When you’re hit with a diagnosis that has the words “heart” and “failure” in it, it’s natural to feel overwhelmed. After all, your heart is your engine. It pumps oxygen and nutrient-rich blood throughout your body. And when it can’t keep up, your body may not get the fuel it needs.
Over time, everyday activities can become more and more difficult. That sounds serious — and it is. But there’s a lot you can do to tackle it head-on.
“Medicines play a very important role in the treatment of heart failure,” says Steven Kheloussi, PharmD. He’s an assistant professor of pharmacy practice at Wilkes University in Wilkes-Barre, Pennsylvania. Medication can help you feel better and prevent the condition from getting worse in the long run.
But keeping up with medications isn’t always easy, especially when it comes to cost.
“The price of medications can vary widely depending on which one you need and where you get it from,” says Kheloussi. And this can make sticking with treatment plans tough. In fact, a study in JAMA Internal Medicine found that the price of 3 popular generic heart failure medications ranged from $12 to nearly $400.
Some people have few or no symptoms of heart failure, says Kheloussi. So if they’re forced to choose between buying their heart failure prescription and, say, another medication that could bring them more relief from a different condition, they may choose the latter.
What can you do to make affording your heart failure medication easier — and protect your long-term health? Here are 5 price-reducing strategies.
(First, check out our free app. You can use it to find discounts on prescription medications, 24/7.)
Ask your doctor about cheaper options
“It’s natural to not want to express concerns about cost with your doctor,” says Kheloussi. But keeping your struggles to yourself may mean missing out on serious savings, especially when it comes to heart failure medication.
There are a lot of medications out there that have been shown to help with heart failure. And that’s a good thing: If one is too expensive, there’s likely a similar (and cheaper) alternative to try.
For example, the medications doctors prescribe first for heart failure are generally interchangeable, says Kheloussi. These first-line medications are split into 3 classes:
- Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax veins and arteries, lowering blood pressure. This makes it easier for your heart to pump blood. Examples include lisinopril (Prinivil®, Zestril®, Qbrelis®) and ramipril (Altace®).
- Angiotensin II receptor blockers (ARBs). These have a similar effect to ACE inhibitors, but they work in a slightly different way. Examples include losartan (Cozaar®), valsartan (Diovan®) and candesartan (Atacand®).
- Angiotensin receptor–neprilysin inhibitor. This is a new class of heart failure medication that’s been shown to be very effective in clinical trials. So far, there’s only 1 option, called Entresto®. It’s a brand-name medication that does double duty. It increases the level of proteins that widen blood vessels, and it blocks the proteins that narrow them.
Generic medications will usually be cheaper than brand-name ones. So if you’re on, say, Entresto and are having trouble footing the bill, ask your doctor if switching to a generic ACE inhibitor or ARB would work for you instead.
Your doctor has the final say in what medications are right for you. But with open communication, they can often prescribe medications that cost less.
Understand your insurance coverage
Have questions about whether a medication will be covered? Call your insurance company. “They can usually tell you how much it will cost at your local pharmacy,” says Kheloussi.
Your insurance company’s medication formulary is another great resource for seeing which ones may be covered, adds Kheloussi. It’s a list that generally divides medications into 3 or 4 tiers.
The formulary will list medications and say which level of coverage you have on each. It won’t necessarily say how much you’ll end up paying on each tier, but it’s a good place to start. Typically, the medications in tier 1 are generic — and the least expensive. Those in tier 4, on the other hand, tend to have the highest cost.
For example, let’s say that your doctor is trying to choose an ACE inhibitor for you. One is in tier 3, while an equally effective option is in tier 1. You can ask to be prescribed the medication that will be best for your wallet.
Be sure to review your insurer’s formulary every year, as prices and plans can change.
