Ways that you may be able to reduce your prescription drug costs
Consider these steps regardless of the type of drug coverage you have
1) Use the lowest-cost refill schedule. In many plans, mail-order (or 90-day) refills are
less expensive than retail pharmacy (or 30-day) refills. In a few plans, though, the
retail refill schedule is less expensive. If you take several drugs, you may be surprised
the amounts you can save by using the lower-cost schedule. If you do switch to a
different refill cycle, you will need new prescriptions from your physician(s).
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Consider using lower-priced substitute drugs for some brand-name prescriptions. A
substitute drug is not necessarily the same as a generically equivalent drug. You can
ask your physician if there are substitute drugs for any expensive medications you’re
taking. You can also use the Consumer Reports Best Buy Drugs web site to find less
expensive substitute drugs. If there are any, you may wish to discuss them with your
physician.
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Consider pill-splitting for certain brand-name drugs. This involves buying a twice-aslarge dosage of the medication you are taking and using a pill-splitter to divide the
tablets in half. As one example, according to Costco.com, a 30-day supply of Lipitor
20mg tablets costs the same as a 30-day supply of Lipitor 40mg tablets -- $156. If
you had no drug coverage, you would save more than $930 a year by purchasing the
40mg tablets and then splitting them. If you have prescription drug insurance, your
savings will likely be $300-$500 a year.
The Consumer Reports Shopper’s Guide to Prescription Drugs recommends pillsplitting as a way to save money, as do the Harvard Men’s Health Watch (November,
2008) and some insurance plans. But some people may have difficulty dividing the
tablets exactly in half (even with the help of a pill-splitter). Last year the FDA issued
a consumer update warning of the risks of pill-splitting, recommending that patients
discuss it with their physicians (who will need to prescribe the larger dosage).
There are about 20 brand-name drugs that are candidates for pill-splitting. One way
to see if you can save money with this tactic is to look up a drug on a web site such
as costco.com or drugstore.com. If there is a dosage that’s twice as large as the one
you take and it costs less than twice as much, you may be able to save money,
subject to the restrictions noted in the next paragraph.
Some medications should not be split. As the Harvard Men’s Health Watch says:
“Small pills and medications with complex shapes are much harder to split
accurately. Medications that require a very precise dosage should not be split. And
you should never split capsules, pills with enteric (stomach-protective) coatings, pills
with extended-, slow-, or time-release formulations, or pills that contain
combinations of two or more medications.”
Consider these additional steps if you have a Medicare Part D plan (either a stand-alone plan
or a Medicare Advantage plan that includes Part D benefits)
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During each year’s annual open enrollment you should find the plans for the coming
year that will have the lowest-cost for the drugs that you take. You can call 800MEDICARE or contact your local state health insurance counseling program to do the
search for you. If you want to use the Medicare web site to conduct your own drug
plan search, you can use our Medicare Part D Plan Finder instructions.
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Unless you don’t take any prescription drugs, ignore a plan’s premiums. It’s not
unusual for a higher-premium plan to be the lowest-cost choice for a particular set
of drugs. The Medicare web site takes into account all costs – premiums,
deductibles, co-payments, and co-insurance – when it lists the lowest-cost plans for
a set of drugs.
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If you are enrolled in a Medicare Advantage plan that has high costs for your drugs,
you may want to consider switching plans (the Medicare web site also shows
Advantage plan’s costs for the drugs you take). But before changing plans, you
should consider these two questions:
1) Can you continue to see your present physicians in the plans with lower drug
costs?
2) Can you save money by switching to a Medigap policy and a stand-alone drug
plan? In a few cases if your prescription drug costs in an Advantage plan are very
high, you might break even or even save money by changing to a Medigap policy,
which allows you to see any physician who accepts Medicare.
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If two or more plans have similar prices, consider each plan’s quality ratings. You
may wish to enroll in a superior-rated plan even though it costs you slightly more
each year.