April 2022 OutreachNC by OutreachNC

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Feature Intro: Cutting Costs: Saving on Prescription Medication As we barrel through 2022, the cost of living is a significant subject of discussion for many Americans. Food prices are rising. Gas is at a 40-year high, impacting everything from the cost to get to the grocery store to the price of airline tickets and more. It seems that everywhere we turn, we’re paying more for what often feels like less. A chief consideration for many senior Americans is the cost of prescription medication. Depending on health insurance plans and medications prescribed, costs can take up a significant chunk of the monthly budget. Of Americans between the ages of 50-64 years, 75% report taking a prescription medication. That percentage jumps to nearly 90% of Americans over the age of 65. With so many Americans relying on prescription medication, the cost of filling these prescriptions becomes an important consideration for many Americans living on fixed incomes with little flexibility to adjust to higher prices and increased costs. In fact, nearly one-fourth of older adults (23%) who take prescription drugs say it is difficult to afford their prescription drugs, including about one in ten (8%) who report paying for meds is “very difficult.” As a result, about one in five older adults (21%) say they did not take their medicines as prescribed at some point in the past year because of the cost. Understanding rising prescription drug prices is a complicated (though worthy) pursuit but identifying ways to save on costs can be an immediate, in-themoment way to curb spending and soften the blow of rising prices. What can you do to decrease your monthly prescription costs while keeping yourself healthy?

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CONTENTS ASK THE EXPERT: WORLD PARKINSON’S DAY FEATURE: CUTTING COSTS - SAVING ON PRESCRIPTION MEDICATION FAITH: THE SPIRITUAL JOURNEY FROM “WOE” TO “WOW”

LETTER FROM THE EDITOR

Amy Phariss, Editor-in-Chief, OutreachNC | editor@outreachnc.com

APRIL 2022 - 2 April is here and the Sandhills are awash in pollen. So begins another spring. The dogwoods are blooming. The weather is warming up with the occasional cold snap to help ease us into summer. We begin to transition from the darkness of winter into a lighter, brighter, more colorful few months, before the sky is hazy with heat and clinging to our skin. This month we explore how to cut costs on what is a growing expense for many Americans: prescription medication. Many of us rely on monthly medication for treatment of health issues, and the cost of many medications continues to increase while insurance benefits and coverage continues to change. Local pharmacist Rob Barrett of Whispering Pines and Seven Lakes Prescription Shoppes helps us understand the pros and cons of savings tips and offers his own suggestions for cutting costs. Aging Outreach Services Care Manager Associate Ashley Seace answers a reader’s question regarding Parkinson’s disease diagnosis in this month’s Ask the Expert. She explains the diagnosis, explores possible treatment options and offers advice for caregivers whose loved ones are recently diagnosed. We are thrilled to have Colette Bachand’s faith column back this month. Bachand writes about woes vs. wows in a column we can all relate to, no matter our circumstances. As I ease into the summer months and watch the world come alive around me, I’m reminded of Goethe’s prescription for seeking beauty:

A man should hear a little music, read a little poetry, and see a fine picture every day of his life, in order that worldly cares may not obliterate the sense of the beautiful which God has implanted in the human soul. In beauty,

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ASK THE EXPERT: WORLD PARKINSON’S DAY

APRIL 2022 - 4 Q: I recently had a loved one diagnosed with Parkinson’s disease. I’m not sure what symptoms I should be looking for and how I could help them. Can you provide me with some guidance for understanding the diagnosis and how I can help my family member? A: This is a great question, especially as we honor World Parkinson’s Day April 11. It is so important to understand the signs and symptoms of Parkinson’s disease, as well as ways that it can be treated to better help your family member. As you may already know, Parkinson’s is a progressive disorder in the nervous system that affects an individual’s movement. Due to its progressive nature, the symptoms are going to begin gradually and slowly increase. This might mean

having a barely noticeable tremor in your hand which over time becomes more pronounced. It is common to be fearful when someone receives a Parkinson’s diagnosis; however, with treatment that individual can be expected to have a near-normal life expectancy. The key is knowing how to treat it, what symptoms to look for, and educating yourself on the disease progression and finding support. Early in the disease progression, the symptoms are most likely going to be mild and could often go unnoticed. However, some signs to look for are a tremor, slowed movement or bradykinesia, rigid muscles, impaired posture or balance, loss of automatic movements, speech changes, and writing changes. Your loved one may see a decrease in ability to perform some of these functions. It is likely that these symptoms will start on one side of the body, then eventually move to the other side.

