Thursday, October 20, 2016

Four Things You Can Do to Avoid Overpaying for Prescription Drugs

We recently hosted a number of sessions to help staff learn more about prescription drug benefits. 
There is a delicate balance to having discussions like this with our staff. I don’t want anyone to feel bad about getting what they need, but we don’t want people to be taken advantage of either. We focused in on four things we can do as consumers to avoid overpaying for prescription drugs.

Look for Generics
This sounds like an obvious suggestion, but maybe not for the reason you think. Generics are not just cheaper. Generics are safer. Generic drugs have been on the market longer and have been taken over longer periods of time by more people. Because of this, the side effects and long term health implications are better known.

Choose a Pharmacy the Same Way you Choose a Gas Station
Prescription drug prices vary from pharmacy to pharmacy the same way gas prices vary between gas stations. Most of us want to strike a balance between convenience and cost when we make this choice. We showed staff how to use the GoodRX tool provided on our Magellan site to compare prices between pharmacies. Right now, this feature is only effective four our staff that have our high deductible plan with the HSA. (Anyone can use the GoodRX app.) 

Participants were shocked to see how dramatically prices vary. We looked up a number of drugs to see how much we could save by driving as little as two miles. For example, 

  • Rosuvastatin the generic for Crestor was $13.59 at Giant pharmacy and $60.46 at Walgreens. 
  • Aripiprazole the generic for Abilify was $100.19 at Harris Teeter and $292.61 at CVS. 

It’s easy to transfer a prescription--if you find it for less at a different pharmacy, just call the new pharmacy and ask them to help you. 

It's access to the GoodRX tool that lead us to Magellan. I liked the app, but wanted it integrated into our health plan so people with our insurance could use it, see our pricing and have what they pay track toward their deductible. That's exactly what Magellan has done. 

In all honesty, we got a little bleeding edge on this one and we spent a lot of time working out the glitches with Magellan, but they are pretty well sorted out at this point and we have a state of the art tool for our staff to use. If you have a high deductible health plan and you don't have this tool, talk with your HR folks and ask for it. 

Beware of Drug Combining
We asked participants to watch out for drug manufacturers combining two old drugs into a single, costly “new” drug. We had a $9,027 charge for Zegerid. Zegerid is a compound of omeprazole [over the counter Prilosec] and sodium bicarbonate [alka-seltzer] that could be purchased for $20.

Similarly, we had a claim for Treximet for $1,471. 
Treximet is a migraine medication that is a combination of generic sumatripan and over-the-counter naproxen [Aleve]. Bought separately, the components cost about $37 for a 90-day supply. 

My doctor shared that she no longer accepts free samples from drug companies because they only provide samples of the newest, most expensive medications. When she shared them with her patients, they either thought they needed that brand and insisted on it or quit taking it because of the cost. I wonder if that’s what led to the claims we have had for Zegerid and Treximet. Check out to see the payments your doctors received from pharmacy companies. It won't tell you if they accept free samples, but it will provide useful information. 

Read How Two Common Medications Became One $455 Millions Specialty Pill to learn more about drug combining and coupons.

Ask Five Questions

How can you avoid being taken advantage of by the prescription drug manufacturers? Ask the 5 questions recommended in the Choosing Wisely campaign before getting any test, treatment, or procedure and carefully considers all options before deciding among them:

► Do I really need this test or procedure?

► What are the risks?

► Are there simpler, safer options?

► What happens if I don't do anything?

► How much does it cost?

Interested in learning more? Take a look at the resources Consumer Reports has put together. Or, search my blog. I've written quite a bit on this topic most recently The Dark Art of Prescription Drug Pricing. Don't miss the John Oliver video in that post. It's definitely worth a few minutes of your time. 

I enjoy Sarah Kliff's reporting on health care for Vox. I recommend The true story of America's sky high prescription drug prices and If Trump wants to lower prescription drug prices, he's going about it all wrong

It's also worth giving some thought to who funds the studies. The Cochrane concluded: "Sponsorship of drug and device studies by the manufacturing company leads to more favorable results and conclusions than sponsorship by other sources. Our analyses suggest the existence of an industry bias that cannot be explained by standard 'Risk of bias' assessments." Learn more about the industry sponsorship and research outcome study here.

This Freakanomics Podcast is worth a listen too. 

Bad Medicine, Part 2: (Drug) Trials and Tribulations

ReleasedDec 08, 2016
How do so many ineffective and even dangerous drugs make it to market? One reason is that clinical trials are often run on "dream patients" who aren't representative of a larger population. On the other hand, sometimes the only thing worse than being excluded from a drug trial is being included. 

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