High Drug Prices

How To Obtain Affordable Drugs

The Problem

The doctor prescribes a new medication. You take the prescription to the pharmacy. The price is outrageous. What do you do?

The Solution

1. Formulary Management Most insurance companies nowadays place drugs on tiers. First-tier drugs are generic drugs, these have the lowest co-pay. (The co-pay is the amount you, the patient, have to pay for the drug.) Second-tier drugs are non-generic drugs which are preferred by the insurance company. Their co-pay is greater than that for first-tier drugs, but less than that for third-tier drugs. Third-tier drugs have the highest co-pay. Ask your doctor whether the drug s/he has prescribed is at the lowest tier possible. Since the doctor may not have access to the formulary of your particular insurance company, it is always a good idea to bring a copy of the formulary to all of your doctor appointments. Simply get on the web site of the insurance company and print out the formulary.
2. Samples Ask your doctor whether s/he has free samples of the drug prescribed. Most doctors have large numbers of samples of many of the most expensive medications. The doctor would be quite happy to give you all the samples you need. Most patients do not realize they can ask. When you run out of the samples you are given, simply call and ask for more.
3. Medication Reviews Periodically, make a special appointment with your doctor just for the purpose of reviewing your medications, and finding alternatives which are cheaper. It is best for this purpose to bring with you a copy of the formulary of your insurance company. Just get on the web site of the insurance company, print off the formulary, and take it with you to the visit.
4. Lifestyle Changes In Lieu of Drugs Whenever the doctor prescribes a medication for you, ask whether it is possible to make a lifestyle change instead of taking medication. Doctors often assume the patient will not be willing to lose 30 pounds, or run a mile a day, or quit smoking. But the patient who is willing to make such lifestyle changes may be able to avoid taking medication for certain medical conditions.
5. Patient Assitance Programs All of the major drug companies have patient assistance programs. These programs are largely based on income level. Simply get on the web site of the medication you have been prescribed to find out whether you might qualify. If you do, you can obtain a free supply of the medication.
6. Other Sources of Free Drugs In some communities there are other sources of free drugs. For example, in Hagerstown, Maryland, where I practice, there is a Community Free Clinic, a resource especially for county residents who have no medical insurance. Doctor visits and medications are free. Of course, not all communities have such resources. Also in Hagerstown is the Med Bank, which is a public service organization which helps patients obtain free drugs from drug companies.
7. Breaking Pills in Half You can sometimes save money on medications by asking your doctor to write a prescription for double the desired dosage, and breaking the pills in half. A common example of this is Viagra, which is usually prescribed at a 50 mg dosage. Though the pills are not scored, the doctor can prescribe 100 mg pills, 1/2 tablet daily. Using a pill cutter (which costs about $7) you then cut the pills in half. Since the 50 mg pills and the 100 mg pills cost the same amount, you cut your expense in half. This approach is only a cost savings if you do not have medication coverage which charges a co-pay for a month's supply. Please note that the practice I am recommending here is different from another cost-saving practice which happens to be illegal: prescribing double the dose and asking the patient to take half the prescribed dose. This is a way of defrauding the insurance company by getting 2 months of medication for a one-month co-pay. Some doctors will do this, but I do not.
8. Bargain Prices for Generic Drugs Some retail outlets (such as Walmart, Target and Sam's Club) offer a subset of generic drugs for rock-bottom prices. For example, at Walmart the price per month for generic drugs on their list is $4. Get on the web sites of the retailers in your area, print out their lists of cheap drugs, and take the lists with you to your next doctor appointment. Ask you doctor whether any of your medications can be changed to the ones on those lists.

Why Should I Have To Do All This?

If you are wondering why all these extra efforts are necessary in the first place, your point is well taken. Doctors traditionally do not spend valuable patient-care time figuring out how they can save their patients money. However, with more and more physician practices moving to Electronic Medical Records, it will become easier and easier for the doctor to know how much the medications s/he is prescribing are going to cost the patient. Eventually, you will not have to make extra efforts to ensure that you are being prescribed the most economical medications.