Expert outlines ways you can save on prescription medications

Wednesday, October 18, 2023
It's getting more expensive to follow the doctor's orders as the cost of medication keeps going up.

But the first price you see doesn't have to be the price you pay.
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There are many reasons your medication costs could suddenly spike. Your insurance company might pay less or stop covering that specific medication. Or you may now need to meet a deductible before your benefits kick in.

"It happens usually at the beginning of your plan year, whenever it like resets for a lot of people -- that's January first," said Lisa Gill, with Consumer Reports. "You go into the pharmacy, and all of a sudden this thing that you may have only been paying $10 copay for is now 80, 90, or into the hundreds of dollars, or even more."

Consumer Reports has been investigating ways to manage that surprise moment at the counter.

First, double check that your pharmacy has the right insurance information on file. If the cost is still high, ask your pharmacist for help finding the best price possible.



"Should I be using a coupon of any kind? Or can your pharmacy help negotiate maybe a lower price outside of my insurance, or is there another way to run it through insurance that I'm just not thinking of?," Gill said. "Start to ask them like, 'what is the best thing? What's the best price that you can find for me that you can get for me?' and go from there."

If you get your medication delivered, compare your online options. Amazon, Costco and HealthWarehouse.com all offer full pharmacy services. You may also be able to find common generic drugs for lower prices at Cost Plus Drugs or Script-co.

"If that doesn't work, then the next thing you want to do is call the insurance company," Gill said. "Now, you wanna help try to understand like, well, why is this drug not covered very well?"

You can file an appeal to have your insurance cover the drug or offer a better rate. Look for appeal instructions on your insurer's patient portal.
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You may also be asked for prior authorization, or proof that you've tried other, less expensive medication already.

Both will take some paperwork, but your doctor, and others, can help you advocate for your health.



After talking to your pharmacist and insurance company for options, you can reach out to the manufacturer directly.
Prescription meds costing more? Call the manufacturer


"If you do have insurance, and you're taking a medication that is a branded drug, typically, the manufacturer offers a copay coupon program," Gill explained.

Manufacturers may offer different copay or coupon programs. Find details are usually on the manufacturer's website or check out the nonprofit NeedyMeds.org.

If you don't have insurance at all, many manufacturers offer patient assistant programs.

"Those are income based. But the income levels can be pretty high a lot of times," Gill said. "They cap out at $100,000, maybe even higher than that."



Not using insurance can sometimes be cheaper, especially for common generics.
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Compare shop prices by using online tools like Pharmacy Checker, IdMe or GoodRX.com. Your local mom-and-pop pharmacy could also be a great resource.

"It's those independent pharmacists who typically own their own pharmacy who are very willing to negotiate with you on price," Gill said. "They will often meet or beat large, like really large, chain pharmacies or online pharmacies because they'd like your business, and they wanna help you."

Sometimes all you need to do is directly ask the manufacturer to make an exception.

"Just call them up, and just at just explain the situation and say, 'can I get this drug for nothing, or for very little,' and describe your situatio," Gill explained.

"Even if you don't get the first customer service agent to help you, hang up and call again," she added. "You'll get another one, and just kinda keep trying until you'll often find somebody who will be willing to help yoo."



This tactic might not always work, but it's worth the ask to get the medication you need.
Join us every weekday morning on Eyewitness News at 5 a.m. for our new segment, ABC7 On Your Side. John Gregory has you covered on money-saving tips, including tricks to save on your bills, smart negotiating tactics, plus where you can score free stuff!
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