Americans spent more than $263 billion on prescription drugs in 2012.
Minimizing your prescription drug costs is easier than it may seem.
Trying to save money on prescription drugs is enough to make you reach for the pain pills. Navigating the annual changes to your health plan, figuring out insurance copays, and finding the pharmacy with the best buys can be daunting. And if you're on Medicare Part D, dealing with the donut hole—the coverage gap that, this year, kicks in after insurance pays $2,850 in drug charges—adds to the challenge.
Dr. Jerry Avorn, professor of medicine at Harvard Medical School, understands the confusion. He has been educating health professionals on cost-effective prescribing practices for three decades. He says that if you employ a few basic principles, you can simplify the process and save money in the bargain.
1. Go for generics
"Generics are just as good as brand-name drugs. They are held to the same rigorous manufacturing standards by the FDA," Dr. Avorn says. "They also have to be very close in bioavailability [the way they perform in the body] to the name version."
Dr. Avorn says it's a common misconception that you always need an identical generic version of a name brand you've been prescribed. "Often, you may only need a prescription for a generic in the same class of drugs," he explains. For example, if you're taking the statin Crestor to lower your cholesterol, you won't find a generic version of that particular drug. However, there are generics for five other statins, at least one of which may well be just as effective for you. "There is usually quite a bit of room to maneuver if you're looking for a substitute for many expensive branded drugs," he says. Consumer Reports now evaluates medications just as it does cars and computers; a useful site is crbestbuydrugs.com.
Coupons covering copays for brand-name drugs may seem like a good alternative to generics, but they could cost you more over time, Dr. Avorn warns. A pharmaceutical company may pick up your 20% copay, but it benefits from getting 80% of an expensive drug's price from your insurance company. Moreover, there's no guaranteeing the drug company will continue to make the coupons available. And if a lot of people in your plan use copay coupons to get brand-name drugs, your insurer is likely to hike your premium to cover its increased costs.
If you're paying out-of-pocket, you might want to consider the generic discount plans offered by several drugstore chains and big-box stores, particularly the $4/$10 plans (for one-month and three-month supplies, respectively).
2. Periodically re-evaluate your drugs
One of the most important things you can bring to your annual physical is a bag containing all the medications you're taking, Dr. Avorn says. Despite the increasing use of electronic medical records, your doctor may not know all the prescription drugs and over-the-counter products you use. Your physician may discover that some drugs duplicate the actions of others, have adverse interactions with one another, or are no longer necessary.
3. Forget about vitamins, minerals, and supplements
The title of a recent editorial in Annals of Internal Medicine sums up current medical opinion: "Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements." If your doctor hasn't prescribed a supplement, you probably don't need to take one. In fact, in some cases supplements can undermine the beneficial effects of medications you are using.
4. Compare drug prices
Retail drug prices vary enormously from store to store. Not only do different pharmacies pay different prices from manufacturers and wholesalers, they use different systems to mark up drugs. For example, one pharmacy may add a certain percentage to the wholesale price for a generic while another will set its price for the same drug based on another calculation.
The best way to comparison shop for drugs is online. At goodrx.com and rxpricequotes.com, you can type in a drug name and your ZIP code and get an idea of what pharmacies in your neighborhood are charging. Follow through with a phone call to the pharmacy, because prices can change.
There is a downside to shopping at several pharmacies to get the best buy on each and every prescription. If you use several stores, the pharmacists won't know the other drugs you're taking and can't cross-check for potential interactions. You may want to have the pharmacy that has the lowest price for your costliest medication fill all your prescriptions.