Have you ever been faced with the choice of buying groceries or paying the rent and filling a drug prescription? Have you or has someone related to you ever skipped taking medication because of the cost? Well, you’re not alone. The burden of increasingly costly prescription drugs is weighing on millions of Americans, and they’re making choices that could jeopardize their health.
Today, the amount consumers have to pay out of pocket for prescribed drugs is rapidly escalating, from about $25 billion in 2000 to a projected $67 billion in 2025. (1) To make matters worse, more than 8.8 percent of American adults, or roughly 28.5 million people, do not have health insurance and must pay for all prescription medications themselves. (2)
But there are ways that you can minimize the effect that the accelerating prescription drug crisis has on your healthcare. This guide to drug pricing and discounts provides the answers to common questions and offers practical information that every consumer needs to know.
Why Are Prescription Drug Prices So High?
Did you know that Americans pay the highest costs for prescription medications in the world? (3) You can partly attribute the exorbitant prices to an intricate and extensive drug research and development (R&D) and approval process, along with an equally complex healthcare system. (4)
No doubt, we have benefited from innovations in the management of diseases for which there were few or no treatment options before. But opponents of the pharmaceutical companies argue that just a small percentage of the drug companies’ costs are used for R&D, with most of the money spent on administration and brand-name drug marketing.
Drug companies don’t tell the whole story behind the rising cost of prescriptions. There are third-party administrators known as pharmacy benefit managers (PBMs), who are paid to negotiate prices between pharmacies and large insurers. These PBMs charge pharmacy providers either a percentage or a flat fee for every prescription filled, which contributes to higher drug prices. (5)
How Can You Save Money on Medication?
Consumers have options when it comes to getting the lowest prices on prescription drugs.
First, if you aren’t shopping around for medications at local pharmacies, using online coupons, or joining buyers’ clubs at drugstores, you’re probably paying way too much.
Just because your pharmacist quotes you a price does not mean that’s the lowest price for that prescription. Comparison shopping for prescription medications can be as quick and easy as following the helpful tips below, reviewing a few websites, and printing some money-saving coupons.
6 Ways You Can Cut Your Drug Costs
These 6 surefire tips will help you save on prescription medications so that you can put the extra funds to other important uses.
1. Search for Discount Coupons Online
A simple Google search of your prescription drug, over-the-counter medicine, or healthcare supplies will bring up pages of websites offering money-saving coupons.
Drug coupons cannot lower your copay, but your pharmacist may apply the coupon to your drug purchase to lower the price.
Scroll through the available sites online to find rebates for your medicine, too. Because pharmacists may run prescriptions through insurance first, make sure the pharmacist is aware of the discount coupon or rebate before you pay the final cost.
What you should do Before you head to the pharmacy to fill a prescription, do a quick Google search to check for money-saving coupons and rebates.
2. Join Your Pharmacy’s Prescription Club
No insurance or not enough coverage? You can find in-store pharmacy prescription clubs at many drugstores. These money-saving programs can lower drug and supply prices.
Also, the in-store programs provide up to an 85 percent savings on thousands of prescriptions, including commonly prescribed generic medications for heart health, diabetes, asthma, mental health issues, women’s health, gastrointestinal health, and other conditions. (6)
While these savings clubs are not health insurance, they can save you money at the pharmacy. (7)
What you should do Compare different in-store pharmacy prescription clubs to get the best prices when checking out. In-store pharmacies at retailers like Walgreens and Kmart also offer prescription clubs.
3. Use a Verified Internet Pharmacy
Verified internet pharmacies are those that have passed stringent reviews by the National Association of Boards of Pharmacy (NABP). These pharmacies often include “.pharmacy” in their URLs to show that they are in compliance with the NABP, although some verified pharmacies are .coms or .orgs. They also carry the designation VIPPS, for Verified Internet Pharmacy Practice Site.
While verified internet pharmacies have passed inspection and are deemed safe, be careful not to use a rogue internet pharmacy that is not verified. Check your internet pharmacy against the Find a Safe Site list to buy safely.
In a revealing 2018 study, Consumer Reports sent secret shoppers to 150 pharmacies in six cities across the country to ask for the retail cash prices for a one-month supply of five commonly prescribed drugs — essentially the prices someone without insurance might pay. The widespread range in prices they uncovered was shocking. While the five-drug “basket” cost was just $66 at the verified internet pharmacy HealthWarehouse.com, two national chain retailers had prices closer to $900 for the five drugs. (7)
What you should do It pays to shop around, and don’t forget to check internet pharmacies like HealthWarehouse.com for greater savings.
4. Use an App to Compare Local Drug Prices
There are several websites and mobile applications that can help you find the best price available for a prescription drug.
One of the most widely used is GoodRx, which allows you to comparison shop and get coupons toward medications. GoodRx collects and compares prices and discounts that you didn’t know existed from more than 70,000 U.S. pharmacies, including CVS, Rite Aid, and Walgreens. (8) It allows you to print free discounted coupons or send them to your phone by email or text message. You can then use a GoodRx discount instead of your health insurance or Medicare Part D or Advantage plan if the cost is lower than your copay.
