Some final tips for reducing Rx costs:

Even if you are getting great prices at your pharmacy, there are a few ways to achieve additional savings!

1. Samples. Ask your doctors for samples of the medications they prescribe. Be up front about any difficulties you are having in paying for prescription, or let them know how much that monthly Rx costs.

Doctors receive daily visits from various pharmaceutical sales reps, including samples, coupons, and other offers. The newer the medication, the more likely they are to have samples available. However, doctors are busy, and see many patients, and may not think to offer the samples, unless you ask!

Specialists in private practices (gastro, cardio, etc.) usually receive additional volumes of samples; after all, their patients are the most likely to use them. Just ask!

2. Coupons and Vouchers. Coupons and vouchers for free samples, discounts at your pharmacy (also referred to as pharmacy checks), and rebates are increasingly common. Even if you are already on a medication, your doctor may write a separate prescription for the free sample, in addition to your regular prescription.

Several offers are listed at

Rx Coupons

Once you fill a trial or use a prescription coupon, the manufacturer will generally provide another. And another…

Several programs also have “Rewards Programs”, allowing you to submit your receipts for rebates and free gifts. $40 - $200 a year in cash back, as well as freebies, can add up quickly in reducing costs.

Don’t assume you cannot use coupons with copayments or insurance plans. In general, you can. The major exception is when your medications are completely covered by Medicare (some breathing meds, diabetic supplies, etc.), in which case you would be being paid to take a drug (not allowed). Your pharmacist will know the requirements and are generally very supportive.

3. Contact the Manufacturers Most manufacturers have prescription assistance programs. While these are changing dramatically with the changes in Medicare plans, they do have programs available. Programs generally require input from your physician, and some program provide the medications directly to your doctor to pass on at regular appointments.

4. Pharmacy Rewards. With the introduction of medicare plans, many patients were required to change pharmacies, or even utilize mail-order programs to meet the insurance requirements. Pharmacies are now offering incentives to keep and bring in new business. $25 gift cards for new or transferred prescriptions are now common.

For new prescriptions, the free trials work well: no need to pass on insurance information, no need to pay for medications, and you get a gift card!

For transferred prescriptions, there are several things to consider. First, no matter what the pharmacy’s price points are, you can transfer a generic or low cost prescription and still generally come out ahead. Second, if the medication is covered under your prescription insurance plan, the costs should be similar (not necessarily the same), between pharmacies. Call and ask the price before you transfer, and make sure you are benefiting by the offer.

Also, remember, transferring a prescription does not mean it needs to be filled at that pharmacy in the future. Just take your empty bottle back to your preferred pharmacy and have it transferred back when it’s time to refill.

5. Doctors Office coupons. As odd as it may seem, the doctors office, and pharmacy counter tops, are becoming loaded with coupons. Some have Rx offers, many have OTC medication offers. Look. Skim through the brochures. You might be pleasantly surprised!

6. Regular Checkups For your Rx costs! Prices change constantly. It’s a competitive business. Evaluate your insurance coverage, evaluate the prices at your pharmacy, and don’t be afraid to make changes when it’s best for you and your family.

You might assume that if you are on an insurance plan, prescription plan, or even a discount plan, the costs from one pharmacy to the next will be the same.

There are two reasons. First, if your medications are not covered, obviously you want to get the lowest prices you can.

But...did you know that your insurance price may not be the lowest price?

Frequently a pharmacy lowers their standard prices to meet the insurance negotiated prices. However, several pharmacies, such as Costco, guarantee to provide your prescriptions at the insurance price OR their price, whichever is lowest. And, surprisingly frequently, the Costco price is lowest. There are many reasons for this, but the only important one for this exercise is, are you paying the lowest price possible.

To see how your rates compare, check online sources. For this example, we will use Costco.com and drugstore.com.

You don't need to be a member of costco.com to compare their prices. Simply go to www.costco.com, click on the "Pharmacy" menu up top, and on "Learn More/Pricing Information" on the page that follows.

You may type in a medication name, or select from their list. A link to the drug, or possible drugs, will appear. Select the link, and scroll through the prices to determine your dosage. Check prices for various pill sizes, and even quantities.

In your spreadsheet or table, add a column and record the prices of each medication in the size and quantity per month you have previously calculated for your current pharmacy.

Remember, insurance prices MAY be lower, this is their default price.

After you have made it through all your medications, repeat at www.drugstore.com

Select Low Prices from the left menu, and perform a drug search as before.

You should now have a table something like:







Now...remember, you do not have to buy ALL of your prescriptions at the same place. If the prices are the same at your regular pharmacy for most drugs, do what's easiest. BUT, if for even one drug you find a significant price difference, consider purchasing at least that one elsewhere.

NOW, I'm NOT recommending Costco or Drugstore.com, these are examples. Do your own research, and see what you can find for your own needs.

