June 29, 2012

Saving Money on Prescription Meds: A Few Tips

Americans spend an average of $59 a month out of their own pockets for prescription medications, according to a 2011 Consumer Reports survey. And 12 percent of those surveyed said they spend more than $100 a month... or $1,200 a year.

These out-of pocket costs are sure to escalate. A recent report from the Kaiser Health News indicated that the new normal for employer health insurance plans will be the high-deductible plans that once were regarded as "catastrophic" alternatives for people with limited financial resources. Seventy percent of large companies recently surveyed by the benefits consultant firm Towers Watson said they'll offer high-deductible insurance by 2013, combined with personal accounts that let patients buy medical services with pretax dollars, often funded by the employer.

But nearly a fifth of these Fortune 500 companies claimed that high-deductible coverage would be the only option in 2013.

So, faced with the ever-escalating cost of drugs and the shrinking reimbursement by employers and the government, what can we can do to spend less on medicine?

Five Cost-Saving Tips from Consumer Reports
Consumer Reports consulted the medical experts at its Best Buy Drugs and they recommended these five ways to cut the cost of your medications without endangering your health:
  1. Ask Your Doctor for Generics. Generic drugs can cost up to 95 percent less that comparable   brand-names, and nearly three-quarters of all medications are available in generic versions. The Food and Drug Administration regulates generics and brand names drugs in the same way. I've been surprised by the number of times a doctor has prescribed a brand-name drug without letting me know a lower-cost generic was available. It pays to ask.
  2. Check out Discount Programs.  Chain drugstores, supermarkets, big-box retailers, and pharmacies at warehouse clubs have all offered so-called "$4 generic drug" discount programs for nearly a decade.  Prices go as low as $10 for a three-month supply of some meds. Most chains offer added perks, such as savings on flu shots or discounts on store-brand products. Program details vary, so it's important to check around. 
  3. Negotiate with Independents.  Although neighborhood independent pharmacies might not advertise or offer discounted generic drug programs like their national chain competitors, store owners might be willing to match the prices of the big chain stores. (In a recent Consumer Reports survey, independents scored highest for personal service and accessibility.) But note: Regardless of which type of pharmacy you use, stick with one place; don't shop around for the best price for each of your meds. Using the same pharmacy for all your prescriptions can help make sure you don't experience negative drug interactions or other safety problems.
  4. Order Online (In the U.S.)  Last year Consumer Reports searched for the best price on                       four widely prescribed  brand-name drugs -- Lipitor, Nexium, Plavix, and Singular. The lowest prices were found on three websites: HealthWarehouse.comFamilymeds.com,and drugstore.com. Those three are fine, CR says. But a recent analysis of more than 8,000 online pharmacies by the National Association of Boards of Pharmacy found that just three percent of them appeared to be legitimate. (As for online Canadian pharmacies, CR and I have different views. See discussion below.)
  5. Follow Your Formulary.  Insurance companies that cover prescription drugs and Medicare Part D plans have formularies that offer pricing advantages when you fill prescriptions from their "tier 1" list (usually generic drugs) and "preferred" medications (branded and generic). On private plans, the average co-pay is $10 for tier 1 drugs, $29 for preferred. Co-pays for drugs on a plan's "non-preferred" list average $49. For very high-priced medications or so-called "lifestyle" drugs (those not medically necessary), the co-pays average $91.
Three Cost-Saving Tips from Me
Here are a few money saving tips I've played around with:
  1. How About Cutting Your Pills in Half? The dosage amounts that are most commonly used by doctors are based on what seems to work for most people. But what works best for any individual can fall anywhere on a broad spectrum of possible dosages. I have a theory, substantiated by some studies I've seen, that seniors generally need less than dosages generally prescribed for most meds. For my three most expensive meds, I now cut the prescribed pill in half, saving myself a good bit of $$. But I decided to do this in each instance for different reasons.
  • Azilect,  A commonly prescribed medication that may slow the progression of Parkinson's is far and away my most expensive med. A 90-day supply costs over $900. Although my out-of-pocket share of this amount is only about $110, the total cost is what is used when calculating my annual drug costs covered by Medicare, and Azilect has been the major factor in pushing me into Medicare 's donut hole for the past two years. When that happens, I pay the full price for all my meds for the rest of the year. I was prescribed a 1mg dose of Azilect, but I noticed in researching Azilect that some doctors prescribe only 0.5 mg. So I got my neurologist's approval to cut my 1mg. pills in half.
  • Tribenzor. This is an expensive blood pressure med. I had to give up on another blood pressure med that had been working pretty well when I developed a chronic cough as a side effect. My internist experimented with other blood pressure meds, but none proved effective until we tried Tribenzor. But I was experiencing nausea and a general feeling of malaise while taking it. So I decided to experiment with cutting the prescribed pill in half. The side effects went away. The lower dosage doesn't work quite as well on the bp readings, but they are usually in the normal range. I use a home bp monitor and when the readings go up above the normal range, I go back to the full dosage for a day or two.
  • Lipitor.  Even though a generic has finally come on the market for this most widely used statin for cholesterol, it still carries a fairly high price. With my internist's OK, I now cut my 20mg pill in half...  but not to save money. I decided to reduce the amount after reading that Lipitor and other statins can result in short-term memory losses in some people.
   2. Ask Your Doctor for Free Samples.  When you're prescribed an expensive medication, there's no harm in asking your doctor if he'd be willing to give you some of his free samples. The sales reps for the major pharmaceutical companies usually give doctors a large supply.  
       
    3. Online Canadian Pharmacies Are An Option.  Consumer Reports recommends against going this route. Most online pharmacies claiming to be Canadian aren't, CR says, adding, "no agency -- U.S. or Canadian -- regulates them, making it hard to know if drugs shipped from Canadian sources are safe." But I know friends who are being treated for different forms of cancer, have been prescribed incredibly expensive drugs, and have decided to take advantage of the significant cost savings by ordering their meds from Canada. One of my friends is writing a guest post for my blog detailing his experience with a Canadian online pharmacy, and I hope to publish it shortly.          
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