Tricks for helping patients save money on prescriptions

As a primary care doctor, I have figured out many tricks for helping patients save money on prescriptions. Some of them I am sure you have never heard of, and others , well – you might have, but they bear repeating.

All of the prices quoted here are from Costco, unless otherwise specified.

1. Price compare between pharmacies. Can’t stress enough the potential differences in medicine prices between pharmacies. Generic medicine prices vary more than branded/trademarked medicine prices.

Z-pack 5 day antibiotic (generic) Costco- $11 OR Kmart- $55

Tricyclen birth control (generic) Target- $9 OR Osco- $33

You can call the pharmacies yourself and find out who is offering the lowest price. The pharmacy tech or the pharmacist will give you the price over the phone if you ask them. You need to be able to tell the pharmacist the strength and quantity of the pills or syrup etc. It is listed on the prescription from your doc. Of course, you can also use LesliesList.org, which is a free community service for Chicagoans — and anyone else who cares ot use it. This website price compares over 550 medicines for you and includes Walgreens, Walgreens with Saver Card, Target, Osco, Walmart, CVS, CVS with Saver Card, Kmart and Costco.

2. Take your “combo pill” as two separate pills. If you are taking a medication that is a combination of medicines, consider taking it as two separate pills. If you are not sure if you are taking a “combo pill” try Googling the name to find out. Usually you can save money by taking the meds separately (even if there is a generic version of your combo med!)

Lotrel (generic) 10/20, #30 tabs – $81 per month OR

amlodipine 10 mg, #30 tabs + benazepril 20 mg, #30 tabs= $8 + $6 = $14 per month.

3. Ask your doctor about changing the dosing schedule of your medication. If you are taking a medication that ends with “XL”, “XR”, “CD”, or “SR”- then you are probably taking a long acting version of your medicine. Therefore, there is probably a short- acting generic version of your medication also available. The trade off would be that you might have to take a pill two or three times a day instead of once or twice a day. If your doctor thinks this is appropriate for you, it could save you big bucks.

Rythmol SR 225 mg, #60 tabs (taken twice a day)- $367/month OR

propafenone (generic Rythmol) 225 mg #100 tabs (taken three times a day)- $34/month

Leslie Ramirez is an internal medicine physician and founder of Leslie’s List, which provides information that enables all patients, but especially the uninsured and underinsured, to find more affordable medications and health care services.

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Comments

http://fertilityfile.com IVF-MD
Great points! We are slowly seeing some free-market benefits from price transparency in drug pricing as pharmacies lower prices in order to compete for business, although we still have a long way to go. Over time, as we educate patients to price-shop, it will punish the overchargers and reward the discounters. This is becoming true for just pharmacies. Now what ideas do people have to increase price transparency with regards to doctors and hospitals and testing centers? The solution centers around increasing the INCENTIVE for these entities to practice price transparency. Ask yourself, why does WalMart go to the trouble of putting up a website with their low drug prices? What gives them this incentive? Why don’t doctors and hospitals feel the desire to do this? Once you arrive at an answer on your own to these questions, you’ll have a clearer view of what’s wrong with healthcare today and what could remedy that?
Finn
I recently called 4 chain pharmacies in my area (CVS, Walgreens, Target, & Costco) and asked for pricing on 3 generic drugs I take. It wasn’t surprising to find that Costco was the cheapest; what was surprising was how enormous the difference was between pharmacies. For one drug, the price CVS quoted was so high that I thought the tech had quoted me the brand name price; it was over 8 times the price quoted by Costco.
http://thedocsquawk.com thedocsquawk
Get pills in bigger dosages and a pill splitter. Usually same price even though there’s more medicine.
Frank in L.A.
I realize that this blog does not normally cover veterinary medicine issues, but I would like to pass on some drug price hints for canine medication.
If your dog is on monthly heartworm medicine (eg. Sentinel) or flea medicine (eg. Comfortis), for which the dose is based on the weight of the dog, ask the vet to prescribe for a heavier dog and then split the pills.
Find the generic name of your dog’s medicine and then check with your drug store. In a lot of cases the veterinary version of a medicine may be identical (a different brand name, perhaps) to that sold for human use, but often significantly cheaper. My dog takes phenobarbitol twice a day for his seizures, and they practically give it away at my drug store. If your vet is unwilling to write a prescription for your pet’s medicine, you need a new vet.
Maggie
I’ll add one too – ask the cash price versus your co-pay price. On the only prescription I take, my co-pay is $55 a month for 30 pills….the cash price for a bottle of 90 pills is $78. I opt to pay cash and just don’t have the prescription submitted to the insurance company….that saves me $87 every three months!
Ed Pullen
An interesting issue with Cheaper cash than insurance cost is letters from insurers to tell us our patients are non-compliant. Can’t win.

gzuckier
Exactly. Patients discover that they can get a script for $4 cash at Walmart, while the copay would be $11 through their insurer’s mail order pharmacy, so they suddenly drop off the pharmacy claims database, and trigger all sorts of alarms at the insurer’s medical management department.

Maggie
The insurer’s medical management department isn’t my concern – my pocketbook, my decision.
And, I do inform my doctor my script is filled and I’m taking it – that’s all he needs to know =)

http://www.drmintz.com Matthew Mintz, MD
Excellent post (as usual). I would add that these tips apply to patients who pay out of pocket for prescriptions. For patients who are fortunate enough to have prescription coverage, the rules are different and being knowledgable is even more important. For example, a combo generic pill is usually actually better for patients with prescription coverage assuming the co-pay for the generic combo is the same as each individual generic co-pay. Patients should know what their formulary plan is and how much they will pay for each tier, since the co-pay for a preferred branded product can vary widely. Patients should discuss cost issues with their doctors. This will allow for the doctor and the patient to choose the best drug for the best price (which sometimes is not the generic product).
DRJEBJ
#1 Consider not taking the medication. Many of us have seen new patients who take medications that are unneccessary or innappropriate such as vitamins or diuretics for leg swelling. Discuss with your doctor whether all of your medications are really necessary.
#2 Consider dropping expensive presription medications in favor of over the counter medications. Aspirin, ibuprofen or naproxen can be very effective for arthritis.
#3 Consider alternatives to medication such as ice and or heat for pain relief.
#3 If you are as nervous as I am about mail order pharmacies you might be pleased to know there are several US mail order houses that have Better Business Bureau ratings and are quite good and inexpensive.
#4 Ask your physician to prescribe in larger quantities for volume discounts.
#5 Ask your physician to use the $4 and $10 presciption lists at WalMart and others to select your meds,
#6 Tell your pharmacist the cheaper prices you see elsewhere. He may match the price.
Dan
If a patient doesn’t have insurance, it is possible to negotiate prices with locally-owned pharmacies. Working in a chain pharmacy, I was surprised when a patient told me that she was getting 9 Sumatriptan 100 mg tablets for 40 dollars without insurance from a locally-owned pharmacy. We are selling it for ~$200. I looked up our wholesale cost, and it was only about $15 a bottle. In order to keep business, some independent pharmacies are willing to negotiate with cash-paying customers.

Tricks for helping patients save money on prescriptions

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