How to save on your prescription costs
Typically, drug prices generally rise twice per year. But in 2022, the increases were significantly higher than they have been in the past.
According to the Office of Health Policy, 2022 had a 10% rise in the first half of the year and a 7.8% rise in the second half.
With this in mind, it is important that you are able to access the very best prices possible when it comes to your prescription medications costs.
Ways to save on prescription costs
Prescription costs can add up, but there are a few different ways to try and keep those costs down.
If you have insurance, get to know your formulary
If you have an insurance plan with coverage for prescription drugs, you will likely have a formulary, also known as a drugs list.
A formulary is a list of drugs that an insurance plan will cover, and it will often include different levels, called tiers. Some plans may have many different tiers, but often there are three or four.
The table below looks at how the different drug tiers may appear:
|Tier 1 may include generic drug versions only or generic along with a few widely available brand-name drugs.
This tier may come with a 0% or low percentage coinsurance or copayment.
|This tier may include a wider selection of brand-name medications or brand-name drugs that the insurer prefers to cover. It can also include some generic options that have a higher price.
Tier 2 can come with a moderate percentage of coinsurance or copayment.
|Tier 3 can include drugs not included on an insurer’s preferred list. This could mean that the copayment or coinsurance is higher.
If you have a specific medical condition and need a prescription for a high-tier medication or for a medication that isn’t listed at all, it can be worthwhile discussing this with the insurer.
They may be able to create an exception, in which they agree to cover the drug, perhaps at a preferential cost.
Try prescription assistance programs
If your household has a limited income, you may be able to get some support when it comes to paying for the costs of prescription medication.
At the end of 2022, the National Conference of State Legislatures listed state pharmaceutical assistance programs by state, so you can easily find the information for your area.
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Get the Optum Perks Discount Card
The Optum Perks Discount Card is a free card you can download or print and take to a pharmacy to get your prescription at the website-listed price. It may be able to save you up to 80% on prescription drug costs.
There is also an Optum Perks Mobile App, available for iOS and Android. The app can store multiple drug coupons and remembers past options, making refills easier. You can also share coupons with family and friends, all at no additional cost.
Generic drug options are more cost-effective
When a drug is first approved, there is typically only a brand-name version available. This is because the manufacturer often conducts many years of research and testing to ensure a drug is safe and effective. This can also be the reason they are more costly.
After a certain amount of time, which can be up to 20 years, other manufacturers can make generic versions of the drug using the same active ingredients.
Generic drugs are often less costly because the original manufacturer has already completed the research and testing, so it does not need to be completed again.
Manufacturers may offer discounts
Manufacturers may offer exclusive discounts on their medications, and sometimes, this could save you more money than using an insurance plan.
It is worth checking with the manufacturer directly for further information, which they typically list on their website.
If you can, order a larger quantity so it lasts you longer
Speaking to a pharmacist about the quantity of a particular medication you can buy may benefit you, as you may get a bigger discount for buying more. Plus, the supply will last you longer.
Find a mail-order pharmacy for convenience
Mail-order pharmacies may help you to save money while also being convenient for those who live in more rural areas.
Some companies offer subscriptions
Subscription services may be available through some pharmacies. This could mean that they send your repeat items to your home automatically each time or send you a reminder when the items are ready for you to collect.
In July 2023, a poll by the Kaiser Family Foundation found that only 28% of Americans can afford their prescription medications, with 3 in 10 adults not taking their recommended medications because of the cost.
Additionally, between 2014 and 2018, some health plans in some states began using formularies with more tiers and added copayments or coinsurance. The reasoning for additional costs and medication availability was also unclear.
Future government legislation could help ensure prescription drugs are available and affordable for everyone, with insurers providing clear and straightforward rules on how their plans work.
There are many different considerations to make when you are thinking about your prescription medication and how to find the best price.
Drug types, discount cards, the amount you buy, and the kind of service you opt for may all play a part in cost-saving.
It is important that you get the doctor-recommended medication you need, and help is available from local state programs if you have a lower income household.
- Bosworth A, et al. (2022). Price increases for prescription drugs 2016-2022. https://aspe.hhs.gov/sites/default/files/documents/d850985c20de42de984942c2d8e24341/price-tracking-brief.pdf
- Hung A, et al. (2021). Formulary tiers, medication cost sharing, and transparency in bronze and silver-qualified health plans in 2014 vs 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391188/
- Kirzinger A, et al. (2023). Public opinion on prescription drugs and their prices. https://www.kff.org/health-costs/poll-finding/public-opinion-on-prescription-drugs-and-their-prices/
- State pharmaceutical assistance programs. (2022). https://www.ncsl.org/health/state-pharmaceutical-assistance-programs