Help with the Cost of Medications

Prescription drug costs have been the fastest-growing health care expenditure, rising at double-digit rates each year for the 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 strain their resources.

Suggestions for Cost Savings

  • 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 costs (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”.
  • 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 any programs available.

Online Resources for Assistance with the Cost of Medication

Medicare subscribers use the Medicare Prescription Drug Plan Finder. This tool will allow you to find the Medicare plans in your state that include the medications you are taking. 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 how often you refill the prescription. You do not enter any personal information such as your name or social security number, so the process is anonymous. After all your medication information is entered, click “continue”. Your results will list all the (Medicare) insurance plans that include your medications and the number of pharmacies that participate in the plan. The program is also available in Spanish.

Industry-related drug discount cards. Some pharmaceutical companies offer their own patient assistance programs. These cards are free and provide discounts on the drugs from the company that makes them. You can find a list of participating manufacturers and medications at Rx Assist. This Web site was created by Volunteers in Health Care (VIH), a national resource center for safety net organizations. VIH operates out of the Brown University Center for Primary Care and Prevention in Rhode Island. You can also read about “Programs That Offer Free or Low Cost Health Care

If you do not have prescription medication coverage and are not eligible for Medicare, you may qualify for a Together RX card. This program provides a 20% – 40% savings on brand name prescription drugs offered by participating pharmaceutical companies and a 14 % discount on generic drugs at participating pharmacies. A list of covered drugs is available on the Website and the card is free to those who qualify.

Contact your state health department to find out if they offer pharmacy assistance program. The National Conference of State Legislatures’ Website provides links and phone numbers for State programs. Look at Table 1 (State Subsidy Programs) for New York’s EPIC (Elderly Pharmaceutical Insurance Coverage) program. Click on “Patients & Caregivers, then on “Start Your Free Online Patient Assistance Request” or on “Medications Search”. You can investigate by the name of a medication, a Patient Assistance Program, or a pharmaceutical company.

The Pharmaceutical and Research Manufacturers of America (PhRMA) hosts The Partnership for Prescription Assistance, which helps qualifying patients without prescription drug coverage get the medicines they need through the program that is right for them. Many patients will get their medications at no cost or at discounted prices. Website available in English or Spanish. PhRMA, located in Washington, D.C. represents the interests of the pharmaceutical and biotechnology industries in the United States.

Needy Meds

The Cancer Resource page on the NeedyMeds Web site a collaborative project of NeedyMeds and the American Cancer Society. It is intended to provide information on cancer and to streamline and simplify the way those with cancer may find assistance paying for their medications is designed to provide information about Patient Assistance Programs (PAPs) which are offered by pharmaceutical companies to help those most in need gain access to their medications at no or low cost.

RX Outreach is income-based and can be used regardless of your age or if you use another discount medicine program or patient assistance program. To use Rx Outreach, your income needs to be less than a certain amount of money each year. This amount differs depending on the number of financially dependant people living in your house. Currently, for a family of four, this figure is about $66,000.