Your activity: 355 p.v.
your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com

Patient education: Coping with high prescription drug prices in the United States (Beyond the Basics)

Patient education: Coping with high prescription drug prices in the United States (Beyond the Basics)
Author:
Jonathan M Zand, PharmD BCPS
Section Editor:
Mark D Aronson, MD
Deputy Editors:
Jane Givens, MD, MSCE
Kelly Crowley
Literature review current through: Nov 2022. | This topic last updated: Dec 02, 2022.

AFFORDING PRESCRIPTION MEDICINES IS DIFFICULT — High prescription drug prices are forcing many Americans to make difficult and sometimes troubling choices, such as deciding between buying the medicines they need and paying for food or other bills. Nearly one in three Americans say they haven't taken their medicine as prescribed due to cost [1]. Not having certain medicines can lead to serious health consequences. For example, if a person with diabetes cannot buy enough of the insulin they need, they will become ill and might need to be hospitalized. Not being able to afford other kinds of medicines can also lead to longer-term harm, even if the effects are not seen right away. For example, when someone with a heart condition or high blood pressure cannot afford their medicines, they can be at greater risk of having an early heart attack, heart failure, or stroke.

This article discusses practical ways you can work with your doctor to safely get the medicines you need at the lowest prices available. It also discusses how to make the most of your prescription drug coverage (drug insurance) if you have it. This article does not discuss the causes of high drug prices. If you would like to learn more about the causes of high drug prices in the United States, information is available from other sources such as the Kaiser Family Foundation, a non-profit, independent organization that focuses on national health issues [2].

The "bottom line" is that lower drug prices can help you better maintain your overall health and wellness.

What you can do — There are several things you can do to get your medicines at lower prices. To get started, you will need to find out what your options are and do some comparison shopping. This article will help you:

Review the cost of your medicines with your doctors or other health care providers

Make sure you need all of the medicines you are prescribed

Let your providers know which drugs have better coverage through your health insurance, if you have it

Find out if you can switch your medicine to a lower-cost generic version, a lower-cost brand version, or a lower-cost non-prescription medicine

Find out how to locate the lowest price for your medicines at a retail pharmacy in your area or by mail order

Look into getting a Medicare Part D prescription plan if you are eligible for Medicare

The ways of lowering costs discussed in this article can help whether or not you have prescription drug coverage. Prescription drug coverage is also called "drug insurance."

GETTING STARTED — Get started by finding out what options you have for lowering your costs and confirming that you need all of the medicines you have been prescribed. You will need to have a discussion with your doctor about this. Here are a few things you should do first to be prepared:

First: Create a list of all of the medicines you take, how you take them, and how much you pay for each prescription every month. Your pharmacy can help you prepare this list and may be able to print one for you.

Create a medication list – An example of a list you can use to keep track of your medicines can be found at https://www.fda.gov/drugs/resources-you-drugs/my-medicine-record.

You should also include on your list any non-prescription (over-the-counter) medicines you take, including any vitamins or herbal supplements.

Ask about lower-cost alternatives – For any medicines that have a high cost, ask your pharmacist if there is a low-cost generic that works in the same way. Have them write down the names of these alternatives on your list; then, you can review these with your doctor to find out if switching to a lower-cost drug makes sense for you.

Next: If you have prescription drug coverage through your health insurance or a Medicare Part D drug plan, get the list of drugs that have the best coverage from your insurance company. You can do this by calling them or printing it off of their website. (See 'Making the most of your insurance' below and 'What if I have Medicare?' below.)

Then you can:

Ask your insurance company about lower-cost alternatives – For each medicine that has a high cost, ask your insurance company for the name of a medicine that works in the same way but has better coverage so you can ask your doctor about switching to it.

Even if you do not have prescription coverage, you can lower your cost by switching to generic medicines and shopping around for the best prices.

Shop around and find the lowest prices – Some big retail and club stores have programs that can get you prices as low as $4 per month on many generic medicines. You can get these lower prices if you have no drug coverage or by not using your drug coverage. Find one or two of these in your area and ask for a list of medicines that are available through this program. The ways to find a $4 per month drug program at a big store or online are discussed below. (See 'Comparing prices' below.)

