Prescription prices are rising again. This shouldn’t come as a shock since most popular drugs have repeatedly increased their prices over the past decade – a trend that’s unlikely to end anytime soon. Our goal in this article is to show you a few simple tricks you can use to reduce your out of pocket costs. But first, it helps to have a basic understanding of how these prices are determined.
Prescription Prices Are Set by Your Insurance
Yes – at the most basic level, the cost of a drug is determined by drug manufacturers. However, as strange as it sounds, this doesn’t necessarily determine what you pay at the counter. That’s because insurance pays for over 95% of prescriptions. There are certainly exceptions to this. If you choose to pay for a prescription out of pocket, have not yet met your deductible for the year, hit a coverage gap (donut hole exceptions), etc. then the situation is a little different. However, for most drugs, your insurance will pay the bulk of the cost and you will just be responsible for a small portion, typically a copay. Now, of course high drug costs from manufacturers still harm patients indirectly. It can prompt insurance plans to remove certain higher priced medications from their formulary, or the list of medications they will cover. It can prompt a rise in your insurance premiums to account for the higher cost. Nevertheless, the actual “price” that a consumer will pay for their medication is set by the insurance company. This is very important to understand.
Lowering Your Out of Pocket Costs for Medication
So now you understand insurance companies set the price you pay for most medications. Great, what can you do about it? Let’s take a look at a few easy to implement tips to lower your out of pocket costs for medication!
Tip 1: Ask Your Doctor if a Generic is Available
Switching from a brand name drug to a generic can be one of the quickest ways to reduce the price. In fact, generic drugs are on average almost 20x less expensive than their branded counterpart. Here is a good example of how the cost of a generic and brand name drug might vary. Now some people might think generic drugs are a lower quality version of the original, but that’s not true. In fact, the FDA requires by law that:
“any generic medicine modeled after a brand-name medicine must perform the same in the body as the brand-name medicine. A generic medicine is the same as a brand-name medicine in dosage, safety, effectiveness, strength, stability, and quality, as well as in the way it is taken and the way it should be used. Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”
Unfortunately, generics are not always available – especially for new drugs. In that case…
Tip 2: Find Out if a Manufacturer Coupon is Available
Manufacturer coupons are coupons issued directly from the drug manufacturers to help lower out of pocket costs for patients. These are usually available for new, brand name medications. Why do manufacturers offer these? Because new brand name medications are typically not covered by insurance or they come with uncharacteristically high copays. By offering coupons, manufacturers can offset these higher costs set by insurance companies and boost demand for their latest drugs. To find drug manufacturer coupons ask your doctor or pharmacist if there is one available. Alternatively, you can find some online by searching “drug coupons” and “insert your medication name”.
Tip 3: See if the Cash Price is Cheaper than Your Copay
Finally, one last easy tip to lower your out of pocket costs – compare cash and copay prices. In some cases, the cash price may actually be lower than the co-pay you pay through your insurance. There are a number of reasons for this, however the important thing to know is it does sometimes happen. Online price checking tools like GoodRx can help you quickly compare cash prices at different chain pharmacies. However, they may not list every pharmacy in an area. The most accurate way to get a cash price is to just call your local pharmacy and ask the pharmacist. At NowRx pharmacy, we typically tell our patients if we see a lower cash price. This way they can decide if they would like to use insurance or not. However, not all pharmacies have this policy. Some will run it through your insurance if they will make more money from insurance reimbursement.
Bonus Tip: Compare Your Options for Health Insurance
We put this tip in as a bonus because it takes a little more effort and preplanning than the others. However, comparing different options for health insurance can be another way to save at the counter. That’s because different insurance providers have different deals with specific drug manufacturers. As a result, certain medications will be cheaper depending on the insurance provider you choose. There are a lot of variables to consider when it comes to health insurance (aside from just medication costs) so compare your options and find one that fits best for you! We hope these tips can help you reduce your out of pocket costs. As always, be sure to reach out to NowRx if you have any questions!
About NowRx NowRx is an on-demand pharmacy, founded with the goal of using software, artificial intelligence, robotics, and smart logistics to create the best retail pharmacy experience possible. Specializing in free same-day delivery of prescription and over the counter medications, NowRx hand-delivers medications right to your door in hours with its fleet of friendly HIPAA trained drivers. By removing the need to visit the pharmacy, NowRx’s hopes to increase medication adherence and provide a more convenient pharmacy experience for millions of people. Learn more at https://www.nowrx.com/.