A few other things to factor in...if you use a 5% cash back for drugstores, if you have executive membership and AmEx with Costco (3% back), if you can purchase bulk quantities (3 months at a time)...factor all those possibilities in to find the best savings for you.


Happy Saving.

Pill splitting is a great way to reduce your prescription costs. Always check with your doctor AND pharmacist before splitting pills! Never split an extended or time released tablet!

Pill splitting is simply purchasing a large size tablet, and cutting (spliting) it in half. Pills that can be easily split are scored (have a line indent running down the middle of the pill) which aids in the ability to snap them in two (along the line).

For example, instead of taking 3 50mg tablets of Zoloft each morning, pill splitting would allow you to take 1.5 100 mg tablets. The cost savings?

90 50mg tablets (one month of 150mg each day) are priced at $310. 50 100mg tablets (one month of 150mg each day) are priced at $182. SAME DOSE, DIFFERENT PRICE!

Adding this information, go back to your list, and consider what pills might be available in larger sizes that can be split. We'll look into this more later. For now, let's add some possible pill split savings into our table.

The most important step in reducing your Rx costs is knowing what you are paying. It may not be obvious. Copays, prescription cards, tiers and levels. But it can be sorted through.


First: next to the list of meds, write down the size pills/inhaler/that is prescribed. For example, Zyrtec is typically 10 mg size tablets.

Next: convert that to the number of pills/inhalers/injections etc. that an average prescription would be each month.

Example, Zyrtec, 10 mg each night is 30 per month. Zoloft, 50 mg pills but three each day is 3 x 30 days = 90 pills.

For inhalers, assume, for this exercize, one per month.

Etc.

NOW: add two columns: the price your pharmacy charges, and the price you pay. Even if you have a low copay, or are on a medical discount card, look at the medical receipt for what the insurance rate charged, and what you pay.

Example, with a discount plan, the pharmacy rate for Zyrtec is $128, but the discount plan rate reduces the actual charge to $94.

You should have something that looks like:


That's the first step.

The first step in reducing prescriptions is going to appear to be very simple. It may or may not be.

Make a list of every prescription medication you and your family have used in the last 12 - 18 months. Every one. Whether it's a medication you use every day, like insulin or glucophage, or a one-time-only antibiotic, whether it's an inhaler you use periodically, or just an Epi-Pen to keep on hand, add it to the list.

If you have recently changed Rx to treat the same condition, list both medications. If you are considering a new or alternate medication, add it to the list.

It may help to look through your tax receipts. Collect any Rx receipts you can find; not the cash register receipts, but the actual medication description, warning, and cost sheet.

At the end of this process, you should have a list, similar to

Regular:
Rx #1
Rx #2
Rx #3
Rx #4

Periodic:
Rx #5
Rx #6
Rx #7

Former:
Rx #8
Rx #9

Future:
Rx #10
Rx #11

That's all you need to do for this step. But be thorough, and include every medication you can possibly think of.

I was, well, moderately furious, at the latest pharmacy campaigns. So many are now designed to indicate " we accept all policies, so your costs are the same no matter what".

It's true that by accepting an insurance plan, a pharmacy agrees to charge prices negotiated with the insurance plan. This does not necessarily mean that your total prescription costs will be the same at that pharmacy.

Unless you have outstanding insurance that covers 100% of every drug (in which case you are probably paying WAY too much for insurance) at some point you will probably be paying the higher rates of the standard pricing at that pharmacy.

Why?

There are limits on coverage. If you have a step program, a tier program, a limited formulary, a co-pay, a deductible, a ceiling, a percentage discount card, or any other expense NOT covered by your insurance, the pharmacy can charge you it's regular prices. If it's not COVERED by your insurance, the pharmacy charges the PHARMACY rates.

Look at the language in your policy. For example, from the standard medicare guidelines:

Standard Coverage (the minimum coverage drug plans must provide):

If you join in 2006, for covered drugs you will pay a monthly premium (varies depending on the plan and coverage you choose)...

...Step therapy is a type of prior authorization. With step therapy, in most cases, you must first try certain less expensive drugs that have been proven effective for most people with your condition. For instance, some plans may require you to first try a generic drug (if available), then a less expensive brand-name drug on their drug list, before you can get a similar, more expensive brand-name drug covered.

If you have been on the "expensive brand-name drug", which include things like Allegra and Imitrex, and have already found they are the most effective for you, you may be paying out of pocket unless (and until) it is determined that the other drugs are "officially" not as effective. In the meantime, NOT COVERED means it does NOT fall under the prices agreed to by your insurance company.

There may also be QUANTITY LIMITATIONS...

For safety and cost reasons, plans may limit the quantity of drugs that they cover over a certain period of time./ In some cases these quantities are fairly low...a policy may cover Zoloft at 50 mg a day, even though 150 mg is a standard dose. Whatever is not covered, again, is not necessarily subject to the insurance price agreements.

