Published January 17th, 2020 by Stephanie
The people of the United States pay more for their prescription medications than any other developed nation in the world. The reasons why are complicated, but they have a lot to do with politics, corporations, and greed. Unfortunately, there isn’t much you can do about the system as an individual when you need to fill your prescriptions. However, you do have some options available if you need to cover high prescription costs because you don’t have insurance or your insurance isn’t enough.
When it comes to food, brand names matter. Most grocery stores have their own generic store brand and sell their own versions of popular foods for less, but these generic brands always taste a little different. Food companies guard their recipes as trade secrets, and while a generic brand can get close in terms of flavors and textures, they’re never quite the same.
However, medications aren’t the same as food. When a pharmaceutical company invents a new drug, they patent the formula, and as part of the patent process the formula becomes public knowledge. Eventually the patent expires, and after that everyone can use the same formula to create the exact same drug. FDA regulations are very strict about additives and other changes, and so a generic prescription drug has to be exactly the same as the brand-name version. In fact, the pill shape and color is often identical, too.
What this means is that brand-name foods and brand-name drugs are not the same things. A brand-name can of soup or box of cereal will taste different from the store brand, but a brand-name prescription drug is identical to the generic versions no matter who the manufacturer is. So if you need a medication and there’s a generic version available, always choose the generic.
Back when Medicaid and Medicare first came out, prescription drugs worked on fewer diseases and were much cheaper than they are today. It was also more common for a pharmacist to mix medications as needed instead of relying on pharmaceutical companies to handle the drug manufacturing process. As such, the basic government plans didn’t specifically cover medication costs.
These days, the prescription drug industry is very different than how it used to look and prescriptions make up a big part of the cost of medical care in America. That’s why Medicare rolled out prescription drug plans (Part D) as part of the Affordable Care Act. These plans are sponsored by health insurance companies and can have very different copays and patient costs, but they can definitely help you save money at the pharmacy if you qualify for government assistance.
You can also find prescription drug plans offered by health insurance companies directly. These plans are much cheaper than regular health insurance since they only cover prescription drug costs, and for certain patients it may be a good idea to get such a plan on top of regular health insurance.
Pharmaceutical companies set initial prices for each of their drugs, and after that they negotiate with each insurance company to bring the price down. The insurance then pays a part of the drug’s price, and their policy holders pay what’s left. The policy holder’s portion is called the copay. Meanwhile, patients who don’t have insurance or whose insurance doesn’t cover a drug they need have to pay the list price and don’t get any chance to negotiate with the drug companies.
Fortunately, there are other companies that have stepped into this gap of service. USA Rx and other businesses like us negotiate discounts on prescription drugs and then provide these discounts to anyone who signs up for our medication discount card. Our payment is a small percentage of each purchase made with our discounts (and this is already factored into the price you pay), and so we give out cards out for free and don’t need to see any personal information. Even if you have other ways to pay for prescriptions, you should still sign up for a medication discount card.
Pharmaceutical companies and insurance companies aren’t the only groups involved in setting drug prices. You can often find very different prices depending on which pharmacy you shop at. Part of the reason is that each pharmacy may stock generic drugs from different manufacturers, and partly it’s because pharmacies and clinic groups have different arrangements with different insurance providers.
Comparing pharmacy drug prices isn’t a simple process, but it’s worth the trouble if you have a large number of medications you need to take regularly or if the medications you need are particularly expensive. Because of this importance, we’ve put a search utility on our USA Rx website that lets you instantly check how much our discounts will save you money based on which local pharmacy you visit. You can also shop on your own, but you should tell your doctor what you’re planning so they can give you several copies of your prescription information.
If you simply can’t get enough money together to keep paying for the medications you need, there are several charity programs that offer assistance to people in need. Each one has a list of requirements you’ll have to qualify for, but these organizations can help those who have no other way of paying. Many hospitals, pharmacies, and drug manufacturers also have special assistance plans that can cut down the prices you have to pay for the medication you need.
Drug prices in the United States go up every year, and unless the problem gets solved for good ordinary Americans need to find ways to pay for the medications they need. For some people this means getting specialized plans that cover drug prices better than standard health plans. Even those without insurance can avoid the list price by getting a medication discount card, and if you are greatly in need you may qualify for assistance. However you do it, you should never have to pay full price for medication.