Just a few years ago, the CDC reported that approximately 1 in 10 adults don’t take their medications because of costs. Although there are no more recent reports available, it can only be predicted that the numbers are the same or higher as the prices attached to prescription medications continue to climb. And the patients who are unable to afford their medications are not just those who are uninsured. Many insured patients find that their insurance doesn’t cover a needed medication because it is “non-formulary” or the medication is covered in a tier system where a copay can be as high as $50. Imagine a patient with one or more chronic medical condition and how that costs quickly adds up when they are on several medications.
What can you do if you can’t afford your medications?
- Talk to your doctor to explore alternatives. In many cases, an equally effective medication may be available and work just as well.
- Ask if there are any available generics. These medications are cheaper because they are being manufactured by more than one pharmaceutical company. Brand names are usually exclusive to only one company who holds the patent and there is no price competition. For the most part, generics work just as well as brand-named medications.
- Appeal insurance coverage decisions. If you know there is only one medication that works for your specific medical condition but your insurance company decided not to cover it, file an appeal before paying out-of-pocket. While this is not always successful, it is important for patients to advocate for their rights. Doctors should also file appeals on behalf of their patients. What good is a medication if a patient cannot afford to take it? Insurance companies should be compelled to cover medications when there are no alternatives available or when a patient is already doing well on a medication they have taken for years and changing it risks destabilizing them.
- Ask your doctor if they have samples. Not only do pharmaceutical companies leave samples at doctor’s office, but they also leaving money-saving coupons that are valid for a year or longer. Also, many of these companies have programs to help patients who can demonstrate financial need by supplying hem with the medication.
- Search for coupons online. FInd out who manufactures the medication in question and go to their website. Many of them offer coupons that can save you significant amounts of money.
- Shop prices before you pick up your medications. There is sometimes a significant price difference in various pharmacies. A free app such as Hippo can make it easier to search cost differences before you head to the pharmacy. You can search pharmacies in your area and compare prices, both with or without insurance.
Medicine is getting more complicated than it ever has been before. Patients are living longer with more chronic diseases, often requiring multiple medications. Drug prices continue to soar and it can only be getting harder for patients to afford their medications. While patients need to fight for the care they deserve, doctors need to be sure their patients have viable options for getting the medicines they need.
Copyright secured by Digiprove © 2018 Linda Girgis, MD, FAAFP
