The Centers for Disease Control and Prevention report that nearly half of Americans took at least one prescription drug in the last month, a number that is on the rise. The use of two drugs or more and five drugs or more are also increasing.
The most common drugs used include children's asthma medications, stimulants for adolescents, antidepressants and cholesterol-lowering drugs. More than $250 billion is spent annually, and as new and improved drugs are found, and Baby Boomers enter the prime age of medical issues, that promises to increase.
About nine out of 10 older Americans older than 60 use prescription drugs. High blood pressure drugs like diuretics and B-blockers and cholesterol lowering drugs are the most popular, with more than 40 percent of that group taking five or more prescribed drugs per month. That use can place a heavy financial burden on seniors because of high insurance deductibles and lower incomes.
The $750 Pill
A pharmaceutical executive recently made headlines when his company raised the rate of a prescription drug pill to $750 per pill. The medication treated a disease that typically afflicts HIV/AIDS and cancer patients who have weakened immune systems, leaving its users potentially facing hundreds of thousands of dollars in additional costs.
Fortunately, the outrage generated by news of this price increase was loud enough that alternatives to taking that pill were found. And in a bit of karmic justice, the executive himself was later arrested on charges related to other aspects of his business.
That’s admittedly an outlier of an example, but it’s not unheard of for drugs to sustain price hikes. While competition can keep most generic drug prices in check, drugs for rare diseases and obscure physical issues can be costly.
Governments in several states are stepping in with “cost transparency” bills that will require drug companies to justify prices of their drugs. The regulators would receive information that will determine if the price to consumers is reasonable based on cost structures from the manufacturer.
Pharmaceutical companies often complain that research costs justify their prices, but the government will make the final determination on that issue. One worrisome note is that manufacturers will present data that does not reflect the total truth about costs, much like movie producers and book publishers often manipulate royalty statements.
While such actions may keep drug prices reasonable, it’s not guaranteed. Another government tactic being considered is to free Medicare to negotiate drug prices, which it is currently barred from doing (Medicare pays what manufacturers request). The idea is to allow Medicare to do what Medicaid and the Veterans Administration already have license to do, resulting in much lower costs for their constituents.
Talk, Eliminate, Ask
Here are some ways that drugs costs can be reduced:
1) Talk with the doctor – Doctors don’t think about the cost, only the cure, when prescribing. In fact, a Consumer Reports survey of doctors discovered that most ranked cost of medications at the bottom of their concerns, and many don’t know the actual out-of-pocket costs to their patients. That means it’s up to the patient to ask about alternatives and remind the doctor of the high costs she or he may be imposing. There may be a different path that can be taken.
2) Eliminate some drugs – Most patients never discuss their drug-taking with their doctor beyond the initial prescription. Drugs used should be reviewed every six months to ensure that the original purposes are being met, interactions avoided, and unnecessary drugs or doses are cut.
3) Generics are cheaper – Generics save money and are as safe and effective as the brand names, sometimes as much as one-third cheaper. If a generic is not available, there may be a different drug that can achieve the same results at a lower cost.
4) Split the pills? -- If you get a pill that’s twice the normal dose, you can split it. Ask your doctor about this, and only divide scored pills using a pill-splitting device. Extended-release drugs and continued-release drugs are not candidates for this procedure, so be careful.
5) Shop for bargains – Not every pharmacy charges the same price, and there may be bargains to be found at discount warehouses and online at AARP.org, Drugstore.com or Familymeds.com, among other websites. DestinationRX is a site for comparisons of drug costs and effectiveness. If you find a lower price, ask your pharmacy if it will match that price.
6) Avoid sampling – Some seniors are offered sample drugs to see if they are effective. This can lead to good results but may wind up costing more out-of-pocket.
7) Advertising is costly – If you see something advertised on television, someone is paying for it, and that’s usually the consumer. Plus, TV ads typically tout new drugs, which may be more expensive and less effective than old reliables. Not to mention that the long-term safety isn’t as clear.
8) Review your insurance – Having a good drug plan is important as you age. Seniors may need to buy supplemental insurance if they have health plans through employers.
9) Ask the manufacturer – Pharmaceutical companies have patient assistance programs that can lower the cost of their drugs. It’s good public relations and rewards some of their best customers. The online site RXAssist.com has details about various programs available.
10) Research – Ask your doctor and pharmacist questions. If you’re not assertive, bring someone along who will act on your behalf. It is important to the bottom line to make sure the best alternatives are evaluated, and many busy doctors may not have all the information needed to determine the best path for an individual.
In the end, there may be alternatives, but they’re not available to the passive. Ask about alternative solutions and do some research by questioning peers, researching online and asking medical professionals. The price in most instances can be reduced by knowing the correct path to a discount.