advocates, and patients access free or low-cost medicines through pharmaceutical company patient assistance programs.
- RXOutreach.com. It’s a fully licensed non-profit digital pharmacy. This mail-order pharmacy offers less expensive generic medicines at even lower prices, particularly to consumers whose household incomes are at or below 300% of the federal poverty level.
These services are also available to consumers with prescription drug plans, including federal or state-funded insurance plans. In many cases, RXOutreach offers medications that are even less expensive than those of insurance providers.
- NeedyMeds.org. Like RXAssist, it’s another nationally recognized information resource that connects patients to PAPs that will help them afford not only their medications but also other healthcare costs.
In addition to pharmaceutical PAPs, several states have their own assistance programs that help their citizens purchase prescription drugs at no or low costs. Note that while these state-based programs provide substantial savings, they’re only available for eligible individuals and require specific requirements.
Additionally, each of these programs may vary depending on the state. Hence, it’s recommended that you contact your area’s Department of Health and Human Services (or Insurance Department) Elderly and Adult Services Division.
3. Generic Medications
While they’re essentially copies of brand-name drugs, generic drugs are approved as effective and safe by the Food and Drug Administration (FDA). Although their inactive ingredients may vary, the active drugs in generic medications have met similar requirements and standards for production as the original brand-name drugs.
On top of all, generic drugs are much more cost-effective, typically 80-85% cheaper than their counterparts. Brand-name drugs are more expensive due to the costs of research and marketing that went into producing and selling them. Since generic drugs are considered “copies” of brand-name drugs, they have less overhead costs, resulting in inexpensive prices.
Once more, generic drugs are the same as brand-name ones despite their lower prices. They can treat conditions in the same manner as the original products. They’re even the preference of most prescription insurance plans due to their effectiveness despite being affordable.
Unfortunately, not all brand-name drugs have generic options. Many medical conditions and treatments require medications only available at brand names. However, don’t lose hope. Ask your healthcare provider and pharmacies whether generic treatment options are available and if they’re appropriate for your condition.
4. Different Pharmacies
Every pharmacy can have different prices for one medication. For example, without insurance savings, the out-of-pocket cost of Atorvastatin (the generic drug for the cholesterol medication Lipitor) can be $4.50 at one pharmacy but can be as high as $140 at a neighboring one.
Note that the lowest drug prices may not always be at renowned and larger retailers. Sometimes, they’re at the less well-known small pharmacies. Hence, it’s essential to do due diligence. While jumping between pharmacies may take some time and effort, it’s worthwhile, especially if you wish to save on drugs’ out-of-pocket costs each month.
5. Prescription Drug Coverage
It’s important to know your plan’s formulary (i.e., the list of medicines it covers) and its tiers (i.e., copay levels) to save more on prescription drug costs. Most insurance companies have “three-tier systems,” as follows:
- Tier 1 – includes generic medicines and has the least expensive copay;
- Tier 2 – includes “preferred brand-name medicines” (typically brand-name drugs) and has a higher copay
- Tier 3 – includes “nonpreferred” (i.e., non-formulary brand-name drugs) and has the highest copay
Once you have each plan’s formulary, compare it with your prescribed drugs. Check if your medicines aren’t covered, are covered in a limited way, or are covered only with a high copay. If there’s any, ask your insurance provider which covered drugs might work for you instead.
Give this information to your primary care provider (PCP). Preferably, bring these lists every time you see and consult a doctor. In this way, if your doctor prescribes a new medicine, he/she can recommend one covered by your insurance at a lower copay.
6. Medicare Part D Prescription Plan
Medicare (US national health insurance for older and disabled people) has low-cost prescription drug coverage called “Medicare Part D.” It’s highly recommended if a person has Part A (hospital insurance) and/or Part B (outpatient care insurance) but doesn’t have drug coverage. Its monthly cost varies depending on the chosen coverage, which also varies by state.
It’s also advisable to enroll in Part D, even without prescription drugs at the moment. Any delay in its enrollment will incur a premium penalty when its coverage is needed later. However, you’ll be automatically enrolled in Part D if enrolled in Medicaid and eligible for the Medicare drug benefit. In this case, you don’t have to pay premiums for Part D.
7. Medicare Extra Help
Medicare also has a program called “Extra Help”. It pays for the monthly premiums and prescription costs of people who receive Medicaid, the US health program for low-income individuals.
Specifically, Extra Help is highly recommended for Medicare beneficiaries with prescription drug coverage but financially struggle with their premiums, deductibles, copays, and coinsurance.
However, Extra Helps requires an application. Social Security assesses applicants based on income, assets, and other factors to determine eligibility. Once approved, they may also be qualified for retroactive reimbursement for drug costs incurred while applying.
Final Thoughts
The key to lower medicine costs is due diligence and communication. Research and compare drug costs, pharmacies, and health plans, and communicate to health care providers, insurance companies, drug manufacturers and retailers, and government bodies.
If unsure, it’s highly recommended that you seek professional guidance. Help is always available, so take advantage of it.
