Prescription medications can help you maintain your health and prevent chronic conditions; however, they can also be very expensive. According to data from the Organization for Economic Cooperation and Development (OECD), the U.S. spent an average of $1,126 per person on prescribed medicines, while comparable countries spent $552 per person. Therefore, it’s no wonder why more than three in four American adults think the costs of prescription drugs are unaffordable and nearly one in three adults say they haven’t taken their medications as prescribed due to costs.
Even with health care coverage, your out-pocket prescription drug expenses can add up quickly, especially if you take more than one medication. It doesn’t help that prices of many brand-name prescription drugs used to treat conditions including diabetes, cystic fibrosis, and cardiovascular disease are more expensive in the U.S. than in nearly every other major country. For instance, a report by the International Federation of Health Plans found the price of Humira in the U.S. is 423% more expensive that the price in the U.K. and 186% more than that in Germany.
The good news is there are some simple things you can do as a health care consumer to keep your prescription drug costs in check:
- Use generic drugs. Many popular but previously expensive medications are now available generically. In fact, the U.S. Food and Drug Administration (FDA) has approved over 10,000 generic drugs, some of which cost up to 85% less than brand-name versions. A generic medicine is required to be the same as a brand-name medicine in dosage, safety, effectiveness, strength, stability, and quality, as well as in the way it is taken.
- Switch to a biosimilar. Biologic medications are used to treat a variety of diseases and conditions, such as cancer, kidney diseases and autoimmune diseases, and are typically administered either by injection or intravenously. A biosimilar is a biologic that is highly similar to a brand-name biologic that’s already FDA-approved, called a reference product. Like generic drugs, biosimilars have the same expected benefits and risks as their reference products but may offer more affordable treatment options to patients. Biosimilars are currently available for many biologic reference products, including Humira and Remicade.
- Ask for a 90-day script. By filling a 90-day supply of maintenance medications instead of the usual 30-day supply, you may only need to pay 2½ copays, which can save you the cost of two full copays a year.* Before you can begin filling a 90-day supply, Independent Health requires you to get a 30-day initial fill. This helps ensure you do not experience any side effects associated with the medication. After the initial fill, ask your pharmacist for a 90-day supply when you refill. Or, if your doctor didn’t write your prescription for a 90-day supply, you can request they send a new prescription to your pharmacy for future refills.
- Take all of your medicines as directed. Research has shown that adherence to medication therapy – taking medications as prescribed – is associated with lower health care costs. By taking your medications correctly, you will avoid problems that can lead to illness and additional out-of-pocket expenses. To help prevent side effects and drug interactions, tell your doctor about any other medicines, herbal supplements, or over-the-counter drugs you may be takingPlus, check with your doctor at each visit to make sure you need to continue taking all your medications. There may be other ways to manage your condition that don’t require medications and/or cost less. You should never stop taking a medication without consulting with your doctor first.
- Get to know your insurance plan’s drug formulary. A drug formulary tells you and your doctor what price category, or tier, a certain drug is in and what it will cost you out-of-pocket. Tier 1 is least expensive while Tier 4 contains the highest-costing specialty drugs. You may find your drug formulary on your health insurer’s website, or you can call them to ask about a certain drug. Reviewing a drug formulary is another way to compare benefits and costs if you ever switch health insurance plans.
Independent Health offers Rx cost comparison tool
Since prices for the same prescription medication may vary by pharmacy, Independent Health has a “Compare Rx Costs” online tool that our members can review the cost of their medications at the different pharmacies in their neighborhood to see if they can save some money on them. If you are currently an Independent Health member, you can access this tool by following these easy steps:
- Sign into your MyIH account at our website. Your account includes a Health Dashboard, helping you view and track personal health recommendations.
- From your Health Dashboard, click on the “Compare Costs” featured option and then click on the “Compare Rx Costs” link.
- Type the name of the prescription in the search bar.
- View results. Review drug uses, alternative options, compare real-time costs and see nearby pharmacy information of where to get your prescriptions — all with pricing and covered options specific to your health plan.
As always, talk to your doctor about your medication needs and if a generic or biosimilar medication might be right for you. In addition, medications that are eligible for a 90-day maintenance supply are designated with an “MM” on Independent Health’s drug formularies, which you can view on our website.
*Benefits vary by plan.