Sunday, February 27, 2011

10 Tips to Help You Save Money on Prescription Drugs

For many years, we had a very liberal pharmacy benefit. This year we moved our insurance to United Heathcare and many of us have found the pharmacy benefit more restrictive and more costly. We're negotiating alternatives with United on issues like supply limits, but some of the changes are here to stay. For example, no insurance companies offer plans with a 90 day supply of a maintenance medication via retail or mail order pharmacy for one copay like we used to have. Here are some tips you can consider to help you manage the cost of prescription medications. 

  1. Use the Prescription Drug List. Take United's prescription drug list with you when you see a doctor. We have a three tiered program with copayments of $10 for a medication in Tier 1, $35 for a medication in Tier 2 and $60 for a medication in Tier 3. When you need a medication, review the list with your physician and discuss the pros and cons of the drugs in each of the tiers. Actively engage with your physician in selecting the drug the most closely matches your needs and cost preferences. Alternatively, you can look for lower cost drug options on and then discuss them with you physician or chat online with or call a nurse at United (888-887-4114) to discuss options and then follow-up with your physician. 
  2. Talk to your pharmacist and consider generics. Let's say you missed the opportunity outlined in Tip #1 and find yourself at a retail pharmacy with a new prescription. Ask your pharmacist how much the drug costs and what alternatives are available. My doctor recently prescribed an antibiotic for me. She told me that she was recommending the brand name drug because the generic sometimes caused stomach upset and she checked dispense as written. When I got to the pharmacy, I asked what the difference in cost was between the generic and the brand name -- the generic was $10, the brand name drug was $60. I chose the generic to save $50 and I was lucky -- it didn't upset my stomach. 
  3. Make the most of online tools. Use to see personalized information about lower-cost alternatives to medications you're currently using, price a medication, review information about drug interactions and side effects, order refills of mediations through the mail-order pharmacy, and review your pharmacy claims and history. If you see more than one physician, it's helpful to print out a list of the medications and take it with you to your appointments. That way you can provide complete information to your doctors and avoid problems from drug interactions. 
  4. Be wary of XL, ER and CR versions of medications. I've been told drug companies often develop extended release or controlled release versions of a drug to extend their patent. I don't know if this is true, but I have noticed that you can find the same drug available as a generic in Tier 1, a suspended release version in Tier 2 and an extended release version in Tier 3. You might also find there is a significant difference in the cost of a medication based on how it is packaged for example in a tube versus a pump dispenser. 
  5. Ask about half tablet programs. In some instances, a medication is available in double the strength in a form that can be split using a pill splitter. United Healthcare has a formal half tablet program to encourage pill splitting. If you participate you can obtain your medication for up to half your normal copayment amount. 
  6. Use mail order. Our plan allows participants to obtain a 90 day supply of maintenance medication for two copays. Our plan is written in the State of Maryland which mandates that fully insured plans allow consumers to obtain "maintenance" medications at retail pharmacies for the same cost as mail order. Our old plan with Guardian provided unrestricted access in this regard. However, most insurers are not so liberal. United Healthcare has a list of "maintenance" medications. Only those drugs are available at a retail pharmacy in a 90 day supply for two copays. 90 day supplies of additional medications not on this list are available through mail order for two copays. Retail pharmacy costs are about 7% higher than mail order costs. Using mail order can save you money when you have your prescription filled. It also keeps our plans pharmacy costs down which results in lower premiums in future years. 
  7. Pay with pre-tax dollars. Participate in the FSA (flexible spending account) program and use the money set aside through the program to pay for prescription drugs with pre-tax dollars.  
  8. Look into promotions at retail pharmacies. For example, Target has a lot of generic prescriptions for only $10 for a 90 day supply. 
  9. Comparison shop for prescription medications not covered by our insurance. A cream I use was recently $226 at Giant and $135 at Walmart. Giant was willing to match Walmart's price, so 10 minutes on the phone saved me $91.
  10. Consider natural alternatives and lifestyle changes. I've blogged recently about heart health and natural alternatives for managing cholesterol. Talk with a professional about trying to manage your condition through diet, exercise and supplements. Some natural supplements can be dangerous when combined with certain prescription medications. Always tell your doctor about supplements you are taking and inquire about possible interactions. 

If you are having trouble getting a medication you need, call Health Advocate at 866-495-9170 or talk with a member of the HR team. 

Interesting post from Benefits Babble on how to save money on prescription drugs

Saturday, February 26, 2011

Individual Intake Cards for Our Weight Loss Program

We decided to try something new this year and have participants in our weight loss program complete an intake card to tell us their weight loss goal for the program and what some of their challenges are. People completed the cards during the initial screenings and set their goals in consultation with Life Work Strategies staff, so we could assure they were safe and reasonable. We used the information to put together teams of participants with similar goals and challenges and focus our educational programs on participant's needs.

Intake Card

Wednesday, February 23, 2011

Natural Alternatives to Statins for Lowering Cholesterol

My last post was about what I learned from David Foreman during a heart health presentation he gave last Sunday. That morning, he was interviewed on Let's Talk Live. It's an informative piece.

13% of the adults covered by our health plan take statins and I'm concerned they could have more of a negative impact on my colleagues' health than a positive one. Our annual prescription drug costs for statins are over $30,000 a year. I'm wondering if there is a better way...

