PR E SC R I P TI O N D R U G S
The Present State of Prescription Drugs and Health Insurance
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How brokers can help clients save cash • By Emma Peters
n this article, we will explore the current state of the industry and highlight key innovations that can empower insurance professionals to better serve their clients. A survey produced by Kaiser Family Foundation shows that 61% of American adults currently take prescription drugs. According to another survey completed by Value Penguin, • • •
persons under 65 pay for 48% of their expenses for prescription drugs out-of-pocket but persons aged 65 to 79 pay 56% those age 80 and older pay 67 % of their total drug expenditures out-ofpocket.
The greatest impact of these statistics is the fact that almost a third of Americans under and over 65 have skipped filling a prescription, mainly because they couldn’t afford it, or because their insurance wouldn’t cover the cost. (https://www.valuepenguin. com/prescription-costs-survey) Although these statistics may seem dismal, there are practical strategies that health insurance professionals should be aware of to best help their clients who are dealing with the high costs of their prescriptions. Discount Drug Options Discount drug programs have emerged as a cost-effective solution for patients struggling with high prescription drug prices, most often for brand name medications. These programs often offered by insurance providers, pharmaceutical companies, or third-party organizations, allow patients to access their medications at reduced prices. 36 | CALIFORNIA BROKER
Here is a table that shows three popular drugs prescribed to people 65 and older, and a comparison of top discount cards that are available. SingleCare is a prescription savings card available to all U.S. residents over the age of 13 for free. It is accepted at major pharmacies and can be used to save up to 80% on prescription prices. > Medicare Extra Help is a discount drug plan for people already receiving Medicare. It is charged annually, and helps clients pay the monthly premium for Medicare’s prescription drug coverage, yearly deductibles, coinsurance, and copayments. Programs like these and more can be recommended by health insurance professionals to help guide their clients towards options that align with their specific medication needs but are lower priced.
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Patient Assistance Programs and Manufacturer Discounts Pharmaceutical companies have started to offer patient assistance programs and manufacturer discounts to make their medications more affordable. These programs span many different kinds of prescriptions for various medical needs. Here is the website for the Asthma and Allergy Foundation where they provide resources explaining Drug Company Assistance Programs for these illnesses. (https://aafa.org/advocacy/advocacyresources/patient-assistance-medicinedrug-programs/) These discounts can significantly reduce out-of-pocket expenses for patients. Health insurance professionals can play a critical role in educating their clients about these opportunities and ensuring they take advantage of any available savings.
DECEMBER 2023
