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Tips on Lowering Drug Costs

Tips on Lowering Drug CostsRecently, a caretaker posed a question recently that highlighted the serious issue of seniors' inability to afford prescription drugs. The question asked, 'How can I find low-cost drug programs for my grandfather?'

'I have recently started caring for my elderly grandfather who lives on a very limited income. He has been prescribed Zocor for cholesterol problems, but this medication is so expensive it is becoming a choice for a place to live or his medication.'

Online Resources for Low-Cost Drugs

  • State Pharmaceutical Assistance Programs: a convenient way to find out if your state has a program to help pay drug costs.
  • RX Hope: research, government and corporate-sponsored patient-assistance programs for over 1,000 medications.
  • Together Rx Access: savings card for people who are not eligible for Medicare and have no prescription drug coverage.
  • PSCard: discount drug card that's free and accepted at 53,000 pharmacies nationwide.
  • The Cost Containment Research Institute: free, downloadable book (also available via mail) titled "Free and Low-Cost Prescription Drugs," which includes 103 free and low-cost programs and 1,104 drug listings.
  • My HealtheVet: an online web-based service for personal health records and prescription refills for veterans.

Studies have shown that many older patients with chronic health problems are cutting back on their medications because they cost too much, not only impairing their daily functioning, but also endangering their lives. In 2009, the nonpartisanSenior Citizens League conducted a study in which 42 percent of the participants said they had either postponed filling their prescription medications or were taking a smaller dosage than prescribed by their physicians, due to the economic recession. Fortunately, low-cost prescription drug options are available for seniors through pharmacies, drug manufacturers and/or government-assistance programs.

Pharmacies

A survey by agingcare.com found that prescription drug prices can vary by as much as 35 percent from one store to another. The survey compared Walgreens, Costco and Target. In one case, 50 mg of Levoxyl cost $14 at Target, $35 at Costco and $42 at Walgreens, but for other drugs, the stores offering the lowest costs were reversed. This means that the drug user needs to contact different stores to find the cheapest prices.

The downside of purchasing prescriptions based solely on cost is not being able to use one trusted pharmacy. One woman commented, on agingcare.com, 'My husband has made a habit of going to the local pharmacy because the pharmacist is his 'buddy.' No doubt this has cost us tremendously. But I do not think we are alone in this situation. Local pharmacists can make it easy to do business'they provide advice, counsel and a more personal face on a difficult medical situation.' Also, using the same pharmacy means that the pharmacist is aware of other drugs being taken and can warn the customer in case one interferes with another or if combining certain drugs may cause harmful effects. (See The Risks of Taking Too Many Drugs in this issue of Senior Spirit.)

Drug Manufacturers

In some cases, drug companies themselves are willing to lower prices on some medications for seniors.

The Minnesota Department of Health has some suggestions:

  • Manufacturer programs for free prescription drugs. Limited prescription drugs are available from drug manufacturers for free or for a small co-payment. Often the doctor who writes the prescription must contact the drug company to provide information about his patient and his/her prescription. Websites provide information such as which pharmaceutical companies offer assistance programs, the prescription drugs covered by each program, how to make a request for assistance and the program's eligibility criteria. Usually the drug company delivers a three-month supply to the doctor, who may need to reapply periodically to continue receiving the prescriptions. For more information, people should talk to their doctors about these types of programs.
  • Partnership for Prescription Assistance. This website states it is a 'single point of access to more than 475 public and private patient assistance programs, including nearly 200 offered by pharmaceutical companies.' This resource provides information to access programs for more than 2,500 prescription drugs. From the home page, 'Get Help' displays programs, the products covered by the programs and application downloads for the programs. 'About Us' offers a directory of the companies offering prescription drugs and their programs. There a 'Frequently Asked Questions' section provides information about how the programs work and who is eligible. Help is also available by phone to find out if someone is eligible. In addition, the site lists co-payment programs that provide financial assistance for certain healthcare costs to patients who qualify financially and medically. Visit the website or call 1-888-477-2669.
  • NeedyMeds.com. This resource provides information on programs that offer lower priced drugs. 'Patient Assistance Programs,' 'Generic Name Drugs' or 'Brand Name Drugs' shows which drug is listed and which programs may be available. Click on 'Company List' for a list of companies that have and do not have prescription assistance programs. The website includes information on disease-based assistance, free/low-cost clinics in each area and discount drug cards.
  • RxAssist. After registering online, this site can be used to locate patient assistance programs. Search its database of prescription drugs by drug name or by the name of the company that manufactures the drug. Some requests can be completed online. The 'Frequently Asked Questions about Patient Assistance Programs' section provides a more detailed explanation of how these programs work. There are eligibility requirements for this program, which is sponsored by Volunteers in Health Care and supported by the Robert Wood Johnson Foundation. Call 1-877-844-8442 or 401-729-3284, or visit the website.
  • Together RX Access Program. Ten pharmaceutical companies sponsor this prescription savings program. A free card is available by application, which provides a savings of 25 to 40 percent on some brand-name prescriptions and certain products. The amount saved depends on the prescription drug purchased, the quantity purchased and the pharmacy where the drug is purchase. Depending on the pharmacy, money can be saved on generics as well. There is no cost to enroll or use the card, although there are eligibility requirements, including an income limit. Also, participants cannot be eligible for Medicare or have any prescription drug coverage. Call 1-800-444-4106 or visit the website.

