Rising prescription drug prices are epidemic. From headline-making multi-thousand-dollar price hikes on certain specialty drugs to significant jumps in everyday generics, consumers are paying more — way more — at the prescription counter.
A recent Consumer Reports survey found that of people currently taking a drug, one-third saw a price increase within the past 12 months. The hike varied from a few dollars to as much as $100 per prescription.
Outrage over the increases can be heard in drugstore aisles, corporate boardrooms and on Capitol Hill. But until a long-term solution can be found, consumers likely will continue to pay more for their meds. Here’s what you can do now to lower your prescription drug costs.
Shop, shop and shop some more.
Consumer Reports secretly shopped more than 200 pharmacies, comparing prices among 5 common generic drugs. The magazine found that the same drug could cost up to 10 times more at one pharmacy over another — even among stores within the same ZIP code. In Dallas, for instance, generic Plavix, a blood thinner, was $150 at CVS and only $23 at an independent pharmacy.
“Because of higher co-pays and changing insurance formularies, even people with drug coverage found they were paying much more out of pocket for prescriptions than they anticipated,” says Lisa Gill, a deputy editor with Consumer Reports Best Buy Drugs. “Everyone is feeling it.”
When you’re filling a prescription, remember to compare prices among all types of outlets — reputable online pharmacies, grocery stores, big-box chains, drugstore chains and independent pharmacies. (Consumer Reports found the highest prices at drugstore chains like CVS and Rite-Aid.) If you find the best deal online, make sure the site carries a VIPPS symbol. That shows it is part of the Verified Internet Pharmacy Practice Sites program.
Next, always ask for a better price.
Pharmacists often have access to discount programs, cards or coupons to help lower the cost. But be careful. Don’t assume that one pharmacy’s discounted price is necessarily less than a competitor’s regular price. And once you find a pharmacy with a price you like, ask your doctor about a 90-day prescription for medicines you need long-term. You’ll save on co-pays and may be eligible for a bulk discount.
Don’t always use insurance.
It is counterintuitive, but for a handful of drugs, some pharmacies charge much lower prices to their customers who do not have insurance. The next time you encounter a large co-pay for a medicine you need, ask what the cost would be without insurance. You may be surprised.
Also, many chain and big-box stores routinely charge as little as $4 to fill common generic prescriptions for customers paying out of pocket. That could be less than your co-pay. Keep in mind those drug costs cannot be applied to deductibles or maximums if you don’t use insurance.
Look for help.
If your insurance doesn’t cover a drug your doctor recommends, consider filing an appeal. In most cases insurers are obligated to cover any medically necessary drug, even if the medicine is not on their formulary. Your doctor can help provide information about the medical necessity of your drug. And during your next open enrollment period, look for an insurer that covers the drugs you need.
In addition, be sure to check programs offered by drug companies and foundations designed to help needy and seriously ill patients pay for their medicines. Check with the Partnership for Prescription Assistance (www.pparx.org) and the Patient Advocate Foundation’s National Financial Resource Directory (www.PatientAdvocate.org). Disease specific organizations such as the American Diabetes Association also provide help.