Three groups will be especially hard hit by today's inflated drug prices: the uninsured, people with high-deductible health insurance plans and those with large co-payments for their prescriptions.
Because Congress shows little interest in addressing the issue, individuals must devise their own strategies to decrease their drug bills.
When your care provider gives you a prescription, ask if the drug is expensive. If so, ask if there's a generic drug or other agent that will serve the same purpose at less cost. Let your provider know if your financial circumstances are stressed. What good is a prescription that you cannot afford to fill?
If your health insurance plan covers outpatient medications, your current prescription must be on a preferred list to obtain the maximum discount in price.
If a new drug is prescribed, ask if samples are available so you can take the drug for several days to see if you can tolerate it. You don't want to buy a prescription that you cannot take because of side effects.
Consider this scenario: Your physician determines that your symptoms of chest discomfort are due to gastro-esophageal reflux. A proton-pump inhibitor prescription will suppress gastric acid production and help heal the inflamed esophagus. The following prices for proton-pump inhibitors are obtained from GoodRx.com and reflect prices at Chattanooga-area pharmacies:
* If it's Nexium, which is advertised widely on television, you will pay $58.14 to $115.80 for a 30-day supply of 40 milligram capsules. The recommended dosage is one capsule daily. Esomeprazole, the generic for Nexium, is priced identically.
* Omeprazole is available as Prilosec, which is over-the-counter and absurdly priced. A prescription for a 30-day supply of omeprazole 20 milligram capsules costs from $8.81 to $11.20. The recommended dosage is one capsule daily.
There are few studies in medical literature that compare the relative effectiveness of each drug for a particular ailment. In the case of proton-pump inhibitors, omeprazole is the best value.
Online pharmacies promote even lower prices. The disadvantage is they remove the personal attention of the pharmacist. In addition to answering your questions, the pharmacist may know of coupons or discounts that may further reduce the cost of your medication. In this setting, you are an individual and not a voice on the telephone or an order number on the internet.
There are other clinical situations that have multiple choices and widely varying costs. Consider statins, a popular class of drugs used along with diet to reduce cholesterol levels. Costs for a 30-day supply range from about $12 to $60, depending on the generic version that is prescribed. Livalo, a statin with no generic, costs $235 for a 30-day supply of 2 milligram tablets. There is little comparative data among the statins to address effectiveness of each kind.
Drug discount cards may cut costs. FamilyWize.com provides online comparisons of costs along with a free, printable card to present to the pharmacy. FamilyWize negotiates discounts with pharmacies similar to those negotiated by insurance companies. Started 10 years ago in Pennsylvania, FamilyWize claims 9 million cardholders who have saved $1 billion in drug costs. But not every pharmacy honors discount cards.
LowestMed.com also offers a free pharmacy discount card and a price-comparison tool.
Generic drugs where possible, access to a price comparison tool, pharmacy discount cards and forthright conversation on drug costs with your health-care provider and your pharmacist can lead to significant savings.
Contact Clif Cleaveland at ccleaveland@timesfreepress.com.