Prescription Blues: Swallowing the Cost of Medications
When I left my doctor’s office with a prescription for Restasis (cyclosporine) this month, I was hopeful I would be able to afford it under my insurance plan this year. But the nearly $500 upfront cost to fill it has put the medicine out of reach again. I’m hardly alone in this situation.
Nearly a quarter of American adults struggle with prescription costs, according to a recent Kaiser Family Foundation Health Tracking Poll. The percentage of people reporting difficulty is even higher among those who spend $100 or more per month on prescriptions (58 percent), are in fair or poor health (49 percent), or are taking four or more medications monthly (35 percent).
People cut corners when money is short. I’ve done it. Six in 10 of those who reported difficulty affording prescription medications did not take them as prescribed because of costs; 41 percent of that group did not even fill the prescription. Guilty. Some of them (29 percent) took an over-the-counter (OTC) medication instead. Guilty. An even larger number (35 percent) cut pills in half or skipped a dose. Guilty.
Battling sarcoidosis has meant being on as many as a dozen medications at a time to combat health issues. Not following my physicians’ recommendations for medications isn’t my first choice — it’s a last resort after other measures to afford them fail.
Shopping around for prescriptions is one way to save, because cash prices can vary widely within cities, states, and regions, according to a report last month by the U.S. Public Interest Research Group (PIRG) Education Fund. Their survey of more than 250 pharmacies in 11 states found, for instance, that consumers could save as much as $5,400 annually on the cash price of medicines.
As an example, the cost of an Advair Diskus inhaler ranged from a minimum of $11.99 to a maximum of $1,136, while a Ventolin HFA inhaler cost anywhere from $11.99 to $137.99. Large pharmacy chains tended to have higher median prices than smaller and independent pharmacies, the report found.
Residents in New Jersey and Pennsylvania can research cash prices for commonly prescribed medications using the Pennsylvania Prescription Price Finder and the New Jersey Prescription Drug Price Registry. Patients can compare prices and get coupons using the GoodRx website or app.
Consider cheaper alternatives
Switching to generic medications “can save you a ton,” PIRG reported. Consumers shouldn’t forget to shop around for generics, as well, which the survey also revealed to have significant price differences. To cut costs, I ask for available samples when physicians want me to try new medications that I may not end up remaining on. If cheaper generic substitutes aren’t available, as Bloomberg Law reports is the case with Restasis, I’ll ask whether any equivalent, cheaper, brand-name prescriptions exist, or if I can be treated with OTC medications or supplements.
Manufacturer coupons can offer savings. Pharmaceutical companies offer a variety of assistance programs that provide eligible patients with free medication. Some that I’ve tapped in the past are the Pfizer Patient Assistance Program; the Allergan Patient Assistance Program, which provides Restasis, among other medications; and Teva Cares Foundation Patient Assistance Programs. Financial assistance is also available through the U.S. Social Security Administration’s Extra Help With Medicare Prescription Drug Plan Costs. Some pharmacy chains offer discount programs, such as Walgreens Prescription Savings Club, which charges an annual membership fee ($20 individual or $35 family).
Do your homework
Make sure you are using your insurer’s preferred network of pharmacies for the cheapest costs, and check regularly because they change. You may also find savings by filling your prescriptions by mail order or by getting a 90-day supply instead of a monthly prescription. If your physician switches you to OTC medications or supplements for treatment, watch for sales and stock up when they occur!
There’s always next year
Unfortunately, even with the wide array of tools available, there are still times when I’m unable to shave my prescription costs down to a price I can swallow. Which is why for now, Restasis will remain on a pharmacy shelf instead of in my medicine cabinet.
Note: Sarcoidosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sarcoidosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to sarcoidosis.
Alan Cameron MD
You should not forget that Canada has the same brand medications available for lesser costs. You can take an American prescription to Canada and have it filled. You can shop for prices on-line. Pharmaceutical companies often have discount coupons available on websites. If you contact your PBO for prescription medications they can help navigate for similar medications that might be available cheaper. PBOs frequently switch preferred providers making the expensive drug cheaper and vice versa. They get discounts if they guarantee a percentage of the market. This is not transparent, but the PBO will want to work with you to get the best deals for everyone. This can be sort of a game, but it is possible to save over 50% on most drugs and still not get counterfeit drugs.