The cost of prescription drugs in the United States may be enough to make you sick.
What you pay varies greatly depending on the drug, pharmacy, your insurance plan, and your deductible, among many other factors. A drug that was cheap or at least affordable the last time you filled it may be much more expensive or not covered at all the next time.
Often, people have no idea how much a prescription will cost until they get to the pharmacy counter, says Lee Purvis, director of health care costs and access to the AARP Institute for Public Policy.
However, finding a way to afford your medications is important. People who don’t take medication as prescribed because of the cost may end up getting sick – or dying.
“What might be a relatively small problem today, like high cholesterol, could turn into a bigger problem like a heart attack in the future if you don’t treat it,” Purvis says.
Check with your doctor and insurance plan
Your doctors may not know the cost of your medications, since they deal with dozens of insurance plans with different formulations, or drug lists, and how they are covered, Purvis explains. Additionally, insurance companies may make deals with certain pharmacies, so a drug that costs $60 in one may cost $160 in the other.
If delivering a medication is a challenge, your doctor may be able to suggest alternatives, such as a generic medication or a different type of medication. There are two other questions you can ask: whether the medication you’ve been taking for a while is still necessary and what lifestyle changes might reduce or eliminate the need for prescriptions.
If you have insurance, review your drug coverage options carefully each year at open enrollment—that annual period in the fall when you choose your health insurance for the following year. Make a list of all medications you take along with their doses, and check how they are covered in each plan. Insurance companies change formats regularly, so you may need to switch plans to get the best coverage. And even if your medications are covered, you will usually have to pay out of pocket for prescriptions to reach your discount amount.
Your insurance company or pharmacy may offer the option to order by mail to reduce costs, but don’t assume this is your best option. Shopping around can bring significant savings.
See prices online
Start searching online. The number of online pharmacies has mushroomed in recent years, giving you more opportunities to save.
Amazon launched a full-service pharmacy in 2020, joining more established dispensaries, such as Costco.com And the HealthWarehouse.com. Besides, several limited-service startups — including Cost Plus, GeniusRx, Honeybee, Ro Pharmacy, and ScriptCo — are offering deals on generic drugs.
Startups usually don’t get insurance, but their prices can be lower than the usual co-pay, according to Consumer Reports. For example, Consumer Research has found that a 30-day supply of 20 milligrams of atorvastatin — a cholesterol medication — ranges from $14.60 at Amazon to $13.99 at Costco.com, to $3 at Honeybee and just 54 cents at ScriptCo. By contrast, insurance payments to workers with coverage for prescription drugs averaged $11 to $12 last year for less expensive drugs, including many generics, according to the KFF, a nonpartisan health care think-tank previously known as On behalf of the Kaiser Family Foundation.
Your savings may be offset by membership fees: an Amazon Prime membership — which you’ll need if you want the lowest prices — is $139 a year or $14.99 a month, while ScriptCo charges $140 a year or $50 per quarter. Costco’s membership fee is $60 per year, but you don’t need to be a member to order prescriptions online or at their warehouse stores.
Check out other discounts
GoodRx has a website and app that lets you compare prices at nearby chain pharmacies, and offers free coupons that can save up to 80 percent off the list price. Another price comparison tool you’ll find includes local pharmacies at NeedyMeds, a non-profit organization that helps people find drug manufacturing discount programs and other ways to reduce drug costs. In addition, many chains including Walgreens, Walmart, Kroger, and HEB have discount programs.
One often-overlooked alternative for Medicare recipients, Purvis says, is the Supplemental Assistance Program, which aims to help seniors with limited incomes and resources pay for their medications. You can apply online or by calling 800-772-1213.
Watch out for drug interactions
Finding the best price can take significant time and effort. Purvis warns that people who shop aggressively for less expensive drugs may face a hidden danger if they get multiple drugs from different pharmacies. Without a single pharmacist to oversee their care, they risk adverse drug interactions.
You can use an online drug interaction checker like the one on WebMD, but it’s best to ask your primary care physician or pharmacist to review the full list of medications at least once a year.
“Making sure someone cares about the big picture is really important,” Purvis says.