Rising prescription drug costs are hitting American families and small business health insurance plan sponsors hard.
According to the Department of Health and Human Services, the average cost of prescription drugs increased by more than 15% in 2023. For approximately 1,900 products, the price increase was more than the average rate of inflation.
It’s no wonder that so many people have a hard time paying for the drugs they need. Even people who have health insurance are feeling the pinch, thanks to deductibles and coinsurance costs.
Who This Blog is For
This blog is a must-read for anyone struggling to afford their prescription drugs, as well as anyone who would rather use their money for themselves and their families, instead of sending it to the pharmaceutical companies.
In this blog, you will learn about the high cost of prescription drugs, the impact of prescription drug costs on people’s health.
You’ll learn some practical, actionable steps you can take to reduce your prescription drug costs in 2024.
We’ll also provide tips for getting the most out of your health insurance coverage and working with your doctor to find the most affordable prescription drug options.
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A Vicious Cycle
Approximately 60% of all adult Americans take at least 1 prescription drug, and about 25% take 4 or more, according to the Kaiser Family Foundation.
Most Americans believe medication costs are out of control. And millions and have a hard time coming up with the money they need to pay premiums copays, coinsurance, and high deductible.
Some even admit to not taking all their medication as prescribed because of costs.
A 2023 study by the Kaiser Family Foundation found that nearly one-third of Americans have had to skip doses of their medications, ration their medications, or not fill prescriptions due to cost.
The study also found that these problems were more common among low-income individuals, minorities, and those with chronic conditions.
That leads to more expensive and more severe health problems down the road. It becomes a vicious spiral, forcing insurance premiums even higher, forcing lower-income Americans and smaller plan sponsors to tighten their budgets even further, causing even more hardship and forcing people to skip even more doses because of cost.
Fortunately, you aren’t completely powerless.
There are still some very effective steps you can take to reduce your exposure to high prescription drug costs, and still retain access to the lifesaving medicines you need to stay healthy.
1. Don’t Skip Meds!
It’s important to take all the medication your doctor prescribes.
If you skip doses or stop taking it completely, it could make your health issues worse. That can be even more costly!
Fortunately, there’s a better way to save money than just skipping doses of your prescribed meds. In this blog we’ve rounded up some great ways to work with your healthcare providers to find the most affordable prescription drug options.
2. Request Samples
Everytime you visit your doctor, ask for samples of the meds you are taking.
Most doctors have a supply of common prescriptions on hand that pharmacy reps have given to them. They want patients to try them in the hopes they will be effective, and that you’ll keep using them.
Sometimes doctors will remember to offer them to you. But if they’re busy, they might not think about it. So don’t be afraid to ask.
Not only will you be getting some free medication, but your doctor will also be clearing out some of their excess drug storage. It’s a win-win!
3. Join a Discount Membership Program
There are organizations out there committed to helping you get the best prices on drugs and other medical necessities.
One innovative example is the HSAAdvantagRX discount card.
This program helps save up to 80% on prescription drugs, and also provides discounts on labs, imaging, and other services.
Membership is free!
Just sign up for the program, download your card, and present it wherever you buy your drugs and other health services. You’ll notice the savings right away!
4. Seek Patient Assistance Programs
There are a variety of Patient Assistance Programs (PAP) out there run by pharmaceutical companies.
These programs are specifically designed to help people in need pay for costly medications.
Use a comprehensive database, such as RxAssist, to find programs that offer free or low-cost drugs. You’ll also find practical tools, news, and articles there to help you find the most useful cost-saving information.
5. Compare Insurance Providers
Depending on the specific drugs you take, you may have a much lower total out-of-pocket cost with one insurance carrier than another.
Here’s why: All ACA-qualified health insurance plans must cover:
- At least one drug in every U.S. Pharmacopeia category and class
- The same number of drugs in each category and class as the benchmark plan selected by the state.
So you should check your plan’s formulary – its list of covered drugs – to see what your drug or drugs will cost you during the year.
In general, a plan that includes the drugs you need to take on the formulary will cost less out of pocket for prescription drug benefits than a plan that doesn’t include your drugs.
Look at the drugs’ tier level, which will tell you what your out-of-pocket co-pays and coinsurance costs will be.
If your drug is not listed on the plan’s formulary, see if there is a generic equivalent listed. If so, it should be available at a relatively low cost.
If the generic is not listed on the plan’s formulary, either, you may check with your doctor or pharmacist to see if there’s another drug available that will have the same therapeutic effect for you – and see if that’s on the formulary.
It may make sense to use your insurance carriers’ preferred pharmacy, which may help you get better pricing.
