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What you should know about prescription supplements

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Dietary supplements are available over the counter. So why do prescription versions exist?
Written by Sara Gaynes Levy
Updated on July 16, 2021

To ensure your body gets the essential vitamins and minerals it needs, it’s important to eat a healthy, well-rounded diet. But sometimes you may need a little help. Enter dietary supplements: pills, capsules, gummies and tinctures that contain concentrated doses of specific compounds intended to keep your body running smoothly.

Broadly speaking, there are 2 classes of dietary supplements. First, there are the over-the-counter (OTC) supplements you’re probably most familiar with. These include vitamins, minerals, herbs and more. You can find them on shelves in drugstores and grocery stores, as well as online.

Anybody can buy OTC supplements. That sets them apart from prescription supplements, which you can purchase only with a prescription from your doctor. (Don’t forget: Optum Perks can help you save money on prescription medications. Just download our discount card and present it at checkout.)

So why do the 2 classes exist? To find out, we turned to Monika Nuffer, PharmD. She’s a senior instructor in the departments of clinical pharmacy and family medicine at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora.

What’s the difference between a prescription supplement and one that’s over the counter?

Nuffer: All prescriptions go through a review process with the U.S. Food and Drug Administration. It evaluates safety and efficacy, and once a prescription has been approved, it can be prescribed by a doctor.

And the precaution doesn’t end there. The FDA continues to regulate approved prescriptions for safety. Providers, as well as consumers, can report any adverse reactions via the FDA’s MedWatch reporting system to determine if a product is unsafe and should be removed.

OTC supplements are a little different. They’re not regulated in the same manner. The FDA doesn’t evaluate them for safety or efficacy, so we can’t say for sure that the label accurately reflects what is in the product. Is it really 500 milligrams of ginseng? Did they use the right part of the plant? Did they harvest it at the right time of year? We don’t know.

That doesn’t necessarily mean OTC supplements are harmful. But they might not work the way you expect them to. The quality just might not be the same as it is with prescriptions.

What are some situations where your doctor might prescribe a supplement?

Nuffer: Say you’re receiving an annual blood test and your doctor finds that you are deficient in certain vitamins or minerals. If it’s a mild deficiency, maybe they recommend an OTC product. If it’s more serious, they might prescribe a supplement.

The doctor might also prescribe a supplement if you’re taking medication that has the potential to deplete a certain vitamin or mineral you need. With a prescription, the doctor can be sure you’re getting a supplement that’s appropriate for your situation, and they can help monitor its effects. [Suggested reading: 7 reasons why you might need more vitamin B.]

What are some of the most commonly prescribed supplements?

Nuffer: Vitamin D is probably the most popular example. Calcium is another one that is frequently given for bone health. Folic acid and fish oil [omega-3 fatty acid] may also be part of a treatment plan. [Click each supplement name to access instant coupons.]

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Will insurance cover my prescription supplements?

Nuffer: That’s difficult to answer since there are different types of insurance. Medicare will in many situations. When it does, it might actually be cheaper to purchase a prescription supplement over an OTC product.

If you realize that something isn’t covered by insurance, you should explore your options. Sometimes a provider writes a prescription for something that isn’t covered by a patient’s insurance. In that case, the pharmacist might go back to the doc and ask if they can switch it for something that is covered. [You can use the Optum Perks app to access discounts on many prescription supplements too. Download it now.]

If you’re already taking OTC supplements, is it worth asking your doctor to prescribe prescription versions?

Nuffer: In some cases, yes. For example, if you’re pregnant and need a prenatal vitamin with folic acid. Maybe you can’t afford the supplement, but you have prescription coverage. In that case, you might go the prescription route. Some of our Medicare patients know they can get vitamin D under a prescription, so they do that to avoid paying out of pocket.

Everybody has different reasons, but it’s really important to talk about what you’re taking and what you need with your doctor or pharmacist. You want to make sure they’re safe for you personally. [Here’s what to do when your prescription isn’t covered by insurance.]

How can I tell if an OTC supplement is reliable?

Nuffer: There are a few great organizations striving for good, safe manufacturing practices. They’re trying to have that extra level of stringency. U.S. Pharmacopeia is one. [ and NSF International are others.]

If you see the seal for one of these companies, you can feel confident that the supplement has been evaluated to ensure pill-to-pill, bottle-to-bottle, what is on the label is in the product. I always suggest that patients pick 1 of these, because that provides some reassurance that it’s a better-quality product than those that have not been evaluated. [If you can’t find the seal you’re looking for, you can always ask your pharmacist to point you to a high-quality brand.]

So the question might be,If a supplement doesn’t have a seal, is it bad?” Well, it’s hard to say. Either that product was never tested, or it didn’t pass. With the seal, you at least know it meets a third-party standard. I also tell patients, “If it sounds too good to be true, it is.” You can’t lose 15 pounds overnight, regardless of what a supplement promises.

[Optum Perks can help you save money on prescription supplements. Download our app to start saving.]

Additional source
Overview of dietary supplements:
National Institutes of Health