Prescription drugs account for nearly 10% of US health care spending, for a total of $ 370 billion in 2019. Notably, only half of that amount comes from insurance companies and the government. The rest is paid for out of pocket by the patient. On average, each American adult fills out 17 prescriptions a year; The number doubles for people aged 65 and over.
Paying for prescription drugs can be a significant financial burden for patients and families. According to a report by Georgetown University40% of patients said they would not fill out prescriptions or cut their expenses on food, heating, and other necessities so they could afford their medication because of the cost.
Trying to save money by skipping or taking less than the prescribed amount of medication is a bad idea. Patients have died of rationing to stretch theirs Supply of insulin or anti-epileptic drugs. There are ways to make prescription drugs more affordable without putting yourself at risk.
Buy generic drugs
When a new drug is approved by the FDA, the drug company that developed and patented the drug is given exclusive rights to reimburse the research costs. After the patent expires (usually five to ten years later), other companies are allowed to manufacture and sell generic formulations that contain the same active ingredient at a fraction of the price of the branded drug. Ask your doctor or pharmacist if a generic equivalent is available.
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Check your insurance formula
Most often, multiple drugs can treat the same disease, but one is preferred by the insurance company based on their contracts with pharmaceutical companies. The insurance formula – or the list of medications insured – is often divided into tiers, with the cheaper, more common, older, and generic drugs at the top and the more expensive, specialized, newer, and branded drugs at the top.
The higher tier drugs will cost you more copay and co-insurance. First of all, make sure that your medication is included in the prescription. Then, write down the coverage level and ask your doctor if there is a similar option in the lower levels.
If you need to take a specific branded drug that is not on the prescription because generic drugs are unavailable or ineffective, you can apply for coverage. The insurance company may require you to try (and fail) one or more similar drugs from their preferred list before agreeing to pay for the drug you need.
Given a choice (e.g., with Medicare Part D or the Marketplace, less likely for employer-sponsored insurance), choose the plan that better covers your medication. Review your insurance plan annually for changes.
Buy in bulk
Save on copays with a prescription for 90 day delivery. Mail order pharmacies are often a good fit for this economical approach. Of course, this only applies to medication that you take in a stable dose over the long term. Some doctors are also willing to write for double the dosage so you don’t have to fill out the prescription as often, but you need to be responsible and organized enough to operate a pill splitter and your medication may not be a prolonged release formulation or special Coatings.
Retail drug prices can vary widely depending on how pharmacies get their inventory. Big box chains (e.g. Walmart) and wholesale clubs (e.g. Costco) may have deals as low as $ 4 per prescription for generic drugs. Call the pharmacy and ask about the cost out of pocket. Or enter the name of your medication Goodrx.com or Werx.org Compare prices.
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Uninsured patients and patients in need of medication who are not insured can apply for earnings-related support. Commercially insured patients can get a discount from pharmaceutical companies to reduce their co-payment. You can find resources on patient assistance programs above the governmentnon-profit groups (e.g. Needymeds.org, Medicineassistancetool.org), disease-specific organizations (e.g. Epilepsy Foundation) and the manufacturer of your medication. The social worker at your doctor’s clinic can also help you manage the application process.
Remember, the money you spend on prescription drugs is tax deductible (if the total amount of your unreimbursed medical expenses exceeds 7.5% of your Adjusted Gross Income). So the tax season is another way of paying for some of the costs.
When it comes to medication, let’s educate patients and discerning buyers.
Qing Yang and Kevin Parker are married and live in Springfield. Dr. Yang received her medical degree from Yale University School of Medicine and completed residency training at Massachusetts General Hospital. She is an anesthetist at HSHS Medical Group. Parker has helped formulate and administer public order with various city and state governments across the country. Previously, he was Group Chief Information Officer for Education at the Illinois Department of Innovation and Technology. This column is not a substitute for professional medical advice, diagnosis or treatment. The opinions are those of the authors and do not reflect the views of their employers.