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

No comments: