The Future of Pharmaceuticals

By Anne Henrickson

How can something so necessary be considered a luxury?

Last March we were told to refill our medications, whether we needed them soon or not, and then to go home and wait. No one was sure what was going to happen. What started as a mad rush for all of us to get enough medication on hand to sit through whatever was going to happen next, has slowly turned into our collective realization that the way we handle our prescription medications, like the way we handle many other things, may look a little different for a while.

Premiums and deductibles are rising. Even when the drug that we need is covered, the copay is often expensive and sometimes prohibitive. Drug formularies can often prefer costly or brand name medications, and when our coverage is lost, we may not be on a regimen that is ideal for paying out of pocket. When we lose a job, or our benefits change and we subsequently have to pay for prescription medications out of pocket, well, that can be a scary and overwhelming experience!

The first thing anyone should do after a loss or change of insurance is to go over the prescribed medication list with his or her prescriber or pharmacist. A community pharmacist is ideal for this review since that professional looks at drug costs all day long. Often, two medications are very similar: one may have a slightly improved efficacy, or slightly decreased side effects, but might be much more expensive! A pharmacist could recognize this and recommend the less expensive alternative.

Another medication may need to be taken twice daily but is much less costly than the alternative once per day--a slight inconvenience for the patient, but if cost savings is the goal, the pharmacist can help recommend these substitutions. Pharmacists can also recommend 90-day cash pricing and “medication sync,” where all maintenance medications are filled simultaneously, and which leads to fewer trips to the pharmacy. As we all know, time is money!

When brand name medications are the best option for a patient, most manufacturers offer patient assistance programs. The income cutoff for these programs is usually three to five times the federal poverty line. The website www. rxassist.com contains a database of these programs and other useful resources.

Another option for patients who need brand name or expensive medications, and are having trouble affording them without insurance, is to visit a community health clinic. The Tri-City Community Health Clinic offers reduced cost prescription medications (340b) to patients who see providers within their clinic system. They also have an enrollment department that can help anyone find a health plan on the exchange to gain insurance coverage.

Discount drug coupons for brand and generic medications can be found everywhere, from doctors’ offices, to magazines, to online! They promise huge savings on prescription medications, but as they say, the devil is in the details, or in this case, in the fine print. When using these coupons, the patient often authorizes the release of personal data; however, some coupons do offer opt-outs of this data sharing. There is no value associated with these coupons, so often that patient is still better off merely talking to the pharmacist about cash pricing--then he or she doesn’t have to worry about the fine print. If you choose to use a coupon, be informed!

The best way for you to save money on prescription medications while paying out of pocket is to work with your prescriber and your pharmacist to review your medications for potentially less expensive alternatives that work within your budget. Keep in mind that not taking a necessary medication can be a costly mistake! If you do stop taking a medication because of cost, don’t be ashamed, but please do let your doctor and pharmacist know so they can help you.