Photo (cc) by e-MagineArt.com
During the decade I spent working in a doctor’s office, the most common complaint I heard from patients was the cost of medications. The doctor helped by getting patients off unnecessary medications. The staff helped by teaching patients to find necessary medications for less.
I’ve taught dozens of patients the same steps that I and my parents (he’s a cardiologist/pharmacologist and she’s his office manager) take when we purchase medications. The following steps will help you find your medications at the lowest possible price from reputable American pharmacies – whether you have health insurance or not.
1. Try generics
As we’ve told you before, switching to a generic version of a brand-name medication is probably the No. 1 way to save money on medications. Sometimes a generic is unavailable, and sometimes a generic doesn’t work as well or causes unwanted side effects for certain patients. But most of the time, the generic is just as good as the brand, so talk to your doctor. If need be, see 3 Ways to Convince Your Doctor to Prescribe Generics.
2. Forget the clubs
Over the last few years, an increasing number of generic medications and online pharmacies have made medication prices more competitive. But a few pharmacies, like Kmart and Walgreens, have decided not to compete. Instead, they attract customers with “prescription savings clubs.”
In other words, they charge customers an annual fee in exchange for access to medication “savings,” but the truth is that other pharmacies often sell the same medications for less – no fee necessary. After all, if these types of pharmacies really offered the greatest savings, they wouldn’t need to suck you in with gimmicks.
3. Re-think your copay
If you pay an insurance copay for your medications, you could be overpaying. Insurance companies usually charge a flat copay rate of at least $10 or $20, but some medications cost as little as $4 (see No. 4 below). So even if you have insurance, you should still comparison shop – and make sure to compare out-of-pocket and with-insurance prices.
4. Compare prices online
If it’s not there, compare the price of your medications at reputable U.S.-based online pharmacies, starting with Costco‘s. My office manager mother finds that Costco usually offers the lowest prices. Plus, you don’t have to be a member to use their online pharmacy.
Other reputable sites include Drugstore.com, FamilyMeds.com, and HealthWarehouse.com. If you’re unsure whether an online pharmacy is reputable, look for the National Association of Boards of Pharmacy’s Verified Internet Pharmacy Practice Sites symbol on their site, or enter their website address into NABP’s verification site.
5. Consider different quantities
Like other goods, medications are often cheaper in bulk. For Target’s and Walmart’s $4 generics, for example, you can get a 90-day supply for $10 – that’s 17 percent less than paying $12 for three 30-day supplies. For other medications, especially those bought from an online pharmacy, the savings may be even higher.
If you find this is true of your medications, nicely ask your doctor to write your prescriptions for 90-day supplies or greater. Make sure you explain how the switch will save you money – because your doctor may assume you’re just trying to get more pills so you don’t have to see him as often.
Be willing to accept a prescription without refills too: A 90-day supply with no refills is the same as a 30-day supply with two refills.
6. Consider different strengths
When you compare a medication’s price at different pharmacies, be sure to compare every pill size that each pharmacy sells – because certain sizes are cheaper than others.
For example, a 30-day supply of the antidepressant sertraline (brand name: Zoloft) in the 50 mg size is currently $12.99 (43 cents per 50 mg dose) at Drugstore.com. But a 30-day supply of the 100 mg size is only $15.99 (27 cents per 50 mg dose).
Your doctor may not have taken this into consideration when prescribing, however. So if you discover that a medication would be cheaper if your doctor prescribed it differently – for example, 15 100-mg size pills to break in half instead of 30 50-mg pills – nicely ask him to rewrite the prescription so that you can avoid unnecessary medical expenses.
7. Make sure it’s safe to ship
Certain medications must be stored away from sunlight and heat. That’s why the thyroid medicine levothyroxine (brand name: Levoxyl, Synthroid, etc.) should not be left in your car, for example.
Such medications should not necessarily be ordered online, either. Getting the cheapest price is a waste of money if the medication arrives degraded because it baked in a non-air conditioned compartment for hours. So check with your doctor before ordering a medication online. Or just play it safe and purchase heat-sensitive medications at a brick-and-mortar pharmacy.
8. Think ahead
None of the online pharmacies mentioned in Step 4 charge for standard shipping – but there’s a catch. The free shipping option means your medications could take up to two weeks to arrive. At Costco, for example, the delivery time for standard shipping is six to 14 days.
So if you want to pay the lowest price possible, you can’t wait till there’s one pill left in the bottle to think about ordering a refill. My family and I always order refills at least two full weeks before a prescription runs out. An easy way to remember to do this is to mark the last-two-weeks window on your calendar every time you first receive a new bottle in the mail.
9. Compare prices online – again
With the exception of $4 generics, prescription prices fluctuate frequently – often by enough that the pharmacy you ordered from last time may not have the lowest price today. So before you ask that pharmacy to refill a medication, take a few minutes to repeat these steps. Just don’t wait until you’re down to your last few pills: If you decide to purchase from a different pharmacy, you may need to get a new prescription from your doctor.
10. Keep your receipts
The IRS includes prescription medications on its list of medical expenses that may be deducted if they total more than 7.5 percent of your income.