Have you noticed your medicine bill taking a bigger bite out of your bank account lately? Consumer Reports recently found that the rising cost of meds is forcing people to cut back on buying groceries, take second jobs, delay retirement, and even forego prescriptions altogether. But you can trim your Rx expenses without harming your health. Follow these 11 tips to cut your drug costs, and in some cases, save hundreds or thousands of dollars per year.
#1 Brush Up on Your Benefits
When it comes to saving money on your prescription drugs, start by understanding how your prescription coverage works. For example, do you have an annual deductible on your prescription drugs? To save on high premiums, some patients these days are choosing plans with deductibles as high as $5,000, $10,000, or more per year, and copays don’t kick in until the deductible has been met. That means that you’re responsible for paying in full for your prescriptions until you hit that deductible amount.
You also need to understand the copay system–where you pay for part of your medication. You may have one, flat-rate copay for all prescriptions. Or, your insurer may charge a percentage of the retail price as your copay. Some plans have tiered copays, with lower copays for cheaper drugs and generics, and higher copays for pricier and brand-name medications. We know it's a lot to manage but putting in the effort can literally pay off.
Jordan Michaels, the director of operations at GoodRx, explained in an interview in Continuum: "The flat $10 copay is going away. We’re seeing more people in high-deductible plans. We’re seeing co-insurance play more of a role in prescription drug benefits. That requires patients to be more knowledgeable and have that information about how and where to shop for their prescriptions."
Also, do you have a flexible spending account (FSA) or health savings account (HSA)? Understanding how these programs work–and how to best take advantage of them–can help you save big on your prescription drugs.
To learn more, the best starting point is your employer’s human resources department, or your health insurer’s website, summary of benefits, and customer help line.
#2 Know the Retail Price of Your Prescriptions
It’s always smart to know the general retail price range for your prescription—before you fill it. Even if you’re one of the few people with top-of-the-line health insurance, low deductibles, and low, flat-rate prescription copays, you may still find retail prices that run less than your copay.
There are several sites—including, Pharmacy Checker, WeRx.org, and GoodRx that provide the retail and discounted costs for drugs at your local pharmacies.
At each site, you'll enter the name of the drug, the dosage, the number of pills, and where you live. You'll get back information on what you can expect to pay for your specific prescription at pharmacies in your area, along with discount coupons or vouchers available at those pharmacies.
#3 Snag Freebies
Saving on prescription drugs can start right at your doctor’s office, when you ask for free samples and coupons. This is most helpful for specialty drugs that have no generic equivalents and high price tags. Drug reps often leave doctors with generous supplies of free samples, as well as discount coupons for popular medications.
After John Saber was diagnosed with atrial fibrillation, his cardiologist prescribed the blood thinner Eliquis as his best choice to help prevent blood clots. There is no generic for Eliquis and the drug's retail price ranges from $450 to $550... per month. Saber faced a $300 copay for every monthly refill until he reached his $6,000 deductible. “My doctor gave me a month of free Eliquis samples to get started,” says Saber. “He also gave me a new prescription coupon from the drug manufacturer, which filled my first prescription free. I saved around $1,000 right out of the gate!”
Copayment coupons are another way to uncover significant savings on some drugs. Typically, these coupons are available for costly brand-name drugs that don't have a generic equivalent.
After Saber got his month of free Eliquis samples—and a free first month with a coupon from the doctor–he still faced a hefty $300 monthly copay. He checked the drug company's website and applied for an Eliquis copayment coupon. “My copay is now $10 a refill, instead of $300, and I’m saving over $2,000 a year,” he says.
There are even bigger savings for some big-ticket drugs without generic equivalents. The list price for Enbrel—a popular brand name-only drug used to treat psoriasis and rheumatoid arthritis—is almost $1,300 per week without insurance, and even with insurance, copays often run hundreds of dollars per week. Enbrel has a copayment program for some insured patients that supplies the first six months of treatment at no cost, and $60 copayments per refill, allowing you to save up to $12,000 per year.