Note: All ACA health plans must offer something in every pharmacopeia category. But that doesn’t mean they have to cover your specific drug, or any given drug, for that matter.
For example, they may include Lispro, a fast-acting insulin, but not Humalog, a more expensive drug in the same category.
It may be excluded altogether, or your plan may simply require a higher copay to fill that prescription.
If you want to take Humalog, rather than Lispro, or if your doctor recommends one or the other for some reason, you may want to shop around for another plan that includes Humalog.
6. Try Different Medications
Sometimes there’s more than one drug that can treat the same condition.
There can be a big cost difference between similar medications.
If your doctor prescribed a drug that is too expensive, or if it’s a drug your insurance doesn’t cover, ask your pharmacist if there’s a cheaper option. Then talk to your doctor about making a change.
Switching to a different but equally effective drug could save you hundreds each month!
7. Start a Health Savings Account
A Health Savings Account (HSA) is a powerful financial tool that can help you save money on medication costs.
They are designed to work with high-deductible health plans (HDHPs). Here’s how they can help:
- Pre-Tax Contributions. The money you put into your HSA is deducted from your taxable income. This reduces your overall tax burden.
- Tax-Free Withdrawals for Qualified Medical Expenses. You can withdraw money from an HSA for qualified medical expenses, including prescription drugs, and it’s tax-free! This means you can pay for your medications using money that has never been taxed. This is especially helpful if you’re in a high tax bracket, or if you have some major medical expenditures.
- Growth Through Investment. Any interest or investment earnings in your HSA accumulate tax-deferred for as long as the assets remain in the HSA.
- No “Use It Or Lose It” Provisions. Unlike Flexible Spending Accounts (FSAs) which force you to forfeit unused funds back to your employer after a certain period, your unused HSA funds can compound tax-deferred, year over year.
- Portability. HSAs stay with you even if you change employment, providing stability and continuity long-term.
Depending on your state and your income tax bracket, you could save 20 to 40% on after-tax prescription drug costs – and all other qualified healthcare costs – simply by paying using your health savings account debit card.
By offering tax advantages, investment opportunities, and the flexibility to carry over unused funds, HSAs provide a practical way to manage and reduce the cost of medications.
8. Switch to a Health Sharing Plan
If you’re in reasonably good health, and not benefiting from an Obamacare subsidy, look into a health sharing plan.
Health sharing plans are not insurance, so they don’t typically provide the same level of drug coverage that an expensive health insurance plan would. But their overall costs are usually more reasonable, and you have the freedom to choose any healthcare provider you want.
The leading plans have hundreds of thousands of members. Being part of a large group has its advantages. They use their power to negotiate big discounts with medical suppliers and drug manufacturers, and then they pass that savings onto you!
There are several key benefits to joining a health share plan:
- Members typically pay lower monthly contributions compared to traditional health insurance premiums.
- There are no network restrictions, and members are free to choose their own healthcare providers.
- Plans offer a wide range of sharing options, allowing individuals and families to select the level that best fits their needs, and their budget!
- There is more transparency, and members have a better understanding of how their contributions are shared.
- Many health sharing plans are founded on common ethical or religious principles, creating a community of members who share similar values and support one another.
- Most communities promote wellness and healthy living, which can lead to better health and reduced healthcare costs overall.
Learn More: How To Combine Health Sharing and Health Savings Accounts
9. Compare Pharmacy Prices
Surprisingly, prices for the same drug can differ greatly between pharmacies.
Call around and compare prices in your area. You might find cheaper options at smaller pharmacies. Location can also make a big difference!
It’s worth a little extra time to search around if it can save you a lot of cash.
10. Ask About Generics
Whenever possible, choose generic equivalent medications.
This might seem like an obvious choice. But people often forget to ask their doctor if the name brand they’ve prescribed has a generic option.
Generics generally work just as well as brand-name drugs, and have the same active ingredients. But they cost up to 85% less compared to brand-name drugs.
So ask your doctor or pharmacist about switching to generics.
Not all drugs have a generic version. Normally, generic manufacturers can’t make drugs until the original patent expires.
But if there is a generic available for the drugs you need, you can save hundreds or even thousands of dollars just by making this small change!
11. Search for Coupons and Discount Programs
Brand-name drugs can be expensive, but drug manufacturers often offer coupons.
Coupons can significantly reduce the price on name brand medications, and you can check the manufacturer’s website directly for special deals.
But if you want to make sure you’re getting the best bang for your buck, you need to shop a variety of sources. All the time.
Prices can change on a daily basis. And there is a lot of variability between discount providers. Here are some of the top programs we have found to get you started:
- HSA AdvantageRx. Save up to 80% on drug prices, and get discounts on labs, imaging, and other services. Membership is free for all HSAForAmerica members!
