It’s not just your imagination—prescription drugs are getting a lot more expensive.
In fact, spending on medications in the United States has gone up 76% between 2000 and 2017, according to a Rand Corporation report.
The U.S. government doesn’t regulate or set maximum prices for medications, so you’re at the mercy of the free market. This makes it possible for brand-name drugs to send overall prices soaring sky high.
Prescription costs aren’t exactly a line item you can cut from your budget. If you do, you risk letting conditions go untreated and paying more for long-term healthcare down the road. I’ve let this happen before and I don’t recommend it.
You can keep prescription prices affordable without cutting corners on your health, and it’s easier than you think.
Always go generic, if possible
Going generic is one of the easiest ways to save a ton of money on prescriptions because brand-name medicines are the biggest factor in high drug prices.
If your medication is available generically—many of them are—you can save between 30% and 80% at the pharmacy. You can think about it like buying generic groceries instead of brand names, but with a promise that you won’t be sacrificing quality.
Generic drugs are designed and required to be as similar to their brand-name counterparts as possible. This means that generics must meet the same safety standards, active ingredients, dosage availability, strength, quality, intended use, and effectiveness.
Since generics go through a strict Food and Drug Administration (FDA) review process before they’re approved, they won’t compromise your health. The biggest difference is that generic medication approvals don’t have to repeat the same clinical studies that brand-name medication approvals do.
How to get generic medications
Ask your healthcare provider about generic options when they’re prescribing your medicine. In a few cases, your doctor may want to stick with the brand-name version for the best results. Otherwise, they’ll often be able to recommend a generic form.
Pharmacists can also guide you towards generics when they’re available, you just have to ask!
To find out if there’s a generic version of your medication, look it up in the FDA-approved drugs database.
Newer drugs may not be available generically, since there’s a five- to seven-year waiting period where the brand-name version has exclusive rights. To see if your medicine has a generic version yet, you can check the First Generic Drug Approvals on the FDA’s website.
Ask about the cash price
Each pharmacy prices medications a little differently, depending on multiple factors. These can include their location, the volume of medicine they can access, and whether they get medicine directly from drug manufacturers or from a third party.
What this means is that the price you get for the same prescription won’t be consistent across different pharmacies.
One way to make sure you’re not paying a markup is to ask about the drug’s retail price, sometimes called a “cash price”. Comparing cash prices can help you find the pharmacy with the best deal.
This is especially helpful if you’re uninsured or your insurance doesn’t cover the medication.
Even if you do have insurance, paying the retail price can save you money. Cash prices may be cheaper than your co-pay—sometimes a lot cheaper.
Keep in mind that if you bypass insurance to pay out of pocket, the purchase won’t always count towards your insurance deductible. Some health plans, like Medicare, do allow the costs to count towards your deductible if your cash price was lower than the co-pay for a drug the plan covers. Your plan may not advertise this benefit, so go ahead and ask at the pharmacy.
Work with your pharmacist
Pharmacists are experts at navigating healthcare systems that seem bizarre to the rest of us. They often have insider knowledge about how to save money on prescriptions.
When you’re at the pharmacy counter, ask if there’s any way to save on your medications. A pharmacist can:
- Look for potential savings through a pharmacy program (like CVS’s Rx Savings Finder).
- Tell you if it’s cheaper to pay the cash price or use insurance.
- Suggest safe cost-cutting options like splitting larger pills or taking medication in a different form (like switching from liquids to capsules).
Shop around for pharmacies
Location matters. Prescription prices can vary widely across pharmacies, so instead of defaulting to the closest or most convenient spot to fill a prescription, take time to compare costs at nearby stores.
Small, independent pharmacies tend to have the lowest prices. Big-box chains like Sam’s Club and Costco sometimes offer low prices too, even if you’re not a member.
Large chain drugstores don’t have to be super expensive, either. Many of them have in-house discount programs for prescriptions, like Walgreens’ Prescription Savings Club. As a bonus, your membership gets you savings on non-medical purchases at the same store.
Understand what your insurance plan covers
Whether you’re picking new health insurance coverage or brushing up on your current plan, you’ll want to check which medications are covered, and how much you’re expected to spend as a co-pay.
You can find out a lot of this info before you commit to a plan. Insurance marketplaces, like Policygenius, let you compare health insurance options side by side—so you can see, for instance, how much your deductible will be with each option.
Most insurers will list the medicines they cover on their websites. Some insurers have even joined the 21st century and started offering apps that let plan participants see their prescription costs right away.
Get familiar with “tiers”
Covered medications are usually grouped into “tiers,” with each tier representing a higher range of co-pay costs. Tier 1 has the least expensive medications—like generics, or “preferred” medications the insurer gets at an affordable rate. Tier 2 medications are more expensive, and so forth. This will give you some idea of what you’ll pay on your plan for each medication.
As long as the medication effects are the same, most healthcare providers are required by insurers to start you on a lower-tier, or lower-cost, drug and only switch to a higher tier if it’s necessary.
Order larger supplies of medication
Ask your healthcare provider or pharmacist if they can fill you a 90-day supply of medication.
If you’re taking the same medicine regularly year-round, or for at least three months at a time, 90-day supplies are a lot cheaper and more convenient than the standard 30-day supply.
You’re only paying one co-pay, as opposed to three. And since drug prices change all the time, you’ve locked in a lower-cost supply in case the price of your prescription rises.
Another possibility with some medicines is to get your supply in a larger individual dose than you need and divide the doses with a pill-splitter.
A longer supply won’t be possible with every prescription. Strong painkillers, for instance, will only be doled out in small doses. And if you’re just starting a medication, your doctor will probably want to evaluate how it’s working before committing to a 90-day supply.
Use a discount prescription service
Discount prescription programs work with pharmacy owners and drug manufacturers to negotiate lower prices on certain drugs for customers.
Most of the time, if you have insurance, you’ll already get the lower price because your insurance plan is picking up part of the tab. So, discount services may not save you much.
But if you’re uninsured, or if your insurance requires an outrageous co-pay for your medication, discount prescription services can get you a bargain—up to 80% off in some cases. Medicare has its own discount prescription program for Medicare-eligible customers.
How to get discount prescriptions
All you have to do is sign up for a program’s card on their website (or download the app), which is typically free. The program lets you comparison-shop your prescription’s cost at local pharmacies in real-time. If you are insured, it’ll show you estimated co-pays.
Some popular prescription savings programs include:
- GoodRx, one of the most well-known, has a mobile app and over 70,000 pharmacies in its network. It claims to cover almost all brand-name and generic drugs the FDA approves.
- SingleCare has a “bonus savings” option where you can earn money towards future payments every time you fill a prescription.
- BlinkHealth offers free delivery from its own online pharmacy.
- Optum Perks.
- ScriptSave WellRx.
- RxSaver has an optional Advocacy Program for people on high-cost maintenance medications. The Advocacy Program fee is $60/month, so if your monthly prescription drug costs add up to a lot more than $60, it’s worth a membership.
There are a few drawbacks to prescription programs. The discounts they show aren’t 100% guaranteed because of fluctuating drug prices. And discount services do collect your personal information, including health data (though GoodRx lets you opt-out of data tracking).
Find drug manufacturer coupons
For newer drugs without a generic version, the best way to save is sometimes to go to the manufacturer and get a coupon.
Discount prescription services offer coupons too, and WebMD has a search engine for prescription coupons. Usually, you won’t be able to use coupons if you’re also using insurance—they may be applied after insurance, so they won’t count towards your deductible.
Try buying online
Yep, you can order almost anything online, including medications. Online pharmacies can be a literal lifesaver if you can’t get to a brick-and-mortar pharmacy. And they usually ship in bulk, so you’ll have a large supply with each order.
The downside is that you’ll have to check carefully to make sure the online pharmacy is legitimate. Here are the non-negotiables to look for:
- A license from the state board of pharmacy (your state and/or the state where the pharmacy operates).
- A physical address and telephone number in the U.S., if you’re located in the U.S. Medicines imported from other countries don’t come with the same safety and effectiveness guarantees as FDA-approved meds.
- A pharmacy that requires a valid prescription.
- A state-licensed pharmacist on staff.
The FDA has some helpful fact sheets about online pharmacies, including a search engine for state-licensed pharmacies and a link to state boards of pharmacy to check licensure.
You can also check the National Association of Boards of Pharmacy’s list of accredited digital pharmacies.
Once you get your med delivery, make sure the dosage is exactly what you ordered and the packaging is intact.
Look for assistance programs
Some federal healthcare assistance benefits, even federal grants, can help people pay for medicine.
Most states have their own subsidized or discount prescription assistance programs for residents who meet certain requirements. Usually, you’ll need to be below a specific income threshold to qualify, and you may need to send proof of income (like a tax return).
This state-by-state breakdown on Benefits.gov is a good place to start looking. Medicare.gov has a state-based search engine too.
Independent assistance sites can plug you into programs that help you get low-cost or free prescriptions. These sites are also designed for low-income customers, though the exact income cutoff may vary.
- NeedyMeds.org is a one-stop-shop for prescription assistance, complete with its own drug discount card.
- RxAssist.org lets you search patient assistance programs for insured and uninsured patients.
- Partnership for Prescription Assistance also links up to a variety of assistance programs, including ones offered directly by pharmaceutical companies.
It may take some searching, but persistence can pay off with free or practically free medications.
Taking care of your health and well-being is always a smart financial decision (for example, you may be saving yourself from hospital bills 5 or 10 years down the road). Having to fill a new prescription can be irritating, but at least you’ll get it filled without going broke.
Featured image: Shutterstock.com/ Eviart
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