Tips for affording expensive medication

Oct 28 2009

You've lost your prescription insurance benefits because of unemployment; you don't have the extra money you once did for the co-pay; you have an expensive medication that isn't covered. Unfortunately, this is the current situation for many Americans. Carriann Richey, director of outreach and assistant professor of pharmacy practice for Butler University's College of Pharmacy and Health Sciences, says while affording medications in today's economy may be more difficult than ever before, there are options out there that can help.

1) Talk to your pharmacist. Pharmacists can help a patient navigate when a generic (lower-cost equivalent) is available or if an alternative, less expensive drug can be used. Many pharmacies also have low-cost options such as $4 generics or free antibiotics and prenatal vitamins. If your pharmacy doesn't have this program, inquire about it. Some will match other pharmacies' prices even if they don't have a program in place.

2) Make an appointment at a reduced-cost or free clinic. Not only can this give a patient access to a physician and many times a pharmacist, these health providers are trained to consider lower-cost alternatives and may be able to provide prescriptions at no cost or a reduced cost. Some clinics focus solely on patients who have no insurance coverage, while others will work with patients who have some benefits.

3) Look for manufacturer and government options. Manufacturers sometimes offer discount cards or programs for brand-name medications free or at a reduced cost. Several internet tools are available that can help patients access this information, such as www.benefitscheckup.org. It is best for a patient to discuss his or her interest in these programs with a physician, as they are often required to sign the paperwork and complete verification requirements.

Government or municipal entities such as counties will sometimes offer discount programs as well. One that is currently available in Indiana is the Indiana Drug Card. The amount of savings with discount cards may vary by pharmacy and medication. Some programs are only open to individuals with no private or government insurance.

Finally, most states offer a program that provides one-on-one counseling and assistance to seniors and their families, often referred to as a senior health insurance or senior assistance program. These entities help answer questions about Medicare, Medicare Supplement Insurance, Medicare Advantage, long-term care insurance, prescription coverage and low-income assistance.

4) Ordering medications through the mail and splitting tablets. Online and mail order pharmacies may offer medications at a lower cost and thus can be an option for patients who take chronic medications (those taken regularly) because they can be ordered in advance in 30, 60 or 90-day supplies. These services are not ideal for acute problems because of the slow turn around from the time the order is placed to the time the prescription is filled and shipped. Because all medications have storage requirements, it's important that the patient or member of the household be home at the time of delivery to prevent the medication from being exposed to weather conditions.

When considering an online pharmacy look for those that have the VIPPS seal. This seal indicates that the site is approved by the National Association of Board of Pharmacy. Some pharmacies also offer home delivery options so talk to your pharmacist to see what is available. This will allow patients to maintain the important relationship with their pharmacist.

Tablet splitting, in some cases, is another cost saving option. But not all medications can be split and not all splitting will save money, so patients should check with their pharmacist or physician before using this technique.

5) Consider other types of help. If a patient has exhausted all of these options he or she should consider if there are other non-medication services available such as food or heating assistance that could free up resources to be used toward medical care. Social service organizations such as local United Way services can help patients locate resources they may need. Finally, don't forget the role of lifestyle changes. Increasing exercise or dietary improvements may allow some patients to become less reliant on medication.