Prescription Drug Costs | |
Prescription drug costs have been the fastest-growing health care expenditure, rising at double-digit rates each year for the past seven years. Here at Roswell Park, we understand that affording prescription medications may present a financial hardship for many people. Certainly, those without health insurance are the hardest hit, but even people with insurance may find co-pays, deductibles, or caps (limitations of coverage for certain items or during a certain time period) may strain their resources.
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Suggestions for Cost Savings | |
Here are some suggestions should you be experiencing financial difficulties due to the cost of your medications:
- Talk to Your Healthcare Team. Be sure your physician knows of your struggle. He or she may be aware of patient assistance programs, alternate drugs, or some other way to achieve the same treatment goals at a lower cost. Samples (of your medications) may also be available.
- Review Your Health Insurer’s Formulary. Ask your healthcare insurer for a copy of their formulary (if they have not already provided you with one) and show it to your doctor. A formulary is the list of drugs that your insurer “covers” under your policy. In many healthcare plans, the formulary is divided into levels or “tiers” – generic drugs, and multiple levels of coverage for Brand name drugs – with increasing higher co-pays at each tier. If your medication is not on the formulary or is in the most expensive groups, your doctor may be able to find an alternative medication from the list.
- Call Your Local Pharmacies. Make a list of each medication you take and how much it cost (be sure to include the dose and how often you take it). Call around to different pharmacies to see what they charge for the same dose/supply of the drug – you may be surprised at the different prices for the exact same product. Certain chain pharmacies, or retail stores that contain a pharmacy, may have special programs for generic or other medications. If you wind up using more than one pharmacy be sure that all the pharmacies enter all your drugs into their computer system to help avoid any adverse drug interactions.
- Get a Long-Term Supply. If the drug is one that you will take daily for a long period of time, consider using a drug wholesale house and getting a 90 day supply rather than the standard 30 day supply. Often, discounts are available if you buy in “bulk”. Be sure to let your doctor or nurse practitioner know that you need a prescription for 90 days, not 30 days.
- Medicare Subscribers. Consider getting a Medicare Drug Discount Card. In January 2006, the new Medicare drug benefit became effective. Medicare recipients are entitled to a discount on their prescriptions with use of an approved Medicare Drug Discount card. Most major drug stores offer these cards, as do the insurance companies and some advocacy organizations. The enrollment fee is usually about $20 or $30 and each provider offers about 70 – 100 drugs at discounted prices. Each person is only entitled to one Discount card – so compare your options before deciding on which card you will get.
Before you choose your card, there are two ways to determine your savings – through your pharmacy, or through an online comparison program offered by Medicare. Your pharmacist can tell you if your drug store participates in any Medicare drug discount card programs and which one would provide the best coverage for you. As the pharmacist what your prescriptions would cost using that care and for the brochure or phone number for the care provider.
If you have access to the Internet, go to www.medicare.gov and click on the drug discount topic. Follow the instructions listed. You will need to have a list of all your prescription drugs, the dose of each, how often you take each one, and the current price you are paying. You also need to enter your income level and if you are receiving any forms of assistance. You do not enter any personal information such as your name or social security number, however, so the process is anonymous. The program will help your pick pharmacies near you by zip code and will make suggestions as to which plans would meet your personal needs. - EPIC (NYS) Program/State Programs. New York's EPIC plan has enacted a wrap around plan that will pay for most drug costs not paid by Medicare, including deductibles, co-insurance or copayments, the gap in coverage above $2,250 and products not covered by Medicare. Enrollees remain responsible for state-established copayments up to $20, fees, or deductibles (up to $1,200). Call 518 452-6828 or, toll free within NY, 800 332-3742. You can get more information on their website: http://www.health.state.ny.us/health_care/epic/index.htm
If you live outside New York, contact your state health departmbent to find out if they offer pharmacy assistance program. The National Conference of State Legislatures’ Web site provides links and phone numbers for these date programs. Go to www.ncsl.org/programs/health/drugaid.htm and look for your state’s program in Table 1. - Together Rx Card. Some pharmaceutical companies offer discounts through the Together RX card, which provides a 20% – 40% savings on brand name prescription drugs offered by the participating pharmaceutical companies and a 14 % discount on generic drugs at participating pharmacies. You can read a list of more than 150 drugs on their Website www.togetherrxaccess.com. The card is free and can be used by anyone who does not have prescription coverage and is not eligible for Medicare.
- Industry-Related Drug Discount Cards. Some pharmacies offer their own discount cards to low income and Medicare enrollees. These cards are free and provide discounts on the drugs from the company that issues them. You can find a list of manufacturers that offer such a program at www.rxassist.org. This Web site is a program of the Robert Wood Johnson Foundation and also contains information about the Express Scripts RX Outreach program, which offers generic drugs at a discount to families with lower income.
- Drug-Specific Programs. Some pharmaceutical companies run drug-specific programs. If you have one medication that is very costly, call the manufacturer directly and ask them if they have such a program available.
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Internet Support | |
The Internet is most likely the fastest most convenient way to access the most information in the shortest amount of time. Look into the Websites listed below to help you meet the financial burden of prescription medications:
- RX Hope
http://www.rxhope.com/
Click on “Patients & Caregivers, then click on “Start Your Free Online Patient Assistance Request” or on “Medications Search”, which allow you to investigate assistance by Brand name, Patient Assistance Program, or pharmaceutical company. - PhRMA
http://www.phrma.org
Pharmaceutical and Research Manufacturers of America:Click on “Patient Assistance Program”. Follow instructions by clicking on either "Patient" or "Caregiver." - Needy Meds
http://www.needymeds.com/
This site is designed to provide information about patient assistance programs that provide no cost prescription medications to eligible participants. Such as state programs, local programs, fee-for-service programs, discount drug cards, Medicaid sites, federal poverty guidelines, articles on patient assistance programs - RX Outreach
http://www.rxoutreach.com/en/
Rx Outreach is an easy and affordable way for people of all ages to get medicines they need. Through this program, people who qualify financially can get more than 350 medications that treat a wide range of conditions. People may take advantage of the program even if they receive medicines through another discount program. The program is available to individuals and families with incomes of up to 250% of the federal poverty level. Currently, for a family of four, this figure is about $55,000.
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