Price shop your prescriptions to dramatically reduce costs

My brother and I, both optometrists, had a heart-to-heart discussion about the loss of one of our patients. We discovered he was not taking his medications as prescribed, which was leading to vision loss. When pressed, the patient said he had a choice of eating, supporting his family, or purchasing his medication.

He was under the impression that the $150 price for his generic Lipitor was “about the same” at any nearby pharmacy. We later realized that some of those nearby pharmacies charged from $11 to $25 for the same medication. Our studies revealed this type of discrepancy existed for almost all of his medications.

Our patient lost his life after suffering a stroke.  This was a bitter pill to swallow, but his loss led us to a period of discovery and determination to prevent this from happening again.

His life could have been saved with the knowledge of the vast price differences at retail pharmacies. That’s when my brother and I began our mission to promote transparency in retail drug pricing. I have left the practice of optometry to dedicate my career to addressing this problem.

This is when we met Sumanah, a 26-year-old event planner in New York City suddenly diagnosed with congestive heart failure.  Sumanah was like many typical 26-year-olds, without health insurance and no savings capable of paying for her medical bills.  Taking 10 medications for her condition, Sumanah was paying full price at what she “thought” was the cheapest pharmacy.  After she discovered that not only were some pharmacies cheaper for the same exact medication, she learned that some pharmacies could be upwards of 16 times more expensive than another pharmacy right across the street.  Using this information, Sumanah was able to price shop for the right pharmacy and save a lot on her prescription costs.  This story, although not uncommon, shows how important shopping around for medications can be.

In their May issue, Consumer Reports published an article confirming the experience Sumanah and many others have each time they go to fill a prescription.  The study focuses on five of the most prescribed medications in the U.S. and reviews more than 200 pharmacies for price comparisons.  The findings show the details of each pharmacy and drug researched as well as the overall discrepancy between the lowest cost pharmacy and the highest cost pharmacy.  For the same prescriptions, the difference was a whopping $749 per month or 447% between the highest and lowest cost options.

Price shopping prescriptions from one pharmacy to another can dramatically reduce out-of-pocket costs for patients without changing medications.  A recent Mayo Clinic study revealed 70% of Americans take at least one prescribed medication monthly and last year 50 million Americans decided not to take their medications due to the high cost.

Currently, medication non-adherence is cited by The IMS Institute of Healthcare Informatics as the largest contributor to health care costs in their June 2013 study, “Avoidable Costs in U.S. Healthcare.” The study shows that a patient’s inability to stay on a prescribed medication is estimated to cause over $100 Billion in avoidable health care costs due to the resulting health complications, hospital visits, and additional advanced treatment.

Many patients, and their health care providers, assume medications at different local pharmacies are about the same price. We’ve been operating solely in our roles as care providers for too long, and have been oblivious to changes in other parts of the health care system. While we work to keep patients healthy, parts of our health care system try to maximize profits at the expense of our patients and the entire system.

It’s time we wake up to the inequities our patients face. Lets join together to improve our health care system and save lives.

Ali Khoshnevis is an optomotrist and managing director, Tesser Health.

Price shop your prescriptions to dramatically reduce costs

This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American health care delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

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  • RenegadeRN

    Excellent advice, but what if your health insurance demands you use a particular place? Mine will not pay for a relatively cheap maintenance drug unless I use CVS/ Caremark. Really ticked me off as I had used the same convenient pharmacy for 30 years! I feel held hostage to use CVS, no matter the cost.

    • Lisa

      It is often cheaper to purchase generic drugs without using insurance. I use CVS because it is the most convenient pharmacy in my area and they do tell me when it is cheaper not use insurance. My co-pay for generic drugs is $10, but it can be cheaper to buy them with using insurance.

      • querywoman

        CVS doesn’t have the $4/$10 generic program either. Many drugs are cheaper at the pharmacies that those programs. I won’t use Walmart, but other stores have the same program. I think Costco started it.

  • Suzi Q 38

    I was fine with using the “Mom and Pop”pharmacy near my house for at least a decade. The woman was a pharm D and her husband was also a Pharm D whose main daytime job as a CEO of a major teaching hospital that I went to for my cervical surgery.

    They were so nice that I loved going to their place of business. I didn’t mind paying extra, because I had good insurance and I only paid the copay of $10.00 for each prescription.

    Fast forward to now…..We decided to change our insurance to a higher deductible. Our deductible is now $5K a year for my husband and me.
    This means all prescriptions will be paid out of pocket.

    When I got the bill for my low dose statin and it was about $150.00 or so for the month, I cancelled the RX and tried Walmart at the advice of my 60 something year old PCP. I think I paid about $22.00 there.

    If the drug I need is generic, I pay $4.00 for each RX, and if the doctor will approve a 3 month supply at one time, I will pay only $10.00 for the three months.

    Part of me is really sad that in this economy, it all comes down to money.

    The people without insurance struggle the most. Some of them do not know how much cheaper it is at different pharmacies. I do call around if the price is higher than I am used to paying. I have taught my adult children who are 28 and 29 to do the same. My son has a cheap insurance plan (he is self employed) with a very high deductible, so he learned fast. Our daughter works for a very large hospital (with an excellent medical insurance plan) and I think she pays a few dollars for her prescriptions, so she hasn’t had to compare prices like we have to.

    I do miss my old pharmacy and wonder how they can compete with places like Walmart.

  • JR DNR

    Do you really just call different pharmacies and ask for a price? Do they need your insurance information to give you a quote?

    • Lisa

      Pharmacies will usually give you information about the price of a particular drug, with insurance and without insurance, in my experience. To give you a quote for the price with insurance, they will need your insurance information. This means what carrier and the plan number, not your identifcation number.

      • JR DNR

        Thank you Lisa!

  • Eric Strong

    Also be aware that most doctors have no idea how much certain drugs cost. It’s not uncommon for a doctor to continue to prescribe expensive medication X for years, instead of relatively cheap medication Y, even when there’s no evidence that medication X is superior. If one of your meds is costing a small fortune, ask your doctor if there is a cheaper alternative that is just as good – there usually is.

  • Patient Kit

    Excellent advice on an important topic. When I was between insurances for six months two years ago (aka uninsured) and with a new cancer dx, I shopped around to try to stay on two Rxs until my new coverage kicked in. The price differences were head-spinning. Costco was the best I found in Brooklyn.

    I suppose it’s too much to hope for to impose some regulation on Big Pharma, both the pharmaceutical companies and the retail drug store industry so that the same drug can’t be sold for $749 more per month? And we haven’t even gotten into the obscene costs of really expensive drugs like chemo for cancer treatment.

    Why is Big Pharma so untouchable? If this is the free market in action, I’ll take some more regulation, please.

    • EmilyAnon

      My experience with Costco (in L.A.) being the cheapest is the same as yours. One of my drugs was $68 at my local chain drugstore, $36 at Costco. I really want to support my neighborhood stores on principle, but sometimes the price difference wins out.

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