Formularies are even more difficult; very few insurance include newer drugs in their formularies. A formulary typically covers at least two drugs in a class. However, this translates to two SSRI antidepressants, for example. Prozac, which is available cheaply as a generic drug, is likely in the formulary, while Cymbalta, a newer and non-generic drug, is likely not. The effectiveness of SSRIs is highly individualized, but your coverage is probably not.

So, choosing a pharmacy can have a huge impact on your drug costs. It did mine. And so, I will blog on tips to evaluate your prescription costs.

Went to Costco today...we picked up peanuts for our squirrel population, and I'm sure a few other things...I have no idea what the final bill came to for groceries, because I was too busy staring at our annual to date Rx costs!

$840. Ack. Ick. Mortified. Kept going through the receipts, double checking...

then I realized it's the end of APRIL, and this is YTD costs.

Came home, ran the totals for these same meds last year. 2005 YTD would have been $5500. OUCH. No wonder the savings account seemed to be slipping away. It was!

If I add in the cost of insurance, which I did not have Rx on last year, it is only at extra $45 a month, or $180 for YTD. So basically I've gone from $5500 to $1000. STILL too high IMHO, but at least I feel a bit better about it.

I still plan to blog on the changes I've made; I just quite hadn't appreciated what a change it has been. A year ago, I thought that the only real way to reduce my out of pocket Rx expenses was to stop taking the meds.

Still working on Mom's issues with Medicare. She's doing better, enough to say her doctor was putting her through H*LL (and she never talks like that!).

Rite-Aid has joined the others, and this week is offering a $20 g/c for any transferred prescription. Grab your local paper, and check it out. They also have a price match or better guarantee.

This is the first national offer I've seen; the local grocery pharmacies still have $20 for transfer, and even an $80 glucose monitor.

Rite-Aid also generally gives out general use g/cs, like Discover cards, so they are much less limited.

Rite Aid is also offering:

$25 worth of money saving coupons right away

Special product offers

New product announcements

Advance notice of free health events and special sales
if you register with them:

https://www.myriteaid.com/prescription_check.jsf

Finally getting round to adding up last years medical costs and taking a fresh look at how we can decrease them.

First:

2005 insurance me: $3600
2005 insurance DH: $6000
2005 out of pocket medical: $25,000
(2005 Rx out of pocket: $20,000)
Total medical 2005: $34,600.


We made a huge dent last October, when we cut Rx costs from $2K to $1K a month without changing any meds.

This year, I've changed insurance to add some Rx coverage without a giant leap in insurance costs. DH will stay the same. So,

2006 insurance me: $4000
2006 insurance DH: $6000

Now, I will start tracking and attacking the medical costs as they come in. First, I will look at how the insurance is reducing the Rx costs, and whether or not it is going to pay for itself in the end. Tommorow...

The deals may be available in your area. They aren't always obvious.

I received 3 g/c for Rx, new or transferred, from the check out coupons that get spit out with the bonus card. They were mixed in with the Wall Street Journal and Disney coupons, and I almost missed them.

One of the warehouse clubs had a $25 offer last month, but it was in one of the coupon books they sent out. Another pharmacy, I think Rite-Aid, had one awhile ago through it's online rewards system (memory here, I'm not a member).

Our Sunday paper has also had 5 - 6 coupons. You do have to take the coupon in to the store. One store even offered $10 g/c if you filled your PET's prescription there. That one was in their weekly ad.

I'm not sure what is available in your specific region, if any. But there is definitely a trend to be alert for.

With the change in medicare, and many companies changing insurance with the new year, many of the grocery pharmacies, as well as some of the pharmacy chains, are offering gift cards for new or transferred prescriptions.

$10 to $50 locally.

Now, I have been through the mill getting costs down switching to cheaper pharmacies. I'm not recommending any one switch pharmacies just to get the deal. BUT, if you want to do a "free trial" Rx, such as the 7 day Ambien or Lunesta, 15 day Crestor, etc., or even if you currently use these and your doctor will give you the short term Rx, you can fill them and get the gift cards. Insurance, etc., is not required for freebies, and if you decided to fill a full Rx later, you need a fresh Rx written anyway, which can be taken to whatever pharmacy you and your insurance use.

Most of the free trials are about $50 - $100 worth of pills, plus with the card, and since it doesn't take insurance, it also doesn't count against a deductible or other limitation.

Okay, I'm trying to get used to all these categories. Seems like with meds and Rx's, I need a separate category to track costs and compare to what it was without insurance versus premiums, etc.

This week was horrible medical wise, on top of everything I have a deep sinus infection or something, lots of CTs and meds.

Good news, the script I filled in December for $400 for 30 days was $36 for 30 days under the new plan. Add to that the "voucher" from the web site, $10, and costs continue to go down. I need to add it all up, though, and see how else I can improve. Keep ya "posted!"