7 Strategies to Reduce Prescription Drug Costs

Tamara Cisowska, PharmD Candidate; Sarah Vergara Pasetes, PharmD Candidate; Jennifer Phun, MS, PharmD Candidate; Micah O. Ahazie, PharmD Candidate; Marilyn Stebbins, PharmD

Disclosures

May 22, 2017

Many patients, even those with insurance, have difficulty paying for their prescription medications.[1] What assistance is available? This seven-part strategy can help healthcare providers play a vital role in making medications more cost-effective for their patients.

Strategy 1: Ask Patients Whether They Can Afford Their Medications

You may never know unless you ask. It is important to initiate and navigate financial discussions with your patients. To start, find out which types of drugs they are having difficulty affording, and then identify opportunities to purchase those drugs at a lower price. This will help patients save money and increase medication adherence.

Strategy 2: Determine the Patient's Insurance Coverage, if Any

Most patients fall into one of three major categories of insurance coverage:

  • Private insurance coverage: Patients are covered by a health plan through their state's health benefit exchange or through their employer.

  • Government insurance coverage: Patients have health insurance coverage through one or more of the following government-subsidized entities: Medicare (including Part D), Medicaid, Veterans Health Administration, or TRICARE.

  • Uninsured: These patients do not have health insurance, or their insurance does not cover a particular medication.

Insurance status dictates which cost-saving strategy can be used; some of the aids described in strategies 3 and 4 have specific restrictions regarding the type of insurance a patient must have in order to benefit.

Strategy 3: Navigate the Medication Formulary

A formulary is a list of medications covered by a health insurance plan. Prescribing drugs on formulary will guarantee that your patients are receiving the best price with their coverage. Many formularies can be found online, including Medicare Part D plans, which are found through Medicare Plan Finder. Formularies provide such information as which alternative medications are covered, restrictions, and quantity limits.

Combination medications also may benefit patients. Using a combination medication instead of two separate medications can reduce the patient's pill burden and monthly copays.

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