(TNND) — Pharmacy professors offered tips to keep drug costs in check as a third of Americans report leaving prescriptions unfilled, cutting doses or taking other steps to deal with affordability challenges.
Adam Pate and Sujith Ramachandran of the University of Mississippi wrote about prescription assistance programs, coupons and discount cards, and more for a new article in The Conversation.
Pate, the chair of the Department of Pharmacy Practice at Ole Miss, said prescription drug affordability challenges are significant, especially for folks on a fixed income.
“Patients should never let drug cost be a reason that they don’t … treat whatever it is that they got going on,” Pate said Wednesday. “Because three out of four times, there’s going to be another drug you could use, or there’s some way that you could get that drug for that patient.”
Pharmacists can help patients navigate those questions, Pate said.
Don’t turn to online pharmacies that might source from foreign countries to save money, Pate said.
Doing so risks drug quality and consistency, he said.
“It’s just so much better to go to your local pharmacist, talk to them, have that discussion here. … There may be options,” Pate said.
Advice for saving money on prescriptions varies greatly, depending on the drug, the patient, and their third-party payer.
But Pate broke his advice down for a few categories of patients.
Advice for people on Medicare
“I think most of the time when pharmacists talk with these folks, it’s picking the right plan,” Pate said of helping Medicare patients. “So, when it’s open enrollment, it is critical that you pick the right plan.”
He said most local pharmacists can help people pick the right Medicare Part D plan.
Do you want a higher deductible, or do you want a lower monthly note?
For all the drugs you’re taking, which plan is going to give you the best price breakdown?
Medication access programs can help, even if you’ve missed open enrollment.
Drugmakers, nonprofits and government agencies sponsor prescription assistance programs, which help patients who are uninsured or underinsured fill prescriptions either at a discount or for free, Pate and Ramachandran wrote.
That’s true even if a patient is on Medicare.
These programs include manufacturer-specific programs, as well as charitable pharmacies like Dispensary of Hope, NOVA Scripts Central and the Patient Advocate Foundation.
Qualifying criteria vary for these programs, but typically you must have a low income and be a citizen or a legal U.S. resident, Pate and Ramachandran wrote.
He also mentioned 340B pharmacies, which can tap into preferred drug pricing because they provide a level of indigent care. Those savings can be passed on to a patient, but the patient needs to be seen by an affiliated provider and meet certain stipulations.
Advice for people who are uninsured or on Medicaid
Folks who are uninsured or on Medicaid should look for assistance from foundations and drug companies, Pate said.
And sometimes, paying cash might be cheaper than the Medicaid copay.
Pate mentioned that Walmart has a $4 drug list, but any pharmacy should be able to help you find the cheapest option possible.
Pate and Ramachandran mentioned a free online tool, such as RxAssist, sponsored by the Robert Wood Johnson Foundation, or a discount card from GoodRx.
GoodRx cards are free and help people compare local pharmacy prices and locate coupons that make prescriptions more affordable.
Some pharmacies don’t accept GoodRx, so you may have to visit more than one pharmacy.
GoodRx cards may make the most sense for uninsured or underinsured patients, but don’t always help those who have insurance, because they might not get a better price, Pate and Ramachandran wrote.
The Trump administration also recently announced a new prescription drug pricing program to connect consumers to companies that have agreed to sell certain prescription drugs at a big discount. Pate and Ramachandran said many experts don’t expect the program, known as TrumpRx, to help people who have health insurance. Instead, they believe it could be most helpful to those with no insurance.
What if you have private insurance or Obamacare coverage?
A small group of House Republicans sided with Democrats on Wednesday to force a vote on a three-year extension of the enhanced Affordable Care Act tax credits, due to expire Dec. 31.
Meanwhile, 160 million Americans are on an employer-sponsored plan, with those health insurance premiums rising fast.
Saving money for people with private insurance often comes down to having a provider who understands the insurance company’s formulary for that patient’s disease state.
Your doctor’s office should be able to help navigate that, even if it means jumping through a few hoops. For example, your doctor might have to prescribe cheaper, covered drugs first to ensure they won’t work before you can win approval for the more expensive option.
“I think the one universal truth is private insurance or otherwise, it’s again, see what resources are available. … Because even some drug companies, if you don’t qualify for patient assistance, you may qualify for a reduced amount to pay for a drug, or there may be some sort of a copay card that would assist that’s funded by the drug company itself,” Pate said.