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The Wal-Mart $4 Generic Drug Plan: Could it Work for You?

Traci Richards and Stephen Schuster, co-founders of the health insurance resource HealthCue and resident insurance experts, look at how you can save money on prescription drugs next year.

Are you willing to change pharmacies to save money on prescription drugs?  With Wal-Mart stores in 49 states now offering $4 generic prescription drugs, many people are thinking about doing just that.  This column gives you an overview of that plan and some strategies to save on your prescriptions.

The Wal-Mart plan has spurred other retailers to create programs of their own.  Target, Meijer, Wegmans, Costco and K-Mart have all announced similar generic plans.  The giant pharmacy benefit manager Medco Health Solutions started the Generics First program for small business.

Why are these plans worth investigating?  Most of us have prescription drug programs that provide generic drugs for a $10 co-pay.  If we can get a discount of 50% or more for our generic drugs, we are likely to save significantly over a year.  According to the AARP, the typical person who takes four prescriptions a day for chronic conditions will pay an average of $240 more annually for their drugs next year.  What if you could save that potential increase?  Or even pay less for your prescriptions next year?  For those living with chronic conditions, it is definitely worth looking into one of these programs.

Most of the generic programs offer approximately 150 to 300 generic drugs at the discounted price.  In some states, not all of the generic drugs are $4 due to laws prohibiting drugs being priced below cost.  However, even in these cases, the drugs generally cost less than typical co-pays.  The generic drugs offered cover most diseases and most chronic conditions such as arthritis, heart disease, high blood pressure, depression and diabetes.

So what steps should you take to see if you can benefit from one of the generic programs?

•    Get a list of the generic drugs offered by the retail store you are thinking about using and is convenient for you to shop at.  For example, you can find Wal-Mart’s list of discounted generic prescription drugs online.  There are over 10,000 outlets nationwide from just the stores mentioned above.

•    Take the list to your physician and see which of the generic drugs listed would be acceptable substitutes for what you are taking now.  For instance, if you now take Pravachol for cholesterol control, the generic version called pravastatin is probably available for the deeply discounted price.  The most popular cholesterol drug, Lipitor, is also one of the most expensive brand name drugs, often costing upwards of $60 for a 30-day prescription.

•    Try to purchase your chronic condition drugs on a 90-day prescription.  Most mail order pharmacies fill prescriptions on a 90-day basis and discount the price.  Why? Well, the cost for actually filling a 90-day prescription is the same as filling a 30-day prescription, so you get the savings for buying the extra two months in advance.  Most retailers are now passing this same kind of discount on to you, so you may only need to travel to your new retail pharmacy once every 90 days.

•    Consider pill-splitting.  Ask your physician about prescribing twice the dosage you need daily, and splitting the pill in half.  This way, you can extend a 90-day prescription to 6 months.  Most 40-milligram dosages cost the same as 20-milligram. dosages.  Most pharmacies sell a little pill splitter tool for less than $10 so you can do this both accurately and safely.

•    Ask your physician for samples.  Over $15 billion of samples are distributed annually by the drug industry to physicians. This works—recently HealthCue asked a physician for a 3-month trial of a prescription drug used to treat a chronic condition.  The physician merely went to a closet in his office and supplied the request.  This represented a retail savings of $270.

Even if you are not considering taking advantage of one of these retail generic drug plans, these tips can save you out-of-pocket expenses with your current health insurance program.  According to the Kaiser Family Foundation, most of us with medical expenses spend 45% of our out-of-pocket costs on prescription drugs.  This means that our prescription costs dominate our out-of-pocket medical spending.  And since most health insurance policies are increasing co-pays for drugs significantly, we all can benefit by considering one or more of the steps above.

Even if the generic substitute for one of your prescription drugs is not on one of the $4 lists, generic drugs are often 80% less expensive than brand name drugs, so switching to a generic will have a large impact on your pocketbook whether you switch pharmacies or not.  To see if you would benefit from a switch to a generic drug, do some comparison shopping.  One of the better places to do this is at www.crbestbuydrugs.org, a Consumer Reports site.

If you have an insurance plan for your prescription drugs, check that plan again.  Most insurance companies are detailing how you can obtain low cost substitutes for brand name prescription drugs, and are giving out valuable information that will make you a more informed health care consumer.  At the very least you will be armed with more intelligent data before you talk with your doctor.

The Wal-Mart program has alerted the general consumer to the fact that generic substitutes are valuable money savers.   Prices for generic drugs will not necessarily go down.  These drugs were already very inexpensive.  Now they are available at retail without regard to health insurance, and that will help all of us maintain our health more cost effectively whether we have insurance or not.


  • Do you have a question about health insurance or your medical coverage? Send it to our health insurance experts at AskHealthCue@thcn.com and check back soon to see if it has been answered.  

 

 

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