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.
Explore manufacturers’ patient assistance programs
If you’re on a brand-name medication, it’s worth looking at the manufacturer’s website.
Many pharmaceutical companies have patient assistance programs that offer free or discounted medications to those who are uninsured or those with limited or no prescription coverage. While they’re not guaranteed and shouldn’t influence which medication you’re taking, they can be a good option, says Kheloussi.
Pharmaceutical companies may also offer copay assistance programs. For example, both Entresto and Farxiga have a copay card savings program. You may also be eligible for a free trial or other offers that aren’t necessarily based on income or insurance.
Try Optum Perks
Even if you have insurance, it’s always worth checking to see if there’s a lower price out there. And that’s where we can help.
By using negotiated prices with retail pharmacies, we’re able to secure discounts for almost every prescription medication out there that’s approved by the U.S. Food and Drug Administration. And then we pass those savings on to you through coupons and our discount pharmacy card.
To find coupons, all you have to do is search for your medication on our website or through our free mobile app. Show the coupons to your pharmacist and ask them to compare the Optum Perks discounted price to what you’d pay through your insurance (or out of pocket). With savings of up to 80%, the benefits may surprise you.
Take advantage of free treatments
You may not think of lifestyle changes such as exercising, cutting back on salt and quitting smoking as treatments. But they’re often one of the first things doctors prescribe to people with heart failure. “Sometimes, the best interventions are the ones you can do for free,” says Kheloussi. “But before implementing any changes, talk to your doctor.”
These lifestyle changes have the same goal as medications: to make your heart’s job easier. And that could help you cut back on your dosages or the number or heart failure medications you take.
Moving more can help you strengthen your heart and improve circulation. Eating less sodium and following a healthy eating pattern (such as the DASH diet) can help lower blood pressure. And quitting smoking can help keep your arteries clear of future buildup and improve heart failure symptoms, such as shortness of breath and fatigue. Here are some tips to help you kick the habit.
A heart failure diagnosis (and the price of treatment) can be scary. But you’re not alone. Know that you have options when it comes to medication and finding the best fit for you.
Heart failure medication costs: JAMA Internal Medicine (2017). “Variability in retail pricing of generic drugs for heart failure”