Sunday, February 20, 2011

A Foundation for Heart Health from David Foreman

Today, I went to the Vitamin Shoppe in Baileys Crossroads to hear my friend, David Foreman aka The Herbal Pharmacist, talk about heart health. I met Dave my first week at the University of South Carolina. (Go Gamecocks!) Dave was a pharmacy major and one of the first things I learned from him was to ask a pharmacist when you have questions about drugs, drug side effects and drug interactions. Dave's a pharmacist and a Naturopathic Doctor. He had his own pharmacy for 14 years and eventually came to the conclusion that there was a better way. He espouses four pillars of health -- diet, exercise, spirituality and supplementation. Like I said, today's talk was at the Vitamin Shoppe, so the focus was on supplements.

Dave shared a four pronged foundational supplement program to support general health as well as heart health.

1. Multivitamin -- Dave suggests we take a multivitamin to make up for what's missing in our day-to-day diets. He suggested we look for a whole food vitamin and buy a vitamin for who we are -- male vs female (with or without iron) etc... He showed us a couple of examples -- New Chapter's Every Man Ii and Garden of Life's Vitamin Code Women.

2. Antioxidants -- OK, I knew a little about antioxidants and could have told you that they neutralize free radicals, but Dave finally explained what that meant in a way I understood. He said if you took a pin and pricked your hand you'd draw a drop of blood and then it would get a bit inflamed and scab over. Free radicals are like little pins floating through our blood vessels. The pricks they cause scab over with plaque. He also compared free radicals to exhaust. The more you exercise, the more exhaust or free radicals you create. Dave and his wife are training for a half marathon that's in Columbia, SC in April. He said he increased his dose of CoQ10 to offset the additional free radicals he's producing while he's training. He suggested the following antioxidants -- Green Tea, Turmeric, CoQ10, Resveratrol, Grape Seed, and Pycnogenol (which he mentioned was also good for varicose veins.) I picked up a bottle of CoQ10 to offset all those free radicals I create kickboxing. I prefer to get my Resveratrol from a nice glass of red wine. 

3. Omega-3's -- Dave talked about fish and plant based Omega-3's. He suggested 1,000 to 2,000 mg of fish oil for most people -- 4,000 to 5,000 if you have high blood pressure. Then, he pointed out something that should have been obvious to me, but wasn't. You need to read the label on fish oil supplements. For example, the bottle I have says 1,000 mg on the front, but when I read the label I learned that each pill has only 600 mg of of Omega-3's. Oops, I thought I had been taking 4,000 mg per day and I was only taking 2,400 mg.

Dave went on to talk about plant based sources of Omega-3's -- Chia Seeds and Flax Seeds. He said Chia Seeds have five times more calcium than dairy. I think I'll skip the ground flax seeds I usually put in my bowl of oatmeal tomorrow morning and try some Chia seeds instead.

4. Probiotics -- Probiotics are the friendly bacteria that finish off the digestive process. A probiotic enhances the nutritional benefits you get from food and other supplements. Dave said we should look for the label to indicate that they bypass stomach acid to get the full effect.

Once you have the foundation in place, Dave suggested we could build upon it with other supplements to protect against or treat other conditions. He talked specifically about stroke, high blood pressure and cholesterol.

For strokes, he recommended Nattokinase for both prevention and recovery and said it was safe to take with coumadin. He said Ginkgo Biloba is a natural blood thinner and has additional health benefits.

For high blood pressure, Dave recommended a supplement like BP Manager.

For cholesterol, Dave recommended Sytrinol. Dave is no fan of statins. He's been on TV quite a few times lately talking about it -- Healthy Alternatives to Cholesterol Medication and Are cholesterol lowering medications good for your health? Dave also suggested that knowing your CRP, C-Reactive Protein, might be more important than knowing your cholesterol. We've offered CRP screening as part of our wellness program, so I was happy to hear him say this. 
Dave has a book coming out in about five weeks -- Pillars of Health Heart. (I'm counting on an autographed copy.) In the meantime, you can listen to his radio show online -- Monday through Friday from 12:00 to 1:00. (There's a link on the left hand side of his website.) I have some ideas of how Dave and I might work together on some workplace wellness initiatives, so stay tuned here too!

Now for the disclaimer, I was a business major. I have no medical training and I'm not a journalist. I hope my notes will help you look into some things that might improve your health. Hopefully, Dave will correct me if I got anything seriously wrong. 

Thursday, February 3, 2011

Recording Weight Loss During LOST @ASHA

During our Biggest Loser campaign a year ago, participants recorded their actual weight on our intranet. The system was set up so that no one could see another person's weight. We could just tell if there were missing entries on a team. I could see all the numbers, but I didn't know who to associate any particular weight with. 

This year we decided to borrow more from the Thintervention model and record changes in weight each week. We also decided it would be fun to visually display each teams progress. My colleague, Terry, came up with this fabulous display. Each week, participants weigh in and they record the change in their weight from their starting point (not from the previous week.) If they've lost weight, they display it on a green dot, blue is neutral and red shows a gain. 

There has been some confusion and debate about recording changes in weight from the starting weight versus the previous weeks weight. I decided to use the starting weight because (1) we had a problem with the scale we used Week 1 and I thought it would throw us off, (2) it seemed more encouraging to look at total weight lost during the program, (3) I can easily tally up the numbers and see which team is in the lead and how much weight participants have lost as a group. I can still compare the numbers to the previous week to note weekly weight lost and observe changes in the trend. I also know each team's total starting weight, so we are announcing weekly team winners based on the percentage of weight lost. Like last year, Lifework Strategies will still keep our "official" records. 

Update February 26, 2011: Never again will we have people record changes in their weight. It's caused mass confusion and I have no confidence in the self reported numbers. It was much easier last year when people recorded their actual weight each week. Live and learn... Lifework Strategies completed the midpoint screenings this week. I'll have official numbers from them soon. Stay tuned.