Once you collect the above information, you will be ready to have a discussion with your doctor or other health care provider. Then, they can prescribe lower-cost medicines for you if appropriate.

If you go to a large health system or hospital for your care, there may be a social worker or pharmacist available to help you collect information about lower-cost alternatives and savings programs. Ask the nurse or pharmacist if there is help available.

Making the most of your insurance — Taking the time to understand your prescription drug coverage can help you save money.

If you have a choice between different drug prescription plans, get the list of medicines that each of the plans covers (called the "formulary") and the different copay levels ("tiers"). Most insurance providers have a three-tier system in which Tier 1 usually has the least expensive copay and includes mostly generic medicines; Tier 2 has a higher copay and includes "preferred brand-name medicines" (ie, the brand-name drugs the plan will cover); and Tier 3 has the highest copay and includes "nonpreferred" or non-formulary brand-name medicines.

After you get the list of medicines that are covered by your insurance, compare this with the list of medicines you take. Check if any of your medicines are not covered or covered only with a high copay or in a limited way. For each of these, ask your insurance company which covered medicines might work for you instead. Then give that information to your doctor. It's a good idea to bring these lists with you each time you visit a doctor; this way, if you need a new medicine, your doctor can try to prescribe one that will be covered by your insurance at a lower copay.

What if I have Medicare? — Medicare (federal health insurance for people 65 and older or with certain disabilities) offers low-cost prescription drug coverage called "Part D." Part D prescription coverage can save you money if you have Medicare and enroll in a Part D drug plan. The tips for lowering drug costs discussed in this article will help you get the most value from Part D prescription coverage.

How do I choose a Medicare Part D drug plan? — The choices for part D prescription plans vary by state; each plan offers a number of options. The monthly cost of a Part D drug plan will vary depending on the specific coverage provided and whether you are eligible for a program called "Extra Help." People who receive Medicaid, as well as many others with limited income and resources, can qualify for Extra Help. The program pays for the monthly premiums and most other prescription costs. Eligibility for Extra Help will be expanded in 2024 [3].

You can use this Medicare website to compare the Part D drug plan features and costs available in your state and find out if you are eligible for Extra Help: https://www.medicare.gov/plan-compare/.

Part D drug plans will be improving in a number of ways over the next few years. There will be a cap on out-of-pocket prescription drug costs ($2000 in 2025), lower premiums, full vaccine coverage, and limits on the cost of certain medicines such as insulins beginning in 2023 [3].

It is worth taking time to compare different Medicare Part D prescription plans to find a plan that is right for you. Fortunately, reliable help is available. (See 'Help with understanding and choosing a Medicare Part D plan' below.)

What if I do not have health insurance? — If you do not have health insurance, it's a good idea to look into getting insured. The basic idea behind health insurance is that you pay a fixed amount each month, and in exchange your insurer pays part or most of your health care-related costs. Many people buy health insurance through their job, but you may also be able to purchase insurance on your own in your state. For information about your options for health coverage, visit the healthcare.gov website.

REVIEW YOUR MEDICINES AT EVERY APPOINTMENT — Ask your doctors (or other health care providers) to review your medicine list at each visit to make sure it has no errors. (See 'Getting started' above.) For example, your doctors should make sure the list does not include any incorrect doses, wrong instructions, or medicines you should have stopped taking.

In some cases, two different doctors prescribe two or more medicines that do the same thing. Taking two or more medicines that do the same thing, or continuing to take medicines that are no longer needed, seems to happen more frequently to older adults and people who take many medicines.

It is a good idea to bring a bag containing all of your medicines (prescription bottles, inhalers, ointments, etc) with you to the doctor's office to have it checked.

TALK WITH YOUR DOCTOR ABOUT LOWER-COST OPTIONS FOR YOUR MEDICINES — It is very important for your doctor to know if you cannot afford your medicines or if you are being forced to cut back on your medicines due to their cost.

Gather the information your doctor will need so they can see what lower-cost options are available to you and whether they are appropriate. (See 'What you can do' above.)

