How can physicians help patients keep prescription costs down? This is a very important and constantly changing problem.  Pharmaceutical companies have figured out how to get more money for their prescriptions.  Some ways to keep inflated prices are that there are limited alternatives to the medication (ex: lead poisoning treatment), older medications with few manufacturers (ex: EpiPen and colchicine), single manufacturer with no generic available (example: humalog insulin), “evergreening” or making slight changes to existing drugs to continue patent exclusivity (ex: ortho tri-cyclen or oxycontin).

It is the rare patient who is not plagued with high prescription drug costs.

How can your physician help manage high prescription drug costs?

• Choose low-cost generic drugs first.  There are many drugs available for $4/month (which may be a long-term medication or for a short course for a specific ailment).  I am a fan of the Walmart $4/month medication list. http://www.walmart.com/cp/4-Prescriptions/1078664.  This list can help to decide which medications could be obtained at Walmart for $4/month.  Consider asking your favorite pharmacy to match their price.
• Learn the costs of your medications.  Your physician may have you on a medication with no generic, but if there is a generic within that same medication class you can consider a switch.  If the generic is just as effective and without side effects, ask your doctor to change prescriptions. For example, there is a cholesterol-lowering medication called pitavastatin (not available in a generic form) for $3000 per year or a generic lovastatin available for $40 per year.
• Do not assume that your insurance will help lower the costs of medications more than paying cash for your medications (as if you had no insurance).  A name-brand medication may cost MORE with insurance than a generic without. Or at times a generic medication may cost MORE with insurance than paying without your insurance.  ALSO, there are some over-the-counter medications like acne cream that are less expensive bought off the shelf than from the pharmacist.
• If your physician’s office offers samples for a drug, consider that even though the samples are free… the medication (when you buy it from the pharmacy) may cost more than if you were started on a less-expensive medication.  When a pharmaceutical representative drops off samples at a physician’s office, those are most-often-than-not EXPENSIVE medications. Beware.

Did you know there are patient assistance programs?  NeedyMeds at www.needymeds.org or  RxAssist at www.rxassist.org help patients find assistance with drug costs.

Want to try a new medication?  Be wary. New medications may have unknown side effects or long-term complications AND are more likely to be expensive.  I understand that pharmaceutical companies need to recoup their research and development costs, but you can be a smart consumer and decide what you are willing to pay for your medications.  The relative safety, effectiveness, tolerability, price, and simplicity of new drugs are presented in the STEPS department in the American Family Physician (our family medicine go-to-journal) at www.aafp.org/afp/steps.

I have no relevant financial affiliations.

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