SPEECH CHANGES

DIZZINESS OR FAINTING

TREMOR RIGID MUSCLES

SLOWED MOVEMENT

APRIL 2022 - 5 What causes these changes? Well, there could be several factors. The neurons in the brain are breaking down and dying in this disease, specifically the ones that produce dopamine. Lack of dopamine can cause impaired movements or the other symptoms of Parkinson’s. This disease could also be caused by genetics, environmental triggers, the presence of Lewy bodies in the brain cells, or the alphasynuclein protein found in the Lewy bodies.

you have the financial means, hiring outside help to assist with this. A geriatric care manager is someone who can provide support and help keep your family member on their medication schedule.

Currently, there is no cure for Parkinson’s disease. However, there are several ways to minimize symptoms. An individual with Parkinson’s can sometimes benefit from medication or surgical treatments. Lifestyle modifications such as getting more exercise and rest are also common treatments. It is common for individuals with Parkinson’s to take a combination of medications at different times of the day and with different doses to manage their symptoms. If your loved one is taking medication for their disease, it’s important to stick to a schedule to avoid missing a dose, which can contribute to unpleasant off periods for the individual living with Parkinson’s. Having assistance with managing the medications could come from an electronic medication box, or if

A big way to help your loved one with their diagnosis is researching the disease. The Parkinson’s Foundation is a great starting place. They have several sources of support including the Foundation’s hotline, educational webinars, books, and podcasts. Another great way to find support is through a support group in your area. This will provide you, as a caregiver, with an outlet to meet other people with shared experience. While receiving a diagnosis can be scary, know that there are ways to support your loved one and to navigate this new way of life. For more information and a Free Newly Diagnosed Kit, visit www.parkinson.org or call the helpline at 800-473-4636. “The Parkinson’s Foundation is here for you at every stage of your journey. We offer the community, resources and advice to support you – and your family – as you begin to build a better life with Parkinson’s disease.”

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CUTTING COSTS: Saving on Prescription Medications by Amy Phariss

continued from page 1 We spoke with Rob Barrett of The Seven Lakes and Whispering Pines Prescription Shoppes about tips and tricks for saving on prescription medication. Barrett offered insight into an often-complicated subject and shed light on how to cut costs without sacrificing needed medication. Medication compliance is an important issue for seniors, so we are excited to explore how to combine medication compliance with lower costs. We offered a few suggestions to lower costs of prescription medication, and Barrett offered his insight as to the pros and cons of each idea. Not every suggestion will work for every person, but we hope at least a few of these ideas will get the ball rolling toward cutting costs in this valuable area of health and wellness. Tip #1: See if you qualify for an assistance program like the Extra Help program – a Medicare program to help pay for medication costs (www.ncdoi.gov). Pros: You may be able to save money through governmentfunded programs such as Extra Help, which helps people with low income and resources pay for Medicare prescription drug costs. Even a program such as GoodRx can save money fairly quickly and easily. Cons: Not everyone qualifies for these programs. For the Extra Help program, for example, single income for 2022 must be below $20,388 annually for a single person and under $27,468 annually for a married person living with a spouse and no other dependents. Also, Barrett notes that other programs exist outside of government options, but he says, “Many brand name medication drug manufacturers have patient assistance programs that will subsidize the cost or send free medications to patients who meet certain income limits. Patients can also ask the pharmacy or visit the medication’s website to see if a coupon exists for the medication. Keep in mind these coupons typically cannot be used along with any federal funded health insurance (Medicare, Medicaid, Tricare, etc).” Finally, Barrett warns that many discount programs such as GoodRx sell personal information for profit. So, you might save money from a discount program, but your information is the ultimate cost.

