Ways To Reduce Medication Costs

 Information about patient assistance programs and "Other Options" taken from: Oregon DUR Board Newsletter, Vol. 5, No. 3, March 2003

•   DO I REALLY NEED THIS MED?  Question your doctor about the necessity of each of your medications.  Don't stop any medication unless you've discussed it with your physician first!
   

•   IS THERE A LESS EXPENSIVE ALTERNATIVE?  Ask your physician if there are any less expensive alternatives.  Often, a prescription is written for the more convenient or newest medication and a less expensive but Equally Effective option may exist.
   

•   SHOP AROUND.  Just as with any big purchase, check the price with several pharmacies.  Even if you checked out the prices when you first filled a prescription, prices on medications change frequently.  If you don't need a full service pharmacy, consider purchasing via mail order or over the internet (see below).  Also, as a general rule, Costco tends to have the bargain basement on price on most medicines.
  

  • Eugene Pharmacies

  • Springfield Pharmacies

  • ONLINE Pharmacies
    

•   CUT TABS IN HALF.  Purchase a pill cutter and ask your pharmacist or doctor if you can chop pills in half.  Often, half of a double strength pill costs less than one single strength pill.
  

•   SEEK OUT GENERICS.  While it is true that some name brands are better, the vast majority of generics are equivalent in the eyes of the FDA and your physician.  Generics are often considerably less expensive so ask your physician about equally effective but cheaper alternatives (newer is not always better BUT is more expensive!)
  
  

  Example of savings using GENERICS vs name brands (taken form an online pharmacy 04/2005)
  Proventil HFA MDI	$38.10 / cannister
  generic albuterol	$13.99 / cannister
  SeptraDS	$1.80/tab
  generic TMP/SMX	$0.30/tab

•   CAN I GET AN OVER-THE-COUNTER ALTERNATIVE?  Ask your doctor about over-the-counter (OTC) alternatives (e.g. NSAIDS, antacids, antihistamines, cough suppressants, etc...) that might be the same or equivalent to prescription Rx
  
  

  Example of savings using over-the-counter version vs prescription version (taken form an online pharmacy 03/2003)
  Rx:  Pepcid  20mg tab	$1.81 / tab
  OTC:  Pepcid Ac 10mg tab	$0.30 / tab
  Rx: Naprosyn 500mg tab	$1.53 / tab
  OTC:  naproxen sodium 220 mg tab	$0.06 / tab

•   COUPONS?  Ask your doctor about any possible coupons.  Also check the drug companies internet sites.
  

•   Patient Assistance Programs.  Another option for patients without prescription coverage is enrollment in patient assistance programs. Pharmaceutical manufacturers offer such programs to provide medications to eligible patients at no or reduced cost as a philanthropic effort. Chisholm, et al. found that approximately 53% of the top 200 prescribed drugs in 1999 were offered through assistance programs.(8) The Oregon DHS web-site contains several links to these programs.(9) Table 2 includes sites that offer free information about industry sponsored patient assistance programs. This table was adapted from information provided by Medicine for People in Need, which also has information about application services that charge various fees.(10)

  A patient may need to apply to several programs in order to get all of their needed drugs. Each program has varying eligibility criteria established by the individual pharmaceutical company. Many companies require that the prescriber initiate enrollment. Some programs allow patients to initiate the process but all require prescriber involvement. Most programs require that patients verify their ineligibility for other coverage (i.e. Medicaid or Veteran's benefits) and provide financial documents such as tax returns. Programs can be restrictive, change at any time, deliveries may take several weeks and reapplication must be made on a regular basis. This option can be extremely labor intensive for clinic staff depending on the number of patients requiring this service.