Bring the list of your medicines with the monthly cost, suggested alternatives from your pharmacist, preferred alternatives from your insurance company (if you have prescription drug coverage), as well as the list of generic medicines available through low-cost store programs to your next appointment.

Ask your doctor if any of these cost-saving options make sense for you:

Switching to a lower-cost generic medicine if one is available (see 'Generic drugs' below)

Switching to a lower-cost brand medicine that is preferred by your insurance coverage (see 'Switching to a different brand-name medicine' below)

Switching to a non-prescription version (see 'Over-the-counter versions of prescription drugs' below)

When you change medicines, it is likely that you will need a new prescription to replace the old one. You will need to work closely with your doctor so this change is done safely and correctly for you.

Generic drugs — The "generic" name of a medicine is the name of the active ingredient. The brand name is the name a drug company gives to the medicine to sell it. For example, "Lipitor" is a brand name for the generic atorvastatin (a cholesterol-lowering drug), "Synthroid" is a brand name for levothyroxine (used for treating hypothyroidism), and "Prilosec" is a brand name for omeprazole (used for treating acid reflux).

Lots of medicines are available as a generic version. If you can buy the generic version of your medicine, it is often much less expensive than the brand-name version, but not always. Generic medicines work just as well as more expensive brand-name medicines. (See 'Are generic drugs as safe and effective as brand-name drugs?' below.)

On average, generic medicines cost about 80 to 85 percent less than the same brand name drug [4]. An easy way to learn if your medicine is available in generic form is to ask your pharmacist. You can also use your computer or smartphone to look up the GoodRx website (www.goodrx.com). If you enter the brand name of your medicine in the GoodRx search engine, it will tell you if a generic or biosimilar is available. The US Food and Drug Administration (FDA) has a website you can use to search for approved generic versions called the Orange Book; however, this website may not be as easy to use.

It is important to understand that prices charged for generic medicines can vary widely from one pharmacy to another, especially if you do not have drug coverage, so shopping around is an absolute must. (See 'Comparing prices' below.)

Why are generic medicines cheaper? — When drug companies develop a new medicine, they spend a lot of money studying and testing it; this research takes time and is expensive. In exchange for that investment in researching new drugs, United States law allows drug companies to hold a "patent" on their new medicines. A patent gives a drug company the right to be the only one to sell a medicine for a certain number of years. After several years when the patent runs out, other companies can make and sell generic copies of the medicine; as a result, the price usually drops due to competition.

Generic medicines generally cost less because the makers do not have to pay for developing or advertising them.

Not all medicines are available in a generic form, but many are. If you take a brand-name medicine, it's a good idea to check whether a generic version is available. Even if there was no generic option when you first started taking the medicine, it's possible that this has changed.

Are generic drugs as safe and effective as brand-name drugs? — Yes.

Sometimes people think generic medicines are not as good as brand-name medicines because they cost less, but they actually work just as well.

A generic medicine version can only be sold in the United States after the FDA has carefully tested and approved it. This means it must meet all of the same requirements for quality, strength, purity, and shelf life as brand-name medicines. You can find more information about the safety of generic drugs in the resources section of this topic. (See 'FDA information for consumers' below.)

Will I save with generic medicines even if I have insurance? — Yes.

You can save by using generic medicines even if you have prescription drug coverage or a Medicare Part D prescription plan. This is because:

Nearly all insurance plans have lower copays (the amount you pay "out of pocket") for generic medicines than they do for brand-name medicines.

Many insurance providers and Medicare Part D plans limit how much money they will spend on your medicines every year. If you go over that limit, you have to start paying for your medicines on your own. So if your medicines cost less, it will take you longer to reach the limit, and once you do, you will be paying less with generics than with brand-name drugs. (See 'What if I have Medicare?' above.)

Some insurance plans require you to spend a certain amount of your own money on medicines first before they will start paying for them. The amount you pay first is called a "deductible" or "coverage gap." If you have a high deductible, paying for brand-name medicines is likely to cost you more out-of-pocket than if you get less expensive generics.

