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

Strategy 4: Consider Generic-Drug Programs

While generic drugs are considered the cheaper alternative to brand-name medications, many patients may still find themselves struggling to afford these.

Generic-drug programs (GDPs), offered by pharmacy chains, provide discounts primarily on generic medications per a program-specific discount formulary. Patients may be able to save money on their medications by paying the GDP price instead of their medication copay through their insurance or the full out-of-pocket price if they are uninsured. These programs have specific eligibility requirements and a variable list of medications that are discounted through their program.

Because GDPs are not insurance plans, it is important that patients with insurance inform their pharmacy to bill the GDP for their prescriptions rather than their primary insurance.

Some GDPs also publish the estimated patient out-of-pocket cost of medications within the GDP on their website.

The majority of GDPs do not have an annual enrollment fee, and each of these programs can serve as a great aid to patients who are struggling with medication copays or out-of-pocket medication costs.

Some common GDPs are described in Table 1.

Table 1. Examples of Generic-Drug Programs in the United States [2,3,4,5]

Pharmacy Cost per Medication* Annual Enrollment Fee Medicare Part D–Eligible?
Walmart[2] $4-$10 Free Yes
Rite Aid[3] $10-$20 Free Yes
Costco[4] Variable Free Yes
Walgreens[5] $5-$30 $20 (individual)
$35 (family)
No
*Costs may be higher based on circumstance

Patients might benefit from a GDP based on their insurance coverage:

  • Uninsured: GDP price for a medication may be significantly less than the cash price for the same medication.

  • Insured: GDP price for a medication might be less than the standard medication copay dictated by the patient's insurance provider.

  • Medicare Part D: GDPs can help Medicare Part D patients avoid the coverage gap, also known as the "donut hole," whereby copays are higher than in the initial coverage period. Patients reach the donut hole when the total annual drug cost billed to the Part D plan reaches a defined amount (for 2017, the amount is $3700). By billing separately through a GDP, the cost of the medication does not add to the total annual drug cost in the Part D plan. This allows Medicare patients to extend their time in the initial coverage period.[6,7]

Table 2 summarizes the price a patient would pay for a 30-day supply of lisinopril 10 mg using a GDP.

Table 2. Estimated Out-of-Pocket Cost for 30-Day Supply of Lisinopril 10 mg

Insurance Coverage Out-of-Pocket Cost GDP Price[2,3,4,5] Amount Patient Saves
Uninsured $12-$16[8] $4-$10 $2-$12
Private insurance* $5-$10[9] $4-$10 $1-$6
*Based on BlueShield of California copays

Strategy 5: Consider Drug Savings Cards

Drug savings cards are similar to GDPs. Both offer discounts on generic and some brand medications, but drug savings cards must be accessed online versus through a pharmacy chain. Examples include GoodRx®, WebMD®Rx, UNA Rx, and AARP® Prescription Discounts.[8,10,11,12] These cards can be given as a printed card or shown as a digital image on a patient's cellphone to most pharmacies for medication discounts. The discounts offered by these drug savings cards might differ from the GDP discounts; therefore, patients should evaluate this according to their situation in order to maximize savings.

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