There are many generic medications that are made with the same active ingredients, in the same form and dosage, as the brand names your doctor prescribes. The only difference? The cost. Seems obvious then to always ask for a generic.
“Buying a generic medication versus the brand name is a great cost-saving idea, and overall, I feel that most medications are therapeutically equivalent in their generic form,” says Suzy Cohen, pharmacist, and author of Drug Muggers. “That said, generics have come under fire lately. The generic version of a drug is supposed to have the same active ingredient, and only slight differences in, for example, the flavor, the colorant, the outer shellac coating, or the biologically inactive filler.”
According to Cohen, the trouble is that you can’t always trust that the active ingredients are the same. Says Cohen, “Reports are coming in that some foreign generic makers are behaving badly, and the United States FDA doesn’t have the time or person-power to inspect all these places prior to our country importing the medications.”
Your best bet is to ask your doctor if there’s a good-quality and effective generic equivalent and whether the generic would be a suitable substitute for you. You can also ask your pharmacist about substituting a generic for a brand-name drug.
How much can you save? A lot. For example, according to GoodRx, the retail cost for the popular antidepressant Wellbutrin runs from $500 to $2,000 per month, depending on the pharmacy. If you get the generic version, bupropion hydrochloride, you could fill it at Walmart for $9 for a 30-pill one-month supply.
Keep in mind that if you are taking a popular generic drug, some pharmacies, retailers, and grocery stores offer some generic medications at a flat rate of $4 per prescription, regardless of your insurance coverage. You can check out the Walmart Generic Drug List and Costco Generic Drug List to get started.
#6 Switch to 90-Day Prescriptions
Many people have chronic conditions like high blood pressure, type 2 diabetes, depression, or hypothyroidism–all conditions that require daily medication, sometimes for life. If you fall into this category, a 90-day prescription can save you money in several ways:
If you're insured, you'll pay one copay instead of three (and only four for the whole year). If your copay is $10, you will save $80 a year per prescription, and at a $30 copay, you would save $240 a year per prescription.
The price for a 90-day supply may be less than the cost of three separate one-month prescriptions.
An example: You can fill a one-month prescription for 30 tablets of zolpidem 10 mg—the generic version of the sleep aid Ambien—for around $14 at a CVS Pharmacy. A 90-day prescription is $24. Getting 90-day prescriptions instead of filling the prescription monthly saves you $72 per year. And if you have a copay of more than $14, you will also save money by paying directly and bypassing your insurance.
“For chronic and maintenance medications, getting a 90-day supply offers savings in both time and money,” confirms Cohen. “The only downside is in the beginning of therapy, when there may be changes as your physician pins down the correct dosage. But if you’ve been on a medication for more than six months, and you have the option to fill a prescription for a 90-day supply, I’d highly recommend it to save.”
#7 Call for Assistance...Prescription Assistance!
Prescription assistance programs (PAPs) are available from some pharmaceutical companies, as well as from some government organizations and foundations to help you get certain medicines, testing strips, and meters at low or no cost. Programs like Partnership for Prescription Assistance's Medicine Assistance Tool are designed to help you if you are low-income, uninsured, or underinsured.
Some drug companies also have their own comprehensive PAP. That means it's important to check the drug manufacturer's website, or call their patient-assistance telephone hotline, to explore what services are available.
Two free resources that can help you find national and drug manufacturer-sponsored PAPs include:
How much can you save with a PAP? Here’s an example: Many people with type 1, insulin-dependent diabetes take both a long-acting insulin daily as well as a rapid-acting insulin with meals. There are no generic equivalents for these newer forms of insulin. A vial of Lantus (a popular brand of long-acting insulin) costs around $325. A vial of Humalog short-acting insulin also runs about $325. If an uninsured or underinsured patient uses one vial of Lantus per month, and two vials of Humalog per month, that’s a total outlay of up to $,1075 per month, just for insulin. Diabetic supplies such as syringes and glucose meter strips can add hundreds more to the monthly cost[
As you can see, the high price of insulin—and the problems patients have affording it—can be a medical crisis for many diabetes patients. This is where a PAP can come in. Lantus's drug manufacturer Sanofi, and Humalog's manufacturer Eli Lilly both have PAPs that can make diabetes drugs available for free or at low cost for some patients. Patients who qualify for low or no-cost drugs from these programs could save tens of thousands of dollars per year!