If you are able to take advantage of a generic drug discount program (available at some big chain stores and online), that might actually save you more than using your prescription insurance or Medicare drug plan [5]. So it's still important to shop around, even if you have insurance coverage. (See 'Comparing prices' below.)

How can I switch to generic medicines? — There are a few different ways you can use generic medicines:

Switch to the generic version of the brand-name drug you take (if one is available) – In many cases, pharmacies will automatically give you the generic version of a brand-name medicine if it is available. If you don't get the generic version, ask your doctor if it's possible to switch. You can easily find out if a generic version is available (See 'Generic drugs' above.)

Switch to a similar medicine that is available in generic form – If the exact medicine your doctor prescribed does not come in a generic form, your doctor might be able to switch you to another medicine that is sold as a generic. Your doctor and pharmacist can help you find out if there is a similar medicine that comes in a less expensive generic form.

Switch to a generic version in a different formulation – Some medicines are sold as brand name-only because they come with a newer formulation that is still under patent. For example, if you take a brand-name medicine that comes as a once-per-day pill and doesn't have a generic equivalent, it may be possible to switch to a generic version that comes as a twice a day pill.

Any time your doctor switches you from one medicine to another, make sure you know what the new medicine looks like and which medicine it is replacing. People sometimes accidentally take the same medicine twice because the brand-name and generic pills look different, and they think that they are taking two different medicines.

Are "biosimilars" the same as generic medicines? — Biosimilars are close, although not exact, copies of "biologic" medicines. Biologic drugs are complex medicines that are made in a lab using living cells. Examples of biologic drugs include insulins and specialty medications such as infliximab (brand name: Remicade). They are costly to develop and can be very expensive.

"Biosimilar" versions are generally less expensive than the original biologic. For example, biosimilar insulin glargine (brand name: Semglee) is about half the cost of the original version (brand name: Lantus). Each year, new biosimilars are approved and become available. If you take an expensive insulin or other biologic drug, ask your pharmacist whether a biosimilar is available.

Over-the-counter versions of prescription drugs — Some medicines that your doctor can prescribe are also sold without a prescription ("over-the-counter"). They are also safe and effective and must be approved by the FDA. If the prescription medicine you take or a similar one is also sold without a prescription at a lower price, ask your doctor if you can take that instead. There are nonprescription versions of medicines to treat acid reflux, allergies, pain, and other health problems. The table lists over-the-counter drugs that you may be able to use instead of a higher cost prescription drug if your doctor agrees (table 1).

Over-the-counter drug prices vary widely between stores and online. You need to compare prices for over-the-counter drugs in order to get the best price. (See 'Comparing prices' below.)

While non-prescription medicines can often save you money, it's important to be aware that they can sometimes be a different strength or be different from the prescription version in other ways. For this reason, it's important not to switch to a non-prescription version of any drug without checking with your doctor first.

Switching to a different brand-name medicine — If you cannot switch to a generic medicine, there may be more than one brand-name medicine that can be used to treat your condition.

How can switching brands save me money? — Different brands of medicines have different costs. For example, if you take insulin for diabetes and your insulin costs too much, you can ask your doctor about switching to a different brand or type of insulin. For example, the "Semglee" brand of long-acting insulin glargine is about half the cost of the "Lantus" brand of insulin glargine. More information on reducing insulin costs is available below. (See 'Insulin cost savings resources' below.)

Inhalers can be particularly expensive. Switching to a different brand may save you money. For example, the "Arnuity Ellipta" brand of steroid inhaler costs about $100 per month less than other brands of steroid inhalers like "Flovent" and "Pulmicort." The GoodRx website can help you identify similar inhalers and compare their prices in your area.

Most drug companies have programs on expensive brand-name drugs that can help you save money, too. (See 'Getting help paying for the medicines you need' below.)

How to stay safe when switching medicines — When switching to a new medicine, you will need to follow the instructions provided by your doctor, including when and how to stop taking the old medicine. Taking two similar medicines when you are supposed to be only taking one can be harmful.