  Table 2 - Links to Patient Assistance Program Information   (Sites that offer no-cost information) (10)
  Program	Comments
  HealthyOregon http://www.HealthyOregon.org	This is an excellent "one stop shopping" web page for Oregon residents.
  RxAssist.org/RxAssist Plus http://www.rxassist.org/  (877) 844-8442	Contains a free and searchable database of patient assistance programs, with up-to-date information on how to access assistance from nearly 100 companies and more than 700 medications. Searches can be performed on any of a multitude of variables: company name, brand drug name, generic name, and drug therapy class. Funded by Robert Wood Johnson Foundation, it includes .pdf versions of more than 40 patient assistance program applications that can be printed out and used. Volunteers in Health Care, the nonprofit organization that operates RxAssist, also makes available patient and medication tracking software called RxAssist Plus to help address the administrative needs of free clinics and other community-based health care programs serving the uninsured.
  2001-2002 Directory of Prescription Drug Patient Assistance Programs http://www.helpingpatients.org	Developed by member companies of the Pharmaceutical Research and Manufacturers of America (PhRMA), this directory lists company programs that provide drugs to physicians whose patients could not otherwise afford them. The programs are listed alphabetically by company. Under the entry for each program is information about how to make a request for assistance, what prescription medicines are covered, and basic eligibility criteria.
  RxHope.com http://www.rxhope.com/ (908) 850-8004	Another website providing free prescription drugs information, it is financially supported by PhRMA and participating pharmaceutical companies. It has a Drug Information Center, which contains the PDR® Family Guide to Prescription Drugs and an Alphabetic Drug Index. There is also a Patient Assistance Information section that allows for retrieval of Indigent Patient Program information for a particular product or company.
  NeedyMeds.com http://www.needymeds.com/	This web site includes an alphabetical list of approximately 1,000 drugs. There are many ways to access the information: by manufacturer, by drug name, or by drug category. An updated book on available programs is offered to physicians and administrators to help fund the web site.
  National Organization for Rare Diseases (NORD) http://www.rarediseases.org/	NORD administers 14 prescription drug assistance programs for people who are uninsured or underinsured. NORD works in conjunction with nine drug manufacturers to offer free medication assistance to patients suffering from uncommon disorders. NORD also administers early access programs for investigational new drugs (IND) under the Food and Drug Administration's (FDA's) approved "Treatment IND" programs
  Medicare.gov http://www.medicare.gov/Prescription/Home.asp	Sponsored by the Medicare program, this is a clearinghouse of information, including a downloadable database. It provides information on programs that offer discounts or free medication to individuals in need. It helps people find information on prescription drug assistance programs, Medicare managed care plans, and Medigap plans that offer prescription drug coverage in their area

• Canadian or Mexican Pharmacies?  Obviously this is where many go to fill their much needed prescriptions at a reduced cost.  Right now we can neither recommend or dissuade people from exploring these options but, buyer beware!  Check out the pharmacy as much as you can and you may want to visit the FDA's website for more info on this topic (http://www.fda.gov/oc/buyonline/faqs.html).

•   Other Options?  The Oregon Senior Prescription Drug Assistance Program is another option available to low income seniors. Up to 100,000 seniors statewide are believed to be eligible for the program, which will enable them to fill prescriptions at the state's reduced Medicaid price (currently at Average Wholesale Price (AWP)-14% and capped generic prices) for a $50 annual fee. Seniors must be 65 years or older, have an income below 185% of the federal poverty level ($16,391 annually for an individual), have less than $2,000 in liquid assets (excluding primary residence) to be eligible. Unfortunately, patients are required not to have been covered by a public or private drug benefit program in the prior six months.

  Pharmacy involvement is voluntary. So far, about 35% of the state's 750-plus pharmacies, including several chains have signed up to participate in the program. An Oregon mail order company, Wellpartner, has agreed to participate at the discounted rate of AWP-17% for branded drugs and AWP-50% for generics.

  Seniors in Baker, Clatsop, Columbia, Douglas, Gilliam, Hood River, Klamath, Lake, Sherman, Tillamook, Union, Wallowa, Wasco, Washington and Wheeler counties may now request an application by calling toll-free (800) 359-9517 (TTY: 800 325-0778). The phone line takes calls weekdays (except holidays) from 8 a.m. to 5 p.m. Seniors in the state's 21 other counties will be phased in during March, April and May. Further information about the program is available by logging on to http://www.dhs.state.or.us/healthplan/app_benefits/spdapinfo.html.

   

•   Do you have any other suggestions?  Email us!