Individual manufacturers have their own patient assistance programs:

Federal Government Programs

  • Medicare Part D. Medicare approves companies to sell Medicare Part D prescription coverage to Medicare enrollees, and the Medicare website lists plans for each area. These plans must cover certain drugs, so enrollees must be sure the plans cover his or her specific medications. Enrollees pay a premium to the health plan providing this prescription coverage. Medicare enrollees need to sign up within a certain time period of being eligible or must pay a late penalty the rest of the time they are enrolled.

Low-income enrollees may be eligible to receive help paying for their Medicare Part D prescription coverage. This assistance is called 'Extra Help' or 'Low-Income Subsidy.' Enrollees may qualify for the full subsidy or a partial subsidy depending on income and assets. With a full subsidy, enrollees do not pay a deductible and have lower co-pays for prescriptions. Depending on the plan chosen, there may be no premium. With a partial subsidy, the deductible is lower, the co-pays are lower and the premium is lower. Call Medicare at 1-800-633-4227 (1-800-MEDICARE) or visit its website.

For information and an application for 'Extra Help', go to the Social Security Administration website or call 1-800-772-1213 to access the Social Security recording and hear eligibility information regarding Medicare prescription drug benefits and to request an application for help with Medicare prescription drug plan costs.

You can also download the recent SCSA educational webinar More About Medicare and Changes in 2014, which will help navigate you through the complexities of Medicare.

  • Veterans. Veterans may receive medications (even for non-service connected conditions) prescribed by a Department of Veteran Affairs (VA) physician through their VA health benefits. Many factors determine whether a co-pay is required and how much it will cost. Contact your VA healthcare facility, call 1-877-222-8387 or visit www/va.gov/elig.

For further information, download Understanding Veterans Benefits: A Guide for Seniors, a comprehensive guide that contains a wide breadth of practical tips and valuable resources to save you time in navigating the maze of veterans benefits.

  • Retired military personnel. Those 65 years and older (enrolled in Part B Medicare) have retail and mail-order drug benefits under 'TRICARE for Life' with a small co-payment. For more information, call 'TRICARE for Life,' 1-866-773-0404)

State Government Programs

For a number of years, states have assisted with prescription drugs, to help residents who lack insurance coverage for medicines or who are not eligible for other government programs, according to the National Conference of State Legislatures. By 2009, at least 42 states had established or authorized some type of program to provide pharmaceutical coverage or assistance to low-income seniors or persons with disabilities who do not qualify for Medicaid. However, several of those programs are not currently operational. The subsidy programs that still exist, often termed "SPAPs," utilize state funds to pay for a portion of the costs, usually for a defined population that meets enrollment criteria.

In addition, an increasing number of states use discounts or bulk-buying approaches that do not spend state funds for the drug purchases. These prescription drug discount programs, sometimes termed Rx Buying Clubs or Discount Cards, generally rely on the large-volume purchasing power of the state to negotiate a sizable discount on a wide selection of prescription products, brand-names and generics. The consumer still pays the resulting discounted price at the pharmacy counter; the state is not involved in individual transactions. Unlike most subsidized SPAP programs, there is no comparable federal program or federal regulation affecting these discount plans. Drugs purchased in this way do not count as part of Medicare or Part D calculations.

Contact your state health department to see if it offers such programs.