In general, it is best not to switch more than one medicine at a time. Your doctor may ask that you come in for an examination or have lab tests to confirm that the new medicine is working as well as the older (more expensive) one.

Keep in mind that there may be reasons your doctor does not want to switch a particular medicine; for example, a medicine similar to the substitute may have been tried before and not worked well for you, or you may be allergic to it, or it might not be appropriate for treating your particular condition. If you have any questions about this, ask your doctor, nurse, or pharmacist.

COMPARING PRICES — There can be big differences in the price charged for the exact same drug depending on what drug store or online pharmacy you are using and whether you ask for their savings program. Shopping around for a good price on your prescriptions can save you a lot of money, especially for generics [6,7].

Following are some tips for locating the best available price for your medicines.

Look into generic drug discount programs — Some big retail and club stores have "generic drug discount programs," which provide excellent prices on hundreds of generic medicines. Examples include Wal-Mart, Target, and Costco (which does not require a membership to use the pharmacy); there are others as well. Their prices for many commonly used medicines can be as low as $4 per month, regardless of whether or not you have insurance. These low prices can be less than your prescription copay if you have drug coverage [8]. So it's important to do the research and compare prices.

You can check to see if the medicines you take are available at these low prices by asking at the pharmacy or by going online. You can find lists of discounted generic medicines for each store by entering the store's name and the words "prescription program" into Google or another search engine.

Online pharmacies — More online pharmacies have become available and their prescription prices can be very competitive. Consumer Reports, an independent non-profit consumer advocacy group, found low prices for a large sample of prescription medicines at several reliable online pharmacies, often less than $12 per month without use of insurance [9]. Some online pharmacies charge a membership fee, but the fee may be worth the savings. Other online pharmacies do not charge a membership fee. (See 'Consumer Reports' below.)

More information about ways to check if an online pharmacy is reliable and properly certified is available below. (See 'Internet drug offers and foreign pharmacies' below.)

Compare prices online or by telephone — Most pharmacies will also give you a price quote over the phone. Be sure to ask if they have a savings program or club, which can sometimes get you lower prices. You can also use GoodRx (www.goodrx.com) to compare local prices and get discount coupons [10]. You can then ask your pharmacy for the discount price from GoodRx. (See 'How to find the lowest prescription prices' below.)

Consider getting more than a one-month supply — Some stores and insurance plans offer a discount if you buy a two- or three-month supply at one time, so ask about this as well. If you know you will be taking a medicine for a while, buying a two- or three-month supply can mean more savings.

Use the mail-order option — Most insurance plans and many pharmacies offer a mail-order option. You may also have the option to order and track your medicines online. These options will often save you money on medicines you take for three months or longer. Mail order is a good idea only if you know for sure that you will be taking a specific medicine at a specific dose for at least three months.

The mail-order option with prescription drug coverage usually has a discounted copay for a 90-day (three-month) supply of generic medicines and preferred brand-name medicines. To use this benefit of your insurance, you will need to register for the mail-order option for your plan. You may also need to ask your doctor to write you prescriptions that cover a 90-day supply with each refill.

Ask if your pharmacy will match another store's price — It is also worth checking and comparing prices at your local pharmacy. Some local pharmacies will "match" the best price you find elsewhere in the area, if you ask. Also ask if there is a discount club or card, as this can save you money as well.

You can find more information on how to get the best price on your prescriptions in the "Resources" section of this topic. (See 'How to find the lowest prescription prices' below and 'Consumer Reports' below.)

Caution about "free" trial offers and coupons on brand-name drugs — These offers may sound good at first, but they do not provide a long-term solution because the drug company can stop the coupons or trial offer after you have been on the medicine for a while. In most cases where drug companies advertise a "free trial" or dollars off your insurance copay for their brand drug, there are generic versions your doctor could prescribe which will save you more money in the long run [11-13].

INTERNET DRUG OFFERS AND FOREIGN PHARMACIES — In some cases, companies or websites advertise deals or other ways to save you money on your medicines. While these can sometimes be a good way to lower costs, it's important to be cautious about any offers, pharmacies, or sites you are not familiar with.

