Surprising Ways To Save on Prescription Drug Prices in 2024.

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Working as a psychiatric nurse practitioner in a community mental health setting for nearly 8 years I had to learn to be frugal on behalf of my patients. Whether patients had insurance or were uninsured, most patients regardless of income and insurance status were concerned about their cost of medications. During my training and as my time as an educator to other mental health care providers, I realized that navigating the cost of treatment is not standard curriculum in school for health care professionals and is not straightforward. It took a bootstrap approach to become savvy enough to start to help myself and my patients save on ever rising health care costs — including prescription drugs.

According to one survey completed in 2023 by KFF Polling, more than 1 in 4 adults taking prescription drugs reported difficulty in affording their medications. Furthermore, 3 out of 10 adults surveyed did not fill a prescription for medication, cut pills in half or skipped doses, or took an alternative, over the counter medication instead of getting the prescription filled.

These statistics certainly shed some light on the financial burden and difficult decisions patients and their families have to make about healthcare every day. It was not unusual for a patient to come after months of struggling with anxiety or depression because they had to stop their mental health medications or had to skip doses or cut the pills in half to make their medication supply last due to lack of funds to pay for a prescription. Sometimes they would pick up their depression medication when things got “really bad” and then skip a month or two of their blood pressure or diabetes medications. Even those with Medicaid where in North Carolina co-pays for brand or generic medications are $4 each, reported to me they went without medications because they could not afford their co-pays to pick up all their medical and psychiatric medications — if they are on five different medications, that is potentially $20 a month. If we made a medication change, often times that meant patients either had to wait until the next month due to financial constraints or be faced with paying another co-pay for another strength of medication. In mental health, getting the right medication at the right dose the first time we see the patient is rare. It is not uncommon for people to have several medication changes before we find “the one” which leads to increasing cost that the patient has to face.

So what did I learn about being frugal over these past 8 years working hand in hand with patients to assist them with affording medications?

1. Don’t be afraid to shop around. In some cases using discount programs can be the solution and bypassing insurance benefits, if you have them, altogether. Programs such as GoodRx and Singlecare which provide patients with an easy to use search tool to shop around for medication using their discount card program. What is surprising is that even with insurance, generic medications can actually cost more when using your insurance benefits. For example, a generic medication with my health insurance costs $25 for a 30 day supply. At my local grocery store with a discount card I can get that same medication for $6 for a 30 day supply. With insurance: $300 a year. Without insurance using discount card: $72 a year. That is a big win in my books. Other increasingly popular options are shopping around on online pharmacies such as Amazon Pharmacy, which offer saving perks for members and Mark Cuban’s CostPlus Drug Company with transparent pricing.
2. Asking for “brand name” medications. Yes, you heard me right. In some situations prescribing a brand name medication to patients can be cheaper than filling a generic medication. Let’s break this down. First, I can offer free samples or free 30-day vouchers that patients can fill at their local pharmacy. These samples or trial periods give the patient and health care professional time to decide if this is going to be a viable option. This can save a lot of money on picking up medication that a patient may only take a few doses of, then stop, due to potential side effects. Another benefit of brand name medications is that for commercially insured patients, brand name medications often offer robust co-pay cards. Some allow first fill or two to be free, and then low monthly co-pays, in some cases lower than generic medication. Another hidden benefit of co-pay cards is that some will actually help “buy down” a pharmacy deductible if you have one. Meaning for each medication fill, the co-pay may apply up to hundreds of dollars to your pharmacy deductible. This allows you to fulfill the pharmacy deductible for your insurance faster without you having to kick in on that yourself. For patients without insurance, providing samples is a way to ensure patients have access to medication before leaving the office and then assisting with transition them to get ongoing free medication thought patient assistance programs.
3. Patient Assistance Programs (PAP). Patient assistance programs are designed to help people that are uninsured or underinsured afford their medications, often times for free. There is specific edibility criteria and does require an application that the patient and healthcare professional will fill out. You will find these programs frequently on the drug’s brand name website under the “resource” section or searching on NeedyMeds. I have helped patients save thousands of dollars a year utilizing these programs all while ensuring access to the best treatment based on my clinical judgement.

So next time you are at the doctor’s office, don’t be afraid to speak up if you have concerns about cost of medications. Consider shopping around, asking your health care office for help with assistance plans and asking about other options if you are having trouble affording your medications.

If you or someone you know is struggling with mental health concerns, Different MHP can help.

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