When you go to GoodRx.com, they will ask for the name of the drug, the dosage, the number of pills, and your zip code. Click the “Find the Lowest Price” button. You will see what you might pay at different chain pharmacies with a GoodRx discount coupon or voucher. You can then print or download the generated coupons and vouchers to your smartphone and show your pharmacist to get savings on your drug purchase. (9,10)
Similarly, Blink Health lets users browse local prices by simply searching for a prescription drug’s name. It also offers the option of having your medication delivered or ready for pickup. Another online and mobile service is OneRx, which lists drug prices in your area and offers discounts to consumers using the OneRx card.
RetailMeNot Rx Saver is a popular and easy-to-use app and program. Here you can search for prices on brand-name and generic drugs. Their coupons can be used an unlimited number of times at retail pharmacies such as Walgreens and CVS.
What you should do Check out these and other no-cost prescription pricing services to see what pharmacies in your area charge for your medications.
5. Shop Local or a Preferred Pharmacy Network
Independent pharmacies may beat major chain drugstores, supermarkets, and big box discounters on price — and by an impressive margin. Independents can also easily beat membership warehouses and clubs.
In contrast, the preferred pharmacy network is a group of chain pharmacies that likely give insurance plans a larger discount than other pharmacies.
The point is that drugstores have different prices — they can vary by hundreds of dollars — so be sure to ask ahead before you pick a specific pharmacy.
What you should do Call your local and preferred retail pharmacies before filling your prescription to find the lowest prices.
6. Get It for Free, if You Can
Some large supermarket chains, including Publix, Harris Teeter, Schnucks, Price Chopper, Walmart, Sam’s Club, Costco, and ShopRite, will fill basic antibiotic prescriptions like amoxicillin for free. Supermarket pharmacies may give prenatal vitamins, metformin, antibiotics, children’s vitamins, and other commonly taken medications and supplements for free if you have a valid prescription. These meds and antibiotics are free for as long your doctor prescribes them. You just have to ask. (11)
What you should do You never know until you ask at the pharmacy to find out what drugs they provide customers for free. So be vocal!
A Patients’ Bill of Rights for Prescription Drugs
If you’re a patient, it’s important to understand the guarantees that you have in the healthcare system. This Patients’ Bill of Rights provides you with specific facts and recommendations on how to safely cut costs on prescription drugs.
- You have the right to safe, effective, and affordable medication. When it comes to affordability, Sara Rogers, PharmD, the director of clinical affairs at the American Society of Pharmacovigilance, says patients should consider using online tools and apps to identify the lowest price. You can then print or download the coupons and vouchers to your smartphone and show them to your pharmacist to save money.
- You have the right to pay less for prescription medications, using discounted coupons, rebates, and vouchers. Check one of the prescription pricing websites and apps to compare the cost of drugs and to find money-saving coupons on commonly prescribed drugs. Another way to save money, according to Jenny Sippel-Tompkins, the director of pharmacy at AdventHealth Orlando, “is to choose a drugstore with an internal discount program, like a $4 generic program, with a pharmacist that you have a relationship with.”
- You have the right to appeal to your health insurance company should they deny coverage of a drug or medical device. A letter from your doctor is needed, but don’t back down if you are denied. You can even contact Congress by finding out who your U.S. representative and senator are.
- You have the right to shop around. Call different pharmacies and ask for the lowest prices on prescription drugs. If you need to go to a different pharmacy to save money on one or more drugs, do so.
- You have the right to ask your pharmacist for the very lowest prices on prescription drugs. Previously, “gag clauses” prohibited pharmacists from telling shoppers about less costly options. Legislation signed into law in 2018 prohibits gag clauses.
- You have the right to go generic. Harris H. McIlwain, MD, a board-certified rheumatologist and geriatrician with two pain clinics in Florida, recommends that patients ask for generic drug equivalents, which are virtually the same as the pricey brand-name drug but much cheaper.
- Dr. McIlwain says, “Patients have the right to ask their doctor for a higher dose. You can ‘split the pills’ into smaller doses, helping you to save money.”
- Instead of a 30-day supply, ask the pharmacist what the charge might be for a 90-day supply. According to Sippel-Tompkins, “if you have a $15 copay for a 30-day supply, it might be cheaper to purchase a 90-day supply and not bill the insurance company.” The more medicine you get, the cheaper the cost is per pill.
- You have the right to ask your chain supermarket pharmacist for free medications such as metformin and antibiotics and prenatal and children’s vitamins. Many large supermarket pharmacies, including Publix, Harris Teeter, Schnucks, Price Chopper, Walmart, Sam’s Club, Costco, and ShopRite, will provide these medications and vitamins free with a valid prescription, but not unless you ask.
- You have the right to contact drug manufacturers and ask about patient assistance programs (PAPs). There are many programs offering free or discounted drugs to those in financial need or even to the general public. Do some homework and find out if your medications are provided free by the pharmaceutical company. Start by locating the pharmaceutical company online. Do a search for the name of the company and the patient assistance programs offered. Fill out the online forms and have your doctor fax a letter of medical need. You should hear back quickly if you are accepted, and they will mail the medication directly to you or your doctor.