Stay away from any pharmacy that offers to sell you prescription medicines without requiring a prescription from a doctor who has actually cared for you. The US Food and Drug Administration (FDA) has found that some internet and foreign pharmacies are not properly licensed and inspected. Plus, they may sell you medicines that are not right for you, have expired, or are fake [14-17].

If you decide that an internet pharmacy is a good choice for saving on your prescriptions, look for one that is licensed to operate in your area and has been certified by the National Association of Boards of Pharmacy [10]. You can find out if an internet pharmacy is licensed in the United States by checking the FDA website called "BeSafeRx: Your Source for Online Pharmacy Information." (See 'FDA information for consumers' below.)

The National Association of Boards of Pharmacy certifies internet pharmacies as licensed and operated according to appropriate quality standards. These websites can be identified by the oval blue seal that reads "VIPPS," which means "verified internet pharmacy practice site." A link to a list of VIPPS websites is provided in the resources section. (See 'National Association of Boards of Pharmacy' below.)

GETTING HELP PAYING FOR THE MEDICINES YOU NEED — If you have already looked into switching to generic medicines and cutting costs in other ways, but you still cannot afford your medicines, you might be able to get help another way. There are state and federal programs that help people pay for their medicines. Plus, there are assistance programs sponsored by nonprofit organizations and by drug companies themselves. Whether you can get help from these programs will depend on things such as your income and how many people are in your family.

You can find information about these programs in the resources section of this topic. (See 'Help paying for your medicine' below.)

If you are cared for at a hospital or in a large medical practice, there should be a social worker or a pharmacist there who can help you find programs that might be able to help you.

RESOURCES

Consumer Reports

"Online pharmacies Can Help you Save Big on Prescription Drugs" (April 5, 2022) https://www.consumerreports.org/online-pharmacies/online-pharmacies-can-help-you-save-big-on-prescription-drugs/

"5 Ways to Save on Prescription Drugs" (April 5, 2022) https://www.consumerreports.org/prescription-drugs/ways-to-save-on-prescription-drugs/

"Simple Steps for Managing Your Medications" (April 26, 2021) https://www.consumerreports.org/drugs/simple-steps-for-managing-your-medications-a8139817290/

“Latest on Prescription & Over-the-Counter Drugs” (April 11, 2022): https://www.consumerreports.org/drugs/guide-to-prescription-otc-medication/

"How to find the Best Medicare Part D Drug Plan" (November 5, 2021): https://www.consumerreports.org/medicare/how-to-find-the-best-medicare-part-d-drug-plan-a6788874634/

How to find the lowest prescription prices — These websites are helpful for comparing prices on prescription drugs.

"GoodRx" website compares prices on prescription drugs available at United States-registered pharmacies in your area: https://www.goodrx.com/

Consumer Reports identified data privacy concerns with GoodRx and provided this article on how the website is addressing the concern: "How data privacy concerns identified by Consumer Reports are being addressed by GoodRx" (March 6, 2020): https://www.consumerreports.org/health-privacy/goodrx-stops-sending-prescription-data-to-facebook/

AARP's "Drug Savings Tool" website helps you determine if there are less expensive options you can discuss with your doctor: https://www.aarp.org/tools/

Insulin cost savings resources

Association of Diabetes Care & Education Specialists “Insulin Cost-Saving Resource Guide” (July 17, 2022) https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/insulin-cost-saving-resource.pdf?sfvrsn=5449058_4

Help with understanding and choosing a Medicare Part D plan — The information in these websites is intended for people eligible for Medicare. To enroll in Medicare, use this government website: "Get started with Medicare"

Medicare — This is the official government website that lists the different Part D prescription plans Medicare offers. Here you can compare the plans offered in your state and view each plan's formulary (list of covered drugs).

