Top 10 Reasons You Pay Too Much for Drugs

Anyone who takes medication on a regular basis is at risk of overpaying. Your pharmacy will have little reason to suggest cost-saving measures. After all, that will affect your bottom line. It’s up to you, the patient, to be proactive in finding an affordable medication regimen.

Here are the top 10 reasons you may be paying more than necessary for medications:

1. You don’t know your shape. If you have insurance, you have a form, whether you know it or not. A formulary is a list of drugs that your insurance covers at various price tiers. Some medications will cost significantly more than others. Your doctor cannot be sure to prescribe a drug on your formulary unless you bring your list of formulary drugs with you to your doctor’s appointment.

2. You don’t know your options. There are always options. While your doctor may suggest only one, when cost is a concern, be sure to ask about less expensive options, as well as the pros and cons associated with each. You may find that the supposed best option costs 5 times as much for a 5% higher profit.

3. You started with a drug that has suffered price increases. It’s not uncommon for a doctor to start a patient on a profitable drug, only to discover years later that the cost has risen sharply. Although it may initially cost less than a competing drug, over time the “playing field” changes. Costs may increase and other drugs may become generic. If you find that you’re paying more and more, ask your doctor about changing your medication. Pharmaceutical manufacturers are well aware that if they can get patients to start taking their drugs, they are likely to stay on them, even if the price rises sharply.

4. Stick with a brand name drug when a generic is available. Although insurance companies usually tell you about this, it’s possible that you could accidentally be taking a brand-name drug even though a generic exists. As long as you’re willing to pay, your pharmacy may not tell you that either. If you’ve been taking a medication for a long time, it doesn’t hurt to ask your pharmacist if a generic might be available or on the horizon.

5. You go to a pharmacy with a higher profit margin. Pharmacies buy medicines at wholesale prices, but charge their customers the retail price. The pharmacy has the right to brand your drug as much as they want, which sometimes makes a significant difference in what you pay: easily $20 on a brand name drug, from one to another. Price comparison is the key to finding the lowest price.

6. Do not buy in bulk. It is almost always cheaper to buy a three-month supply of a drug than to buy a month’s supply three times separately. Pharmacies charge a dispensing fee to prepare your bottle of medicine. You will pay this fee three times separately if you buy your drug monthly instead of in three-month allotments.

7. You are taking a more expensive dosage regimen. For example, many drugs are cheaper if you take a higher dose once a day than a lower dose twice a day. Also, the most commonly used dosage strengths are often the least expensive, regardless of dosage. Ask your pharmacist if there is a way to change your dosing schedule to lower your cost.

8. You’re taking a ‘cadillac’ drug when a ‘pick-up’ would work too. Physicians are often encouraged to use the latest and greatest, even though yesterday’s best is almost as good as today’s. Ask your doctor if it’s worth trying an older remedy first.

9. You’re taking medicine you don’t need. Just because you needed a medicine 5 years ago doesn’t necessarily mean you need it today. Ask your doctor to re-evaluate your entire medication regimen. This can take a good 15 minutes to discuss, so don’t try to add it at the end of a visit, when it’s not likely to be thoroughly covered. You may be better off making a separate appointment for the sole purpose of reviewing your medication options. Even if this costs you $100, you could easily make up that difference in a month or two by taking less expensive medications.

10. You are taking a higher dose of medication than necessary. Again, although you may have needed a certain strength of medication initially, as your disease becomes better controlled, you may actually need less. A good example of this is medications to control asthma, such as inhaled steroids.

Some thought about your medication is a good starting point. Know the cost of each medication before discussing it with your doctor. Anyone who takes more than one or two medications is likely to find a way to shave at least several dollars a month off their drug bill, which easily adds up to a hundred dollars a year.

Copyright 2010 Cynthia J. Koelker, MD