Top 10 Reasons You Pay Too Much For Medication

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Anyone taking medication on a regular basis is at risk for over-paying. Your pharmacy will have little reason to suggest cost-saving measures. After all, that will affect their bottom line. It is up to you, the patient, to be pro-active in finding an affordable regimen of medications.

Here are the top 10 reasons why you may be paying more than you need to for medication:

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

2. You don’t know your options. There are always options. Although 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 related to each one. You may find that the so-called best choice costs 5 times as much for a 5% greater benefit.

3. You started on a medication that has suffered price increases. It’s not uncommon for a doctor to start a patient on a cost-effective medication, only to find years later that the cost has increased considerably. Though initially it may have cost lost than a competing drug, with time the ‘playing field’ changes. Costs may increase and other drugs may go generic. If you find you are paying more and more, ask your doctor about changing your medication. Pharmaceutical manufacturers are well aware that if they can get patients started on their drugs, they are likely to continue them, even if the price increases considerably.

4. You continue on a brand name medication when a generic becomes available. Although insurance companies usually bring this to your attention, you may accidentally be taking a brand-name medicine even though a generic exists. As long as you’re willing to pay, your pharmacy may not point this out either. If you’ve been on a medication a long time, it doesn’t hurt to ask your pharmacist whether there might be a generic available or on the horizon.

5. You go to a pharmacy with a higher mark-up. Pharmacies purchase medicine at wholesale prices, but charge their customers the retail price. The pharmacy has the right to mark up their drug as much as they wish, which sometimes makes a significant difference in what you pay – easily $20 on a brand-name drug, from one pharmacy to the next. Price-shopping is the key to finding the lowest price.

6. You don’t buy in bulk. It’s almost always cheaper to buy a three-month supply of a drug rather than buy a one-month supply three separate times. Pharmacies charge a dispensing fee to prepare your bottle of medicine. You’ll pay this fee three separate times if you purchase your medicine monthly rather than in three-month allotments.

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

8. You’re taking a ‘cadillac’ drug when a ‘pick-up’ would do as well. Doctors are often encouraged to use the latest and best, even though yesterday’s best is nearly as good as today’s. Ask your physician if an older remedy might be worth trying first.

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

10. You’re taking a higher dose of medicine than required. Again, although you may have needed a certain strength of medication initially, as your disease comes under better control you may actually require less. A good example of this is asthma controller-medication, such as inhaled steroids.

Giving some thought to your medication is a good place to start. Learn the cost of each medication before discussing it with your doctor. Anyone taking more than one or two medicines is likely to find some way to trim at least several dollars a month from their medication bill, easily amounting to a hundred dollars a year.

Copyright 2010 Cynthia J. Koelker, M.D.

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