This post originally appeared on Forbes, where I am a contributor.
If you’re like a lot of Americans, your prescription prices keep going up and up.
What to do? Here are eight easy hacks for saving money on meds.
Before the hacks though, one important point: If your insurance company won’t pay for something that is recommended by your doctor, get the doctor and the insurer talking right away.
Insurers say their rules for not paying for medications are designed to avoid unnecessary or ineffective care. Doctors say they should decide what medication you take. The result: A doctor tells you to take Medication X while the insurer insists you need Medication Y. Big Pharma and the pharmacy benefit managers, who run medications for the insurers and have behind-the-scenes deals, play a role here too.
So if your doctor and insurer disagree, get them talking right away. Ask the doctor to reinforce the reasons. Ask and ask again. Be persistent.
And now to our eight hacks.
- Ask if the cash price for the med is lower than the insured price. This happens with surprising frequency, though you would expect that your insurance gives you a lower price. To find out, ask the pharmacy “What will this cost me with my insurance? And what’s the cash price?” A lot of news coverage about this has sprung up of late; we’ve been writing about it for years. Here’s a California doctor writing about the topic. This investigation of the topic by one of our news partners, Lee Zurik at WVUE Fox 8 Live in New Orleans, spawned about a dozen lawsuits nationwide with documented evidence of, for example, a drug that a patient paid $50 for in co-pay, but could have bought for $17 for cash.
- See if there’s a generic, or an over-the-counter equivalent. Generics can cost a fraction of name brands. Certain rules govern when a name brand can be manufactured and sold as a generic; this can change the status of your med, and its price, quickly. Some allergy meds like Claritin and Allegra, and heartburn meds like Prevacid and Nexium, were once only prescription, but may now be over-the-counter or exist in both OTC and prescription versions. Dosages may differ, of course, but if they’re exactly the same, one is likely to be cheaper than the other. Do your homework — online, through the insurer or through your pharmacist.
- Try GoodRx.com. This company essentially gives a discount card to people that they can use to buy meds at participating providers. The company and the participating pharmacy have arrangements, and make money off a cut of the transaction. Ask the pharmacy you pick what the price is 1) with your insurance, 2) with the GoodRx coupon — and 3) on cash, without the GoodRx coupon or insurance.
- Be wary of all discount cards. Those discount cards in general can be a mixed bag: In one example our partner found, the discount card price was $317 but paying with cash, the medication cost $227. I myself found a $2 savings without a discount card.
- Try BlinkHealth.com. Blink negotiates with pharmacies to accept an agreed-upon price. Then you buy your medication through the app, and go to the pharmacy to pick it up. Blink takes a cut of the sale. This works most frequently for generics — and something like 80 percent of all medications nationwide are generics. BlinkHealth has had some agreements go south, like this dispute with CVS, so check for sure that your pharmacy participates.
- Maybe you want to buy mail order from overseas.If you’re contemplating this, you should know that there are official restrictions on this, and also that there may be quality issues. (Of course, there can be quality issues with U.S. manufacturers too, though sometimes drugs bought in the U.S. are manufactured overseas.) Here’s an in-depth look at the topic from NPR. We’ve also heard of people who travel overseas and buy meds to bring back in their bags.
- Look for patient assistance programs and manufacturer’s coupons. If you Google “Patient assistance” and “Abilify,” for example, or the name of your medication, you can see how manufacturers offer aid in purchasing. These programs and coupons are either specifically from the company, or from an umbrella group that works with the companies. Often, these come with strings – for example, Medicare patients can’t use them, or you can get only a few months’ worth. Also, the manufacturers generally write off this aid on taxes or elsewhere, and industry observers point out that the patient eventually winds up paying somehow – perhaps in higher insurance premiums overall to cover the cost of these coupons systemwide. Beyond that, these coupons can serve to encourage the use of name-brand drugs — which puts money in the pocket of Big Pharma — while you might save on an equally effective generic.
- Keep careful records and ask questions. if you have big prescription costs, or if you’re very organized, take a look at this guest post that we ran from a woman who is extremely smart about all this. She has advice for shopping for meds for both family members and pets. She has a binder with printed lists, and every time she goes to the doctor, she has a conversation about medications. It’s a great example of how you can save a lot of money by doing your homework.
Two more resources: If you’re not sure what’s on your formulary, the list of preferred medications from your insurer, you can try this nationwide formulary listing. We have not completely vetted it, but it looks pretty useful. This could be a big help if you’re switching insurers in this open enrollment period, and you know you need a prescription, to help decide which plan will cover it.
We’ve collected these and other resources on our “buying prescriptions” page. If you change your pattern of buying and ask questions, you can save a ton of money.
Jeanne Pinder is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded ClearHealthCosts.
She was previously a fellow at the Tow Center for Digital Journalism at the Columbia University School of Journalism. ClearHealthCosts has won grants from the Tow-Knight Center for Entrepreneurial Journalism at the Craig Newmark Graduate School of Journalism at the City University of New York; the International Women’s Media Foundation; the John S. and James L. Knight Foundation with KQED public radio in San Francisco and KPCC in Los Angeles; the Lenfest Foundation in Philadelphia for a partnership with The Philadelphia Inquirer; and the New York State Health Foundation for a partnership with WNYC public radio/Gothamist in New York; and other honors.
Her TED talk about fixing health costs has surpassed 2 million views.