- The Mark Cuban Cost-Plus Drug Company. An innovative model that provides transparent pricing and information to help you save on hundreds of the most commonly-prescribed drugs.
- WellRX.com. This program is free to join and accepted nationwide at more than 65,000 pharmacies. Savings are typically between 65% – 80%.
- GoodRX. Find coupons at more than 60,000 US pharmacies with this well-known discount card. Download the app on your smartphone to make it even easier to check prices from wherever you are.
- WebRxMD. Locate your nearest pharmacy for convenient pickups, and find massive discounts in your area.
- MyFreePharmacy. Pay a low monthly subscription price of $29.95, and access hundreds of the most commonly-prescribed generic drugs for free! This is an excellent option for families using a lot of medications on a regular basis.
- USA Rx. This site offers a pharmacy discount card that can be used for pets also!
- SingleCare. A free service that helps you compare costs and get discounts.
- RxGo. Get discounts of up to 80% on prescription medications.
- BuzzRx. Use their free app and prescription discount card to get great discounts.
- RXSaver. Another great program that gives you free coupons and helps you find the best prices on prescription drugs.
These are just a few of the excellent discount programs available. Watch for new plans that pop up, and keep your options open!
12. Use Multiple Plans
Don’t settle for the first discount program you come across, and don’t feel like you can only use one at a time.
You can easily combine multiple discount plans to make sure you are always getting the best deal. Each plan has its own unique offerings, so putting the perks together can help you save the most money.
13. Take Advantage of New Insulin Price Caps
Until recently, a vial of insulin cost patients hundreds of dollars. Even those with insurance still had to pay deductibles and coinsurance costs amounting to hundreds or even thousands of dollars.
But now, the key manufacturers of insulin are limiting out-of-pocket costs of certain insulin products to just $35 per month per drug.
14. Order More Than One Month at a Time
Each time you submit a prescription, your pharmacist has to find the right drug, measure the correct dose, package it properly, and check all the paperwork.
You aren’t just paying for the drugs. You are also paying for the time and effort it takes to fill the order.
When you take certain drugs on a recurring basis, paying for your order month by month can really add up!
If you know you’ll be taking medication long-term, ask your doctor to prescribe more than just one month at a time. Some pharmacies will give you enough for 90 days or more.
Make sure they won’t expire before you take them. But the more you can order at a time, the less you pay per dose.
You can save a lot of money by getting as much as possible in each order.
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15. Order by Mail
Don’t forget you can order your medication online or by phone, and have it delivered by mail.
Mail order pharmacies often have the lowest prices, especially for long-term medications. Since they don’t have to pay for a brick-and-mortar store, they can pass the savings on to you.
You can bulk order so you’ll never run out, and they’ll deliver right to your door. How convenient!
Are you concerned about not having a pharmacist on hand?
There’s no need to worry. You can consult with a pharmacist whenever necessary, as most provide a number for you to call at any time.
Even if you need an emergency prescription filled immediately, a mail-order pharmacy can help. They often have arrangements with local stores so you can pick up a short-term supply at a nearby location while you wait for the rest of your order to arrive by mail.
When it comes to convenience and affordability, a mail-order pharmacy is hard to beat!
16. Buy From Other Countries
The FDA recently approved a plan for Florida to import millions of dollars worth of medications from Canada where prescription drugs are much cheaper than in the U.S.
This will allow state residents to buy drugs at a much lower cost. Other states may soon decide to do the same. If this trend continues, people will have wider access to more affordable drug options.
Currently, you can purchase a 90-day supply of medication for personal use from a foreign pharmacy.
Drug costs are nearly always lower in other countries, especially for name-brand drugs. Resources such as PharmacyChecker.com can help you find the best prices from the most reliable places.
Caution: You should be aware that pharmacies in other countries aren’t regulated in the same way as they are in the U.S. You’ll need to be careful, as some foreign pharmacies may sell expired, contaminated, or fake medications.
If the price seems too good to be true, it probably is.
But if you buy from countries with stricter regulations, such as Canada, Western Europe, Australia, and New Zealand, you’ll find some great prices.
17. Control Your Own Costs!
It feels great when you find ways to improve your own health and reduce your medical costs at the same time.
Knowledge is power. So be proactive, and do your research!
Ready to explore all the other ways you can save?
Make an appointment with a Personal Benefits Manager to discuss your best options.
The process is easy, and free! You’re under no obligation.
For Further Reading: How To Use Your HSA to Pay For OTC Medication | Why You Should Use Independent Doctors | At Last, You Can Combine Health Sharing With HSAs! | Get Help Paying for Prescription Drugs: A Guide to Patient Assistance Programs
