Help With Cost of Medications

Prescription Drug Costs

Prescription drug costs have been the fastest-growing healthcare expenditure, rising at double-digit rates each year forthe past seven years. Here at Roswell Park, we understand that affording prescription medications may present a financial hardship for many people. Certainly those without health insurance are the hardest hit, but even people with insurance may find co-pays, deductibles, or caps (limitations of coverage for certain items or during a certain time period) may find their resources strained.

Suggestions for Cost Savings

Here are some suggestions should you be experiencing financial difficulties due to the cost of your medications:

• Talk to your healthcare team. Be sure your physician knows of your struggle. He or she may be aware of patient assistance programs, alternate drugs, or some other way to achieve the same treatment goals at a lower cost. Samples (of your medications) may also be available.
  
• Ask your healthcare insurer for a copy of their formulary (if they have not already provided you with one) and show it to your physician. A formulary is the list of drugs that your insurer “covers” under your policy. In many healthcare plans, the formulary is divided into levels or “tiers” – generic drugs, and multiple levels of coverage for Brand name drugs – with increasing higher co-pays at each tier. If your medication is not on the formulary or is in the most expensive groups, your doctor may be able to find an alternative medication from the list.
  
• Make a list of each medication you take and how much it cost (be sure to include the dose and how often you take it). Call around to different pharmacies to see what they charge for the same dose/supply of the drug – you may be surprised at the different prices for the exact same product. If you wind up using more than one pharmacy be sure that all the pharmacies enter all your drugs into their computer system to help avoid any adverse drug interactions.
  
• Get a long-term supply. If the drug is one that you will take daily for a long period of time, consider using a drug wholesale house and getting a 90 day supply rather than the standard 30 day supply. Often, discounts are available if you buy in “bulk.”
  
• Medicare subscribers: Consider getting a Medicare Drug Discount Card. In January 2006, the new Medicare drug benefit becomes effective. Medicare recipients are entitled to a discount on their prescriptions with use of an approved Medicare Drug Discount card. Most major drug stores offer these cards, as do the insurance companies and some advocacy organizations. The enrollment fee is usually about $20 or $30 and each provider offers about 70 – 100 drugs at discounted prices. Each person is only entitled one Discount card – so compare your options before deciding on which card you will get. 
  
• Before you chose your card, there are two ways to determine your savings – through your pharmacy, or though on online comparison program offered by Medicare. Your pharmacist can tell you if your drug store participates in any Medicare drug discount card programs, and which would provide the best coverage for you. As the pharmacist what your prescriptions would cost using that care and for the brochure or phone number for the care provider.
  
• If you have access to the Internet, go to www.medicare.gov and click on the drug discount topic. Follow the instructions listed. You will need to have a list of all your prescription drugs, the dose of each, how often you take each one, and the current price you are paying. You also need to enter your income level and if you are receiving any forms of assistance. You do not enter any personal information such as your name or social security number, however, so the process is anonymous. The program will help your pick pharmacies near you by zip code and will make suggestions as to which plans would meet your personal needs.
  
• Industry-related drug discount cards. Some pharmacies offer their own discount cards to low income and Medicare enrollees. These cards are free and provide discounts on the drugs from the company that issues them. You can find a list of manufacturers that offer such a program at www.rxassist.org.   This Web site is a program of the Robert Wood Johnson Foundation and also contains information about the Express Scripts RX Outreach program, which offers generic drugs at a discount to families with lower income.
  
• Some pharmaceutical companies offer discount to Medicare enrollees through the Together RX card, which provides a 20% – 40% savings on brand name prescription drugs offered by the participating pharmaceutical companies and a 14 % discount on generic drugs at participating pharmacies. You can read a list of more than 150 drugs on their Website www.togetherrx.com. The card is free and can be used by anyone who has a Medicare drug discount card until January 2006.
  
• Contact your state health department to find out if they offer pharmacy assistance program. The National Conference of State Legislatures’ Web site provides links and phone numbers for these date programs. Go to www.ncsl.org/programs/health/drugaid.htm and look at Table 1. 
  
• Some pharmaceutical companies run drug-specific programs. If you have one medication that is very costly, call the manufacturer and ask them if they have such a program available.

Internet Support

The Internet is most likely the fastest most convenient way to access the most information in the shortest amount of time. Look into the Websites listed below to help you meet the financial burden of prescription medications:

• RX Hope:  http://www.rxhope.com/
• Project of PhRMA - Pharmaceutical and Research Manufacturers of America:  Includes patient assistance programs – searchable by the name of the drug, state, or drug manufacturer.  http://www.rxhope.com/pap_info.asp 
• Advanced Search is a powerful tool that will help you determine your eligibility for both State-Sponsored and Company-Sponsored Patient Assistance Programs depending on which medication you need. http://www.rxhope.com/papinfo/pap_advanced_search.asp?start=true 
• Needy Meds:  This site is designed to provide information about patient assistance programs that provide no cost prescription medications to eligible participants.  http://www.needymeds.com/
  • State Programs
  • Local Programs
  • Fee-For-Service Programs
  • Discount Drug Cards
  • Medicaid Sites
  • Federal Poverty Guidelines
  • Other Useful Forms
  • Articles on Patient Assistance Programs
    
• RX Outreach:  Rx Outreach is an easy and affordable way for people of all ages to get medicines they need. Through this program, people who qualify financially can get more than 50 generic medications that treat a wide range of conditions including diabetes, asthma, heart disease, and depression. People may take advantage of the program even if they receive medicines through another discount program. The program is available to individuals and families with incomes of up to 250 percent of the federal poverty level. For a family of four, this figure is about $47,000 per year. http://www.rxoutreach.com/en/