General site: www.medicare.gov

Review options for Medicare prescription coverage: https://www.medicare.gov/plan-compare/#/?year=2023

Site with information on state help with drug payment (how to contact each program, who is eligible, and other information): https://www.medicare.gov/plan-compare/#/pharmaceutical-assistance-program/states?year=2023&lang=en

Ways to lower your Medicare prescription drug costs: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap/5-ways-to-get-help-with-prescription-costs

Consumer Reports “How to find the Best Medicare Part D Drug Plan” (November 5, 2021): https://www.consumerreports.org/medicare/how-to-find-the-best-medicare-part-d-drug-plan-a6788874634/

Phone: 1-800-MEDICARE (1-800-633-4227)

Medicare Rights Center — This is an independent nonprofit consumer advocacy group that helps people navigate the Medicare system. The group offers a hotline with counselors who can answer questions and help you make the most out of your Medicare coverage.

Website: www.medicarerights.org

Phone: 1-800-333-4114

Social Security Extra Help Program — Only for people with Medicare, this official government site has information about the Extra Help program. The Extra Help program helps people pay for the costs (monthly premiums, annual deductibles, and prescription copayments) related to a Medicare prescription drug plan.

Website: www.ssa.gov/benefits/medicare/prescriptionhelp.html

SHIP: State Health Insurance Assistance Program — SHIP is a national program that offers counseling and help to people with Medicare and their families. This website can help you find a counselor in your area who will meet with you one-on-one and talk to you about your Medicare options.

Website: www.shiphelp.org/

Online application: secure.ssa.gov/i1020/start

Help paying for your medicine — These websites provide information about different programs to help you pay for medicine.

Benefits Checkup (National Council on Aging) — This website gives people lists of services and programs for which they can apply. The lists include programs to help pay for medicines, but also programs that do not have to do with health care directly. For example, this website has information on finding housing, getting food stamps, and finding care for older adults. You can search for all types of programs at once, or target your search to find a specific kind of service.

Website: www.benefitscheckup.org

Needymeds — This is an independent nonprofit organization that provides information about patient assistance from drug companies and the government. The website also offers people a discount card that they can use on prescriptions if they have no insurance or choose not to use their insurance. This card is especially useful in paying for medicines if you reach the Medicare coverage gap and Medicare is no longer paying for your prescriptions.

General website: www.needymeds.org

Website with SHIP information: www.needymeds.org/ship

Partnership for Prescription Assistance — This program is run by drug companies and their trade group. It is only for people who do not have prescription drug coverage. The website helps people find programs that will get them medicines for free or for a reduced cost.

Website: www.pparx.org

Phone: 1-888-4PPA-NOW (1-888-477-2669)

Rx Assist — This website lets you enter the name of a medicine or the name of a drug company to find programs that can help you get that medicine or medicines made by that company at a reduced cost. In many cases, the online applications for those programs are included.

Website: www.rxassist.org/patients

Rx Outreach — This website offers medicines and diabetic-treatment supplies at a reduced cost to people who make less than a certain amount of money each year.

Website: www.rxoutreach.org

Phone: 1-800-RXO-1234 (1-800-796-1234)

Learn more — These websites provide extra information and tips to help you make smart choices and protect your rights when looking for health care.

FDA information for consumers

Government websites with information about safety and quality of generic drugs:

"Generic Drugs": https://www.fda.gov/drugs/buying-using-medicine-safely/generic-drugs

"Generic Drugs: Questions and Answers": https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers

Government websites with information about buying drugs online safely:

"Know your Online Pharmacy": https://www.fda.gov/drugs/quick-tips-buying-medicines-over-internet/besaferx-your-source-online-pharmacy-information

(See 'National Association of Boards of Pharmacy' below.)

Government websites with information about the risks of foreign and internet pharmacies:

"The Possible Dangers of Buying Medicines Over the Internet": https://www.fda.gov/consumers/consumer-updates/how-buy-medicines-safely-online-pharmacy

"Buying Medicine from Outside the United States": https://www.fda.gov/drugs/buying-using-medicine-safely/buying-medicine-outside-united-states

National Association of Boards of Pharmacy

Online (internet) pharmacies certified by the National Association of Boards of Pharmacy are licensed and operated according to appropriate quality standards: https://nabp.pharmacy/programs/accreditations-inspections/digital-pharmacy/accredited-digital-pharmacies/

WHERE TO GET MORE INFORMATION — Your healthcare provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our website (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.

Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Coping with high drug prices (The Basics)
Patient education: When you have multiple health problems (The Basics)
Patient education: Brand versus generic medicines (The Basics)

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

ACKNOWLEDGMENT — The editorial staff at UpToDate would like to acknowledge Becky Briesacher, PhD, who contributed to an earlier version of this topic review.

  1. Hamel, L Lopes, L Kirzinger A et al; "Public Opinion on Prescription Drugs and Their Prices" Kaiser Family Foundation Polling (published October 20, 2022) https://www.kff.org/health-costs/poll-finding/public-opinion-on-prescription-drugs-and-their-prices/ (Accessed on October 28, 2022).
  2. Nisha Kurani, Dustin Cotliar, and Cynthia Cox; "How do prescription drug costs in the United States compare to other countries?" Peterson Center on Healthcare and Kaiser Family Foundation Health System Tracker https://www.healthsystemtracker.org/chart-collection/how-do-prescription-drug-costs-in-the-united-states-compare-to-other-countries/ (Accessed on October 20, 2022).
  3. The Inflation Reduction Act Lowers Health Care Costs for Millions of Americans; Fact Sheet Centers for Medicare & Medicaid Services (October 5, 2022) https://www.cms.gov/newsroom/fact-sheets/inflation-reduction-act-lowers-health-care-costs-millions-americans (Accessed on October 16, 2022).
  4. 2020 Report: Generic Drug and Biosimilars Access and Savings in the U.S.,” Association for Accessible Medicines https://accessiblemeds.org/2020-Access-Savings-Report (Accessed on October 20, 2022).
  5. Liu P, Dhruva SS, Shah ND, Ross JS. Medicare Beneficiary Out-of-Pocket Costs for Generic Cardiovascular Medications Available Through $4 Generic Drug Discount Programs. Ann Intern Med 2018; 169:817.
  6. Hauptman PJ, Goff ZD, Vidic A, et al. Variability in Retail Pricing of Generic Drugs for Heart Failure. JAMA Intern Med 2017; 177:126.
  7. Luo J, Kulldorff M, Sarpatwari A, et al. Variation in Prescription Drug Prices by Retail Pharmacy Type: A National Cross-sectional Study. Ann Intern Med 2019; 171:605.
  8. Van Nuys K, Joyce G, Ribero R, Goldman DP. Frequency and Magnitude of Co-payments Exceeding Prescription Drug Costs. JAMA 2018; 319:1045.
  9. "Online Pharmacies Can Help You Save Big on Prescription Drugs" Consumer Reports (April 5, 2022) https://www.consumerreports.org/online-pharmacies/online-pharmacies-can-help-you-save-big-on-prescription-drugs/ (Accessed on October 20, 2022).
  10. Greenberg J. Ten Tips to Help Outpatients Save Money. Am J Med 2017; 130:283.
  11. Ross JS, Kesselheim AS. Prescription-drug coupons--no such thing as a free lunch. N Engl J Med 2013; 369:1188.
  12. Ubel PA, Bach PB. Copay Assistance for Expensive Drugs: A Helping Hand That Raises Costs. Ann Intern Med 2016; 165:878.
  13. Law MR, Chan FKI, Harrison M, Worthington HC. Impact of brand drug discount cards on private insurer, government and patient expenditures. CMAJ 2019; 191:E1237.
  14. The Possible Dangers of Buying Medicines over the Internet http://www.fda.gov/forconsumers/consumerupdates/ucm048396.htm (Accessed on October 01, 2012).
  15. BeSafeRx: Know Your Online Pharmacy http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/BuyingMedicinesOvertheInternet/BeSafeRxKnowYourOnlinePharmacy/default.htm (Accessed on October 01, 2012).
  16. FDA takes action against thousands of illegal Internet pharmacies http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm322492.htm (Accessed on October 16, 2012).
  17. How to Save Money on Medicines: Dos and Don’ts (May 8, 2016) https://crediblemeds.org/blog/save-money-medicines-dos-and-donts/.
This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms ©2023 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
Topic 16279 Version 72.0

References