A health insurance policy is no guarantee that prescription medications will be cheap. Many plans include a very high deductible, which means paying the drugs' full cost out of pocket, at least for a while. If this proves financially taxing, several pharmacies, insurance plans, pharmaceutical companies, and nonprofits offer assistance in lowering the cost of necessary medications.
Chain Store Prices.
The drugstore isn't necessarily the best place to shop for cheap prescription drugs. A 2013 study by Consumer Reports found that prices for the same medicine varied widely by pharmacy, with the warehouse club Costco charging the least overall and CVS the most. The generic form of the anti-depressant Lexapro cost $7 at Costco, for example, and $126 at CVS (and you don't have to be a Costco member to use the pharmacy). A more recent search by Cheapism.com found Lexapro to be cheapest at Walmart ($8.71) and most expensive at Rite Aid ($64.08).
Tip: Don't assume that national chains post the lowest prices. Independent drugstores often are willing to negotiate prices because they have more leeway in setting prices than the chains do.
Pharmacy chains such as Walmart, Walgreens, Kmart, Target, and even Kroger offer discount drug programs that cover hundreds of commonly prescribed generics. Some stores require an upfront membership fee to be eligible for these cheap prices. The Costco program is free for members, but CVS charges $15 a person, Kmart charges $10 for a household, and Walgreen's costs $20 a person or $35 for a family. (Fees may vary by location.) These in-store pharmacies charge $4 for a monthly supply of generics and $10 for a 90-day supply. That's all well and good, but a generic may not be what your doctor prescribes even though the medication adheres to the identical formulation of the original patented drug.
Consumer spending on pharmaceuticals jumped 13.1 percent to $374 billion in 2014, according to IMS Institute for Healthcare Informatics, in part due to the introduction of new brands and strong demand for specialty medicines. These drugs, and many of the top 10 sellers (total prescriptions), have no generic counterparts; only medications that have been available long enough for their patents to expire have generic equivalents. And inevitably, the original brand name drug is really expensive. Still, it always pays to ask the doctor if a cheaper generic is available. If not, there are alternative paths to lower-cost meds.
Health insurance companies usually offer tiered co-pays for prescription drugs, with the generic version being cheaper and brand names more expensive. Brand name drug manufacturers may subsidize the cost for financially strapped patients with health insurance through Patient Assistance Programs (PAPs). This is often the only way that medications, particularly new formulations, are affordable. Sometimes doctors hand out discount cards along with the prescription; if they don't, ask for one. Most pharmaceutical companies also offer low-cost medications, with prices varying by income, for patients who lack health insurance or prescription coverage.
If your doctor doesn't have a discount card and the medication is costly, go to NeedyMeds for information about PAPs and access to a discount card that opens the door to deals from drug manufacturers. The card is good for prescription drugs that aren't covered by insurance or if the pharmacy price with the discount card is lower than your co-pay. Look up the drug on the site to see if you can get help paying for it.
GoodRx provides coupons and discounts for use at pharmacies (e.g., Walgreens, Target, Rite Aid, and Safeway) and identifies the cheapest local source for your prescription. A search for the medication turns up the prices at your neighborhood drugstores and at online mail-order houses. GoodRx also indicates if there is a generic formulation and, if not, when the drug comes off patent.
Another money-saving resource is Rx Pharmacy Coupons. This site posts discount coupons for drugs, both brand name and generic, that can be used at dozens of drugstore chains and supermarket pharmacies across the country, as well as some independent pharmacies.
Using any or all of these resources can save consumers money. For example, the rosacea medication Oracea costs between $263 and $483 for a one-month supply, according to GoodRx, and a generic equivalent won't be available until 2022. The manufacturer has a PAP, which provides a discount to people without insurance if their income is within 200 percent of the poverty line. Another alternative would be visiting Rx Pharmacy Coupons, which offers a coupon worth 50 percent off at participating pharmacies.
Several sites offer help with co-pays for people presenting with conditions that require expensive drugs not covered by insurance.
The Patient Access Network Foundation focuses on people with chronic conditions who are insured but whose income falls at, or below, the poverty line. The site contains a list of the covered drugs and a referral service to other organizations that offer co-payment assistance.
Cancer drugs are among the most expensive, and insurance doesn't always cover them. Cancer Care Co-Payment Assistance Foundation helps out with chemotherapy and FDA-approved "targeted therapy" drugs aimed at cancers. Assistance is available to patients with insurance or Medicare policies that cover a portion of the cost.
Pharmaceutical companies are constantly giving away free samples to doctors, who often pass them on to patients. The samples are always relatively new brand names without generic equivalents.
Beware the moment when it's time to get more of the same, though. A study published in JAMA Dermatology in 2014 found that dermatologists who pass out free samples continue to prescribe the sample drugs, which cost more than alternative medications. If the drug is needed for an acute condition that's not likely to recur, a free sample could be just the ticket. If the condition is chronic, ask for more samples. Or, turn to another money-saving option.