#8 Avoid Clawbacks
You know the drill. Your doctor prescribes a medication, and you go to the pharmacy to fill it. The pharmacist asks for a $10, $30, or another copayment amount, and you hand over your money, assuming that the cost of the drug must be more and that your insurance is covering the difference.
While that's true in some cases, there are also many situations where you pay more with your insurance than if you paid retail. The savings go back to the middle-man—usually a pharmacy benefit manager (PBM). This practice is known as a "clawback." The PBM is “clawing back” the savings between the drug's cost and what you paid as a copay. Let that sink in. You pay more than the retail value of the drug, and someone else gets the savings.
The lesson: Clawbacks mean that many of us are overpaying when we make a copay for a prescription. According to research done at the University of Southern California's Schaeffer Center for Health Policy & Economics, almost one in four customers overpay for prescriptions, with an average overpayment of nearly $8 per prescription. If you take even one drug per month, that's more than $100 a year that the PBMs are clawing back from you... even more if you take several medications. Clawbacks are also more common for brand-name drugs and popular generics, like levothyroxine, the thyroid hormone replacement drug used to treat hypothyroidism. The USC research study found that 42 percent of levothyroxine prescriptions were subject to clawback, and people were overpaying by an average of $6 per prescription. If you pay the cash price instead of a copay, you could save $72 a year.
Clawbacks are illegal in some states, and a few states require that pharmacists tell patients about less expensive options. But many states still permit them. And many pharmacists are subject to gag clauses that prohibit them from even volunteering information about less expensive options! They are violating the gag clause unless you specifically ask for the information.
Want to avoid clawbacks? Suzy Cohen recommends that every time you get a prescription filled, “Ask your pharmacist or pharmacy staff to run your price using your insurance copay versus the retail price of the drug.” If the retail price is less, you can pocket the savings, instead of the PBM!
#9 Join the Club (The Discount Club, That Is!)
While shopping around, you should also investigate discount clubs and programs. Discount and savings clubs and cards can help you if you're paying cash because you're uninsured, or if your insurance won't cover a particular prescription. Both SingleCare and Drugs.com offer free discount cards with savings up to 80% off some medications. There are also many discount programs specific to pharmacy chains, as well as some retail and grocery store chains with pharmacies. For example, free membership in Walgreens Prescription Savings Club gets you discounts off the cash price of thousands of brand-name and generic medications.
#10 Fill Your Prescriptions with Online and Mail-Order Pharmacies
If you have health insurance, find out whether there are discounts for using a mail-order pharmacy.
There are online companies that buy prescription medications from drug manufacturers and sell them directly to individuals at a discount. One such company, Health Warehouse, is licensed to fill online prescriptions and ship medication to every U.S. state. RxOutreach is unique in that it's a non-profit online pharmacy, offering mail-order delivery of prescriptions at a low cost.
A relative and popular newcomer in the field is BlinkHealth. With Blink, you purchase your prescriptions online, and then you can pick them up at your local retailer or get them by home delivery. Bonus: They also offer a price-match guarantee on generics.
#11 Develop a Relationship With Your Pharmacist
Finally, Cohen urges patients not to overlook the health and cost-saving benefits of developing a relationship with your pharmacist and pharmacy staff. “Pharmacists may ‘lick, stick, and pour’ as they say, but most pharmacists love to help and are generally willing to lend an ear during the slower hours,” says Cohen.
Pharmacists may be able to help you find discount coupons, and, according to Cohen, pharmacists always have at least one pharmacy tech on site, the person who runs your prescription through your insurance company to generate the price. “A good technician will check the cash price against your insurance co-pay to see which is cheaper, or even call your insurance company to authorize a less expensive therapeutic alternative,” says Cohen. “Having a good relationship with your local pharmacy can translate to saving hundreds, and sometimes thousands, of dollars per year. And how much does this perk cost? Nothing!”