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STATISTICS: US consumers spend approximately $1,011 per year on prescription medication. This is almost three times as much as consumers in Sweden who spend only $351. The average cost of a sample medication in the US costs 300% more than the average price across the world. The most prescribed drug in North Carolina is Cetirizine (Zyrtec). The most expensive out-of-pocket drugs are anti-depressants and drugs related to treatment of diabetes. The most expensive drugs overall (not out-of-pocket) are insulins and antiretrovirals. Louisiana, Kentucky and Tennessee are the states with the highest out-of-pocket spending per person. As of 2021, the medication with the greatest cost increase is Viagra. In 2012, the cost of Viagra was $127. By 2017, the cost rose to $370, a 190% increase. Other drug increases include Cialis, Forteo, Lexapro, Zetia, Lipitor and Lyrica (among others). National Prescription Take Back Day is April 30, 2022. For more information, visit www. deadiversion.usdoj.gov/drug_ disposal/takeback/. Source: nicerx.com

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TOP 3 TIPS FOR SAVING With all the pros and cons to weigh, it can seem difficult to decide the best ways to save on prescription medications. We asked Barrett his top three tips/choices for saving.

The main thing is to ask your doctor for generic alternatives that may be more cost effective.

Also ask your pharmacist for a Medication Therapy Review to discuss cost savings options.

Review your insurance plan each year. The Seven Lakes and Whispering Pines Prescription Shoppes offer Medicare Plan reviews starting October 15th - December 7th to evaluate the best plan for your needs.

Tip #2: Split pills. Pros: If your medication is available in a double dose, for example, you can ask your physician to prescribe a double dose (100 mg. vs. 50 mg.) and then split the pills. The cost per prescription is often similar, but you now have double the number of pills. Cons: Barrett says, “While splitting pills often times can be done, it is highly discouraged for a number of reasons. Many pills do not contain a “score” in the middle for ease of splitting. Some medications, known as narrow therapeutic index drugs, such as thyroid medication, should never be split due to fluctuations in the dose received caused by pill splitting. Always check with your pharmacist before splitting pills, and some pharmacies will provide this service for you.” Also, you’ll need your thumbs up from your doctor as well, as he or she will be prescribing the medication and can help determine if pill splitting is safe and advisable. Finally, remember that pill splitting takes time. Some pharmacies won’t have extra time for this service, so be sure to check in advance. Tip # 3: Have a comprehensive medical review regarding medication. Pros: Barrett is a fan of this tip and says, “This can certainly be done, sometimes for a fee, where the pharmacist will sit down with you and look for ways to improve your medication regimen or look for lower cost alternatives.”

“In many instances a generic drug may be just as effective as an expensive brand name medication.” Also, this can be done with your primary care doctor as well. Speak with your doctor to determine if each of your medications is necessary at all. Often, patients come home from a comprehensive review with fewer prescriptions and better medication options. Cons: You may need to pay for an office visit with your primary care doctor, as many physicians cannot complete this service during an office visit related to another issue.

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Tip #4: Avoid wasting money on vitamins and herbal supplements that may not be effective or even well researched. Pros: By researching and asking your doctor or pharmacist about vitamins and supplements, you can avoid paying for products that are unhelpful or, worse, cause unwanted side effects. As Barrett says, “OTC vitamins and supplements are not held to the same standard by the FDA as prescription medications but that doesn’t mean they don’t provide benefit.

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There are many medications that actually cause vitamin deficiency. For example, Metformin (a common diabetes medication) is known to decrease the body’s levels of vitamin B12. Talk to your pharmacist about drug nutrient depletion.” Cons: It can be confusing to figure out which vitamins and supplements can be helpful. Research can be time consuming and frustrating. But the savings to both your wallet and health may be worth the effort involved in exploring these options before buying. Tip 5: Use Mail Order Pharmacies Pros: Medication is delivered right to your doorstep and is usually set on a recurring schedule. There is less to think about, and some insurance providers offer a discount for using mail order services. Cons: According to Barrett, “Mail order pharmacies are owned by Pharmacy Benefits Managers who provide claim billing assistance for insurance companies. These companies suck billions of dollars out of the healthcare system and claim they save the healthcare system money. Since PBMs were first established in 1968 the cost of prescription drugs has skyrocketed.

