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Patient education: Coping with high drug prices (The Basics)

Patient education: Coping with high drug prices (The Basics)

What should I do if I can't afford all of my medicines? — This is a problem for many Americans. If you can't afford your medicines, talk to your doctor, nurse, or pharmacist. They might have ways to lower the costs of your medicines or be able to help in other ways. Do not skip doses or take smaller doses to try to save money. This could cause serious health problems.

This article includes some tips for how you can get your medicines at a lower cost. These tips can help whether or not you have prescription drug coverage. Prescription drug coverage is also called "drug insurance."

What if I do not have health insurance? — If you live in the US and do not have health insurance, look into getting insured. In many states, more people are eligible for lower-cost insurance or Medicaid. Most insurance options include prescription coverage. For information about health insurance options, visit the website.

What if I have Medicare? — Medicare offers low-cost prescription coverage called Part D. The ways of lowering medicine costs listed here work if you have or can get Part D prescription coverage. The table provides help for choosing a Medicare Part D plan (table 1).

Ask for medicines that are available as generics — Ask your doctor, nurse, or pharmacist if any of the medicines you take are "brand name" medicines. If so, it might be possible to switch them for less expensive "generic" medicines. Generic medicines are copies of brand name medicines, and are usually much less expensive. They contain the exact same medicine as the brand name medicine, and they have been tested and shown to be just as good. Using generics can save you money even if you have insurance.

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 ( Enter the brand name of your medicine to see if a generic version is available.

Many newer medicines do not come as generics. So it's not always possible to switch to generics. If you cannot switch to a generic, it might be possible to switch to a less expensive brand name medicine. Your doctor can tell you if this might be an option.

Look into non-prescription versions — Some medicines that your doctor can prescribe are also sold without a prescription. This is also called "over the counter" (or "OTC"). If your prescription medicine is also sold without a prescription at a lower price, ask your doctor if you can take that instead. This is often true for stomach medicines, allergy medicines, and pain relievers (table 2).

Any time you switch a medicine, you must work closely with your doctor. With some switches, your doctor might need to check to be sure that it is working right for you. Also, a medicine sold without a prescription might not be exactly the same as the prescription version, even if it has the same name. Your doctor can help make sure that you are taking the right medicine and dose.

When you switch, learn what the new medicine looks like and which medicine it replaces. That way, you don't take both the new one and the old one at the same time by mistake.

Always compare prices — There can be big differences in the price charged for the exact same medicine depending on what store you use. Shopping around for a good price on your prescriptions can save you a lot of money, especially for generics.

Big chain retail stores often have great prices on many generic medicines. Their prices can be as low as $4 for 1 month and $10 for 3 months, with no insurance needed. Find out if the medicines that you take are sold at low prices by asking at the store or by going online. To find information online, type the store's name and the words "prescription program" into Google or another search engine. These low prices can be less than your co-pay if you have prescription drug coverage.

Most pharmacies will give you price information over the phone. Ask if they have a savings program or club. You can also compare prices online or on your smartphone by going to the GoodRx website ( This website compares local prices and offers discount coupons. You can then ask your pharmacy for the discount price from GoodRx.

Depending on which pharmacy you use, you might need a store club membership, a coupon, or a store discount card to get the best prices. There are also resources for ideas on how to get the lowest price for your prescriptions (table 3).

If you take several medicines and want to buy them from different pharmacies, let your doctor know. Also, give each pharmacy a full list of the medicines that you take. They can check for drug interactions.

Make the most of your insurance — If you have insurance, there are lots of things that you can do to get the most out of your coverage. Take time to learn about your drug coverage options. If you are eligible for Medicare Part D, reliable help is available (table 1).

Each year, get a list of the drugs covered by your plan. This is called the "formulary." Also, get written information about:

Co-pays – Co-pays are the amount of money you pay each time that you get a prescription filled.

Tiers – Most insurance companies put drugs into different categories or "tiers" that have different co-pay amounts. Drugs in Tier 1 are usually the cheapest. Tier 1 is also called the "preferred" list. Drugs in Tier 3 are usually the most expensive.

Deductibles – A deductible is the total amount of money that you must spend before your insurance starts to pay for anything.

Check if any of your medicines are not covered, or are covered but in a limited way or with a high co-pay. For each of these, ask your insurance company or pharmacist which medicines in Tier 1 might work for you instead. Then, give that information to your doctor.

Bring the list of medicines covered by your insurance and their cost to your doctor visits. Then, ask your doctor if any of the medicines in Tier 1 can replace any you take that are expensive or not covered.

Most drug coverage plans offer a mail-order option, which can save you money on medicines you take for 3 months or longer. Mail-order is a good idea only after you know for sure that you will be taking a medicine at the same dose for at least 3 months.

Make sure you need all of the medicines you take — Some people are prescribed more medicines than they really need. That might happen if you see 2 different doctors who prescribe medicines that do the same thing. To avoid this problem, bring a list of all of the medicines you take each time that you visit any doctor. An example of this kind of list is at the following website: Ask your doctor to review your medicine list to make sure that there are no mistakes. It also helps to bring a bag containing all of your medicines with you to the doctor's office to have it checked. This includes pill bottles, inhalers, and any other forms of medicine you take.

Get help paying for the medicines you need — If you still can't afford your medicines even after following the steps described above, 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 programs paid for by non-profit groups and by drug companies. These programs choose which people to help based on their income, the size of their family, and other factors. Ask your doctor, pharmacist, or social worker if these programs are available to you (table 4).

Foreign or internet-only pharmacies — Stay away from any pharmacy that will sell you prescription medicines without a prescription from a doctor who has actually seen you. Some internet and foreign pharmacies are not licensed or inspected the way that they should be. They could sell you medicines that are not right for you or that are expired or even fake.

If you decide to use an internet pharmacy to save money on your prescriptions, look for one that has been certified by the National Association of Boards of Pharmacy (table 3). More internet pharmacies have become available, and they do often have good prices. It's just important to make sure that the one you choose is reliable.

More on this topic

Patient education: Brand versus generic medicines (The Basics)

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

This topic retrieved from UpToDate on: Jan 02, 2023.
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