Six annoying steps that reduced my prescription drug costs by $2000 per year
Show me the money
Here’s a flowchart I plan to use every time I am prescribed something that costs more than I want it to. Bookmark this page and I will keep it updated as I find new methods to reduce the cost of prescription drugs in the US.
In copy-pasteable bullet form:
Get a prescription from physician for brand name medication and take it to local pharmacy
Ask your physician if they can prescribe the generic version
Ask your pharmacist if they can recommend alternatives and ask your physician to prescribe them
Ask the pharmacy/your physician if they can prescribe you more than a 30-day supply of the medication
Check goodrx.com for any coupons in both the generic and the brand name for your pharmacy as well as all others close by
Check to see if the manufacturer has any coupons that apply to you, eg AstraZeneca at www.azpatientsupport.com
Plead with your pharmacist for help
Here’s the story behind it
Allergy season meant my asthma flared up again. I was prodded into visiting a primary care physician by my partner (and we wonder why married men live longer) because of my unusual breathlessness. The doctor examined me, removed her stethoscope, and asked how long I had been smoking. When I told her I had never smoked she was shocked. The rhonci she heard in my lungs was so bad she prescribed me, for the first time in my life, a steroidal inhaler: AstraZeneca’s Symbicort.
Unlike with other areas of medicine in the US you at least know the cost of the prescription drugs before you purchase the item. This allows you to make slightly more informed decisions. Much as American doctors like to think they are here to heal us no matter the cost, prices clearly matter to consumers. In my opinion obscuring them destroys the informational transparency that goes with market-based capitalism to offer consumers low-priced products and opaque pricing is one reason the healthcare system is broken.
The pharmacist at my local drug store was a very important and very busy pillar of the community. She was so busy she seemed not especially bothered with my particular plight. While my insurance covered Symbicort (without insurance: $240/month), she told me I would still have to pay about $190 for the inhaler. Bear in mind this is a once-a-month prescription, so I was looking at $2300 a year of costs that my apparently good health insurance didn’t cover. That seemed unreasonably high to me.
After she walked off to re-attend to the administration on her computer that I had interrupted, the pharmacist’s assistant suggested I ask my physician to re-prescribe the generic. This would likely be cheaper. After a call with the physician’s office I passed the message along.
Returning to the pharmacy, we found the generic came to $150/month and the same pharmacist seemed pleased with that outcome. She didn’t tell me that this didn’t count towards my deductible, unlike the $190 from the insured product. I had to figure that out later. It makes complete sense if you know that the generic isn’t covered by insurance but did I know that at the time? Nonetheless from one extra phone call I saved myself $500 a year. Annually this was still going to be a four figure outlay. Plus there was the added complexity of not contributing to my deductible. Ugh.
I knew about goodrx.com and checked their site for any further discounts. None were available though I noticed that the coupon dropped the Walgreens product to a lower price than the one from the pharmacy I was at. I was in a rush this particular time so wasn’t able to go to a Walgreens which would have saved another $20, or $240 annualized.
I meekly asked the pharmacist if there was anything else I could do. She said that I could ask my physician to prescribe alternatives called something like BoogleDangThing and FrimpyBooHaHa. I scribbled these names down and called the doctor’s office again. While their website said they were open until 6pm and it was just after 5pm the person who answered the phone insisted the doctor had left for the day. With desperation and annoyance creeping into my voice I implored them to ask the doctor to literally write a few words and make my day. They said they would see what they could do.
My girlfriend can be an intimidating force of nature if you ask her nicely. She was working at home while I made the consecutive trips to the pharmacy and was star witness to my increasing frustration. She donned a fake wedding ring and came with me on this third trip, prepared to use her “can I talk to your manager” voice to ask the pharmacist to directly prescribe those medications to her hapless partner. “Is that something they can do?” “Yes!”. It was a handy backup in case the doctors had truly left their offices before their official close times. Luckily it turned out that she didn’t need to; the prescriptions had gone through. None of these alternatives were any cheaper than the generic-plus-coupon. Wasn’t I grateful to pay for insurance that didn’t help me at all?
I left $150 poorer.
A month later, I got the message to refill my prescription so I slumped back to the pharmacy, fully prepared to shell out another $150. This time I had a different, more personable pharmacist. I described to her what had happened so far. We re-checked goodrx.com and she asked if I’d tried to find any manufacturer’s coupons. I hadn’t heard about these and my google search was fruitless. She googled as well, found one, and filled out a form on her end on my behalf. Lo and behold my new monthly outlay that month and from now on was $35! From $190 down to $35! I have saved $1860 per year.
From a little more research online, there’s at least one more trick to try that I haven’t yet: getting a 90 day supply (or in my case the 160mcg Symbicort) than a 30-day supply from your medication. I put this all together in a handy flowchart at the top of this post that I plan to keep updated as I continue to navigate the world of prescription costs. I sure as hell can’t change the system. That’s a job for the NYTimes? But I can at least make it a little easier to interact with.