You as a consumer have the right to ask your physician if the course of treatment he/she is providing is the most cost effective. When your doctor prescribes a medication, you should always be sure to ask if a generic equivalent is available and safe for you to take. If your doctor determines that generic is safe for you but the medication you need is not available in a generic equivalent, ask if there is a similar medication in the same class that may have a generic equivalent. 

According to the FDA, generic prescriptions can cost between 30 and 80 percent less than brand-name drugs. The FDA reports that according to the National Association of Chain Drug Stores, in 2004 the average price of a generic drug was $28.74 compared to the average price of a brand-name drug at $96.01.

It is important to realize that the retail cost of prescriptions varies from pharmacy to pharmacy. Shop around.  It is also important to realize that just like physicians, each pharmacy may have a different contracted rate with your pharmacy administrator. Call your pharmacy administrator to find out the cost of a prescription at one pharmacy compared to others. Finding a good price on medication is important, but if you obtain prescriptions from more than one pharmacy you should always be sure your pharmacist knows what medications you are taking, including dietary supplements and herbs. 

Another way to save money for those who take medications consistently is to obtain the prescriptions through a mail order pharmacy.

You may be wondering – “How does the cost of medications at different pharmacies affect me?”  This is a very good question. The answer is in the utilization of the pharmacy benefits.  The cost to the insurance carrier for prescriptions plays a large role in determining premiums to the employer group. This can in turn be felt by the employees in the premiums they pay as well as in the members cost sharing. Cost sharing is your copays, deductibles and coinsurance. In other words, as health care costs increase, your cost sharing may increase over time. 

Interesting facts:

Generic equivalents are less expensive because the manufacturers of generic prescriptions do not generally have the costs involved with research, development, patents and promotion as do the manufacturers who produced the brand-name drug.  A generic drug cannot be sold until the patent on the brand-name expires, and it has been thoroughly tested and approved by the FDA.  The FDA requires that all medications meet identity, strength, quality, purity and potency specifications.  Generic drugs look different than brand-name drugs due to the inactive ingredients, like color and taste.  Trademark laws also prevent a generic drug from being made to look like other drugs already produced.  More information can be found at www.fda.gov/cder. 

How can you save money on prescriptions?

1)  Ask for generic whenever possible. 

2)  Ask for the help of your physician.  If your prescription medication bill is a hardship, ask your physician for medications that are less expensive but just as effective.

3)  Buy prescriptions in bulk through mail order.

4)  Find the pharmacy with the lowest retail cost and or contracted rate.

5)  Some pharmaceutical companies offer patient assistance programs. This includes free or discounted drugs for those who cannot afford them. For these programs, your physician will need to assist in the process of applying. You may have to supply information to verify your income.  For more information go to www.rxassist.org .

6)  For those with a rare disease who cannot afford their medication, but their income is too high to qualify for Medicaid, the National Organization for Rare Disorders has a medication assistance program. For more information go to www.rarediseases.org/programs/medication

Retail vs Mail Order

If you regularly fill a non-formulary prescription drug with a $40 copay per month for a 30-day supply at a retail pharmacy, you will spend $480 per year. If you fill the same non-formulary prescription drug using mail order you will receive a 90-day supply for 2 times the retail copay, $80.  Because you will only need to fill it 4 times you will pay $320 per year.  This represents a savings of $160 on the same prescription plus the convenience of having the prescription delivered directly to you at your home or office. Imagine if you filled all of the prescriptions you take on a regular basis through mail order – the savings would be even higher!!!  (this example is for illustration purposes only and may not reflect the actual copays of your employer’s group medical plan)