Did you know that Americans pay twice as much for their prescriptions as people in other developed countries, where pharmaceuticals are more tightly regulated? That’s because here, the Food and Drug Administration (FDA), by law, cannot consider the price of any drugs it may approve for sale — even when their development was financed with hundreds of millions of taxpayer dollars. It’s common for you to pay $50 for the very same drugs that go for $5 in Germany or England. Those high prices lead one out of every five people to cut back on medications, often with serious consequences. Luckily, asking these questions can save your health — and your bank account. Just ask, and you could save hundreds of dollars on your prescriptions!
6 Questions for your doctor …
Why are you prescribing this specific drug?
Your doctor should be able to describe the drug’s benefits clearly and, importantly, tell you when you should expect to experience them, and how long you should continue taking the drug after you feel relief. For instance, a woman with a common urinary tract infection should feel better in two days on the antibiotic nitrofurantoin. But studies show that it takes a full seven days for this antibiotic to wipe out the bad bugs that need wiping out. That’s important information, because it can save you money while ensuring you get the best result in two ways. First, you won’t pay for what you don’t need. In this case, you’ll simply buy a seven-day supply, as opposed to a 30-day supply, which is some doctors’ automatic default. Second, if it’s working, you’ll be sure to take the entire course of your prescription for maximum effect; and, if it’s not working as expected, you’ll know to check back to learn what your next best option is.
Why are you suggesting this specific dosage?
Nearly always, you want to take the least amount of medicine that’s effective. Also, though drug prices are generally flat dose to dose, there are cases of drugs costing $800 or $4, depending on the dosage. And insurers routinely cover one dose of a drug and put it in their formulary (the list of exact drugs they cover), but they won’t give you a dime for another dosage not on that approved list.
Can I split this pill in half and save 50 percent?
Thanks to the drug-industry practice of flat pricing, many pills cost roughly the same regardless of potency. For example, you can pay $35 for a 30-day supply of 40 mg. Lipitor for your heart, or $36 for an 80 mg. supply. If your doctor wants you to take 40 mg. a day, why not buy the 80 mg. tablet and split it in half, or take the capsule form every other day? Warning: Never split pills without an explicit okay from your doctor.
Is there a low-cost generic available?
On average, brand-name drugs cost four times as much as generics, which are nothing less than FDA-approved copies with the same active ingredient, strength, safety, and effectiveness. Once in a while, a doctor may insist on a brand name with a coating to protect against gastrointestinal issues. But generally, why pay even three times as much for Crestor for your cholesterol, for example, versus generic rosuvastatin? Also, if there isn’t a generic for your prescription today, keep checking with your insurer. The FDA is approving three new generics every day.
Do you have a manufacturer’s discount card for this drug?
Your doctor has stacks of discount cards in her cabinet that were dropped off by drug-maker salespeople. She could hand you one. If she doesn’t have one, check the drug maker’s website. Experts estimate that manufacturers offer customer-building savings cards for nine out of 10 of their brand-name drugs. Their idea is to hook you on the drug at, say, $10 a month for a limited period and then keep you coming back at the full $90 price. But discount cards can work for your prescriptions too. You get to try the drug at a deep discount and decide whether it’s worth full price.
Better yet, can you give me free samples?
Drug company salespeople give doctors around $12 billion worth of free samples every year. So there’s a good chance your doctor can give you a generous supply — for free. Then you can judge whether the drug works for you and is worth a prescription.
And 3 questions for your pharmacist …
Can you name three preferred drugstores near me?
Your friendly local pharmacist, like any merchant, can charge whatever he wants for prescriptions, say, from $4 to $400. Insurers protect you by negotiating prices with drugstores in return for their customer traffic. As a result, you can save 25 percent or more on your prescriptions at your plan’s preferred stores, which nearly always include nationwide chains like CVS or Walgreens. And don’t stop there: Check the costs among the preferred stores; you could save even more.
Can I save money by ordering through your mail-order program?
You might be able to get three-month supplies of prescriptions for chronic conditions like diabetes and high-blood pressure at zero copay and with free shipping, through your plan. But, as with all mail order, you run the risk of delays and damage. So, also ask if you can get your 90-day supplies locally. Many insurers offer that option at mail-order prices through chains like CVS and Walgreens.
Are each of my medicines on the insurer’s formulary?
Insurers constantly change the list of exact drugs they cover — their formularies — thereby forcing you to regularly check that your drugs are still covered. Check on your refills as well as any new drug before it’s prescribed. Also, always call your insurer before renewing your drug plan to be certain your medicines will still be covered in the new year. Be specific. Ask about the medicine’s dosage and its form. For example, recently if one had coverage with insurance company WellCare, they would be charged $83 for 30 days of the 2 mg. capsule of muscle-relaxer tizanidine — or $300 with no insurance — because the capsule wasn’t in its formulary. But it costs only $8 for the same dosage in tablet form, which is in its formulary.
This article originally appeared in our print magazine, Save on Healthcare (Buy on Amazon, $12.99).