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I say all of this to tell you healthcare is local and you will get better care locally, not through the mail or through telemedicine. Be careful ordering medications through the mail as many of these programs are on autoship and end up costing you and the healthcare system more money due to wastage.” Just like most decisions, there are pros and cons to cutting costs on prescription medication. Some options are better than others and finding the right fit will be an individual choice. Some people may not care about personal privacy, and GoodRx will be a great choice for cost savings. Others will save money through switching to generic alternatives or getting off medications entirely after a review with their physician. Rather than cutting out a necessary medication or taking it less often than prescribed, speak to your doctor about alternatives or costsaving programs.

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ACROSS 1. Carried luggage or supplies 9. Chief Pontiac, e.g. 15. Veto 16. Blotto 17. Potherb leaves 18. Stifled, with "down" 19. Deuce topper 20. Cleared as profit 22. "___ Maria" 23. Afflict 24. Appearance 25. Beam 26. Bottom of the barrel 28. Princes, e.g. 29. Produce 30. Mr., in India 31. Sleeping sickness transmitter (2 wds) 33. Cut down 35. Brewer's equipment 36. Specializing physician

39. Ring bearer, maybe 42. Injured, in a way 43. A chip, maybe 44. Big bore 46. Jewish month 47. European language 48. PC "brain" (acronym) 49. "Dear" one 50. City government heads 52. Attempt 53. Bullhorn 55. Having the most froth 57. Temper, as metal 58. Mark 59. In a wise manner 60. Blushed DOWN 1. Bad way to go? 2. Egg-producing organs 3. Noisy partier

4. "Iliad" city 5. "To ___ is human ..." 6. Archaeological site 7. Charity dependent 8. Preordain 9. Ancient 10. Contemptible one 11. Actor Arnold 12. Dress 13. Having snout beetles 14. Number next to a plus sign 21. Male hormone 25. Having natural talent 27. Female sibling 28. Antares, for one 29. "Absolutely!" 32. Fill 34. ___ Zeppelin 36. ___ Jones, of film fame 37. Coming close 38. To such an extent 40. Precambrian time

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41. Comeback 42. Baked buckwheat dishes 45. Hit golf ball lightly toward hole on green 47. Before the due date 50. Breakfast, lunch or dinner 51. Beach, basically 52. Locale 54. "Malcolm X" director 56. ___ Squad, 1960s TV show

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FAITH: THE SPIRITUAL JOURNEY FROM “WOE” TO “WOW”

How big is your list of “woes”? … your list of things that are a struggle, the things that weigh heavy on your heart and wake you at 2:00 am to say, “Hello there! It’s me again, your woe!” Most people I know have a long list of woes these days, things that are making us sad, discouraged, burned out, hopeless, frustrated, and leaving us tempted to exclaim at the end of the day, “Woe is me!” While some of our woes are global things like pandemics and the situation in the Ukraine, the list of woes I’m thinking about are personal ones like a need to move, retirement or job changes, embracing a walker, working through a cancer treatment, facing cataract surgery, relationship changes and the like. Sometimes in our heads we make this list of woes and spend a lot of time focusing on them. But I’m reminded that the April celebration of Easter this month is one that invites us to change our woes into wows. Here’s what I mean. One day recently, after a particularly challenging day, I sat down and made my list of woes. They included things like a recent death in the family, divorce a few years ago, a major life move, health issue (broken hip), helping a community through the pandemic, personal financial worries, etc. But as I sat

APRIL 2022 - 15 and looked at my list of “woes,” I suddenly saw them differently. Rather than “Woe is me,” they became a list of “Wow is me!” Wow, I healed from a divorce! Wow, I’m rebuilding my finances! Wow, I can dance again despite that hip break! Wow, I was strong enough to support a community through the virus! Wow, my deceased relative is at peace and with God! I changed my woes into wows.

And isn’t that what the Easter season is all about? When God takes the woe of Good Friday and makes it a wow of Easter Sunday? Our spiritual journeys, those paths we take that draw us closer to God’s source of love, strength, support and hope, these journeys are not about getting everything right and never having detours, but about trusting that we have the capacity to turn our woes into wows. Reframing our hardships and sorrows doesn’t mean we’re pretending they aren’t happening or aren’t real, it just means we see our strength in the midst of it. So, what’s your list of woes? Write them down, turn them into a wow, and practice saying it not “woe is me” but “Wow is Me!”

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