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Fact Checked

How Much Do Prescription Drugs Cost Without Insurance?

When it comes to taking prescription drugs, Americans are at the forefront worldwide. The United States spends the most on prescription drugs among all developed countries, and the rise in total expenditure on prescription drugs in the U.S. has risen rapidly over the past fifteen years. According to the Centers for Medicare and Medicaid Services (CMS), in 2007 the total expenditure on prescription drugs annually was $23.6 billion. By 2014, annual expenditure increased to $297.9 billion and last year in 2019, this number rose even more to $360.3 billion. This is a tremendous figure compared to the expenditure of prescription drugs in other countries. Part of the reason that expenditure on prescription drugs is so high in the U.S. is due to the higher individual cost of drugs in this country. An example is the price of the drug, Humira, made by the company AbbieVie, which is a leader in treating autoimmune conditions like arthritis. According to the CMS, the price of Humira in the U.S. is three times higher than the price of Humira in European countries like Switzerland. The annual price a patient spent on Humira rose from $19,000 in 2012 to a whopping $60,000 in 2019. Another example of this is the price of the EpiPen, manufactured by Mylan that spiked over 500 percent in less than ten years, from $100 to $600. For patients that require an EpiPen for severe life-threatening allergic reactions, this hike in the cost of EpiPen over a short span of time can come as a huge financial burden and may even make accessibility to life-saving healthcare not a feasible option for them anymore. The difference in prices of drugs in the U.S. compared to other parts of the world may be attributed to pharmaceutical companies, how the drug is manufactured within each country, and organizations within the pharmaceutical industry that decide how a drug should be priced. However, the overall take home message is that prescription drug prices are on average much steeper in the U.S. compared to the rest of the world and also compared to other developed countries. 

According to statistical surveys, the average American took at least one prescription drug in the past month. This means that the overall higher cost of prescription drugs in the U.S. affects individual Americans in their day-to-day lives, and how much they have to spend to cover their health care costs. Many Americans have chronic or long-term illnesses that require taking daily prescription medications. For example, patients with diabetes have to purchase insulin on a regular basis to keep their condition under control. Patients with high blood pressure have to take medication to keep their blood pressure down. These medications are often prescribed life-long, which means that for individuals who are affected by diseases like diabetes or hypertension, the cost of purchasing their prescription drug can cause a significant dent in their annual income. For many Americans, this can cause a substantial financial strain on their lifestyle. For conditions where lowering anxiety and stress is important, like in hypertension, worrying about how to buy your prescription drug at an affordable price can be counter-productive. Taking prescription drugs for such conditions is also not optional, as it is crucial for maintaining good health and for preventing more serious health complications from occurring. 

Health Insurance for Prescription Drugs 

So what can be done about the rising cost of prescription drugs? Health insurance helps make prescription drugs affordable to some extent. Many drugs that are deemed to be essential for healthcare are covered under most health insurance plans. Of course, the amount that you can save with health insurance will depend on the specific plan and coverage that you have. Health insurance can usually help save on prescription drugs at least to some extent as long as the medical reason for taking the drug is justified by your physician. Exactly how much you save depends on several factors of your health insurance plan, with the main ones being: 

  • Is the prescription drug on the list of drugs that your plan covers?
  • What is the amount of your annual deductible (cost that you must pay out of pocket before the insurance company will cover your medication)
  • What kind of deal does your insurance company have with the manufacturer of the prescription drug that you need?

These factors are especially relevant for brand-name prescription drugs like Humira mentioned above. Brand name drugs are under patent-protection and have a higher cost than their generic counterparts. Drugs under certain health classes are sometimes not covered as well as other drugs by certain health insurance plans. Unfortunately, this is not uncommonly a problem with drugs that are prescribed for reasons like mental health conditions and can result in a higher out-of-pocket cost for patients who need to take them. 

Pharmaceutical companies are able to price certain drugs so high because it may be the only drug available for a specific health condition that works well to treat that condition. The expiration of a patent on a drug, or introduction of other drugs that work for a condition can bring the price of these prescription drugs down, but the base price usually still remains on the high side. This is also not untrue for older prescription drugs that have a high market-demand, but have been on the market for a long time, like insulin. Although generic versions of insulin are readily available, the price of insulin has continued to rise steeply since 2012. Between just 2002 and 2012 the price of insulin tripled. This price hike may not have affected diabetic patients with health insurance plans that cover the net price. However, for patients yet to meet their annual deductible, or worse for patients without health insurance or plans that do not cover prescription drugs, this huge increase in the cost of insulin proved to be a huge financial burden to the extent that many patients were not purchasing their insulin. This price increase of insulin has serious consequences to the health of diabetic patients, as not taking insulin as recommended for their condition can be life threatening. 

In fact, some drugs without health insurance are priced at almost $1,000 per pill. Sovaldi, manufactured by Gilead, was one such drug for the treatment of Hepatitis C. Over the course of an entire treatment, this can lead to costs as high as $100,000 per year for patients who need the drug. In 2019, the most expensive drug was priced at more than $5,000 per vial. This drug, known as Myalept, used to treat a very rare disease that causes abnormal fat distribution in the body, is the only treatment available for this condition. Therefore, patients have no option but to use this treatment and the price of the drug remains high and can continue to rise. Patients with this condition have to use multiple vials a month, making their monthly expenditure on this drug alone more than $50,000. Even with health insurance, such a steep drug price is hardly affordable for the average American. 

Save even more on Prescription drugs with a Discount Card 

How can you save more on prescription drugs? Prescription drug discount cards can help with additional savings. If you don’t have health insurance, getting a prescription discount card is definitely something you want to do to help you save on costs of prescription drugs. The discount card can save you up to 75 percent on some prescription drugs, with a minimum of at least 10 percent savings on most drugs. Discount cards are also accepted at almost all pharmacies across the country, including in Hawaii and Alaska. How does the discount card work? All you have to do is find a pharmacy discount card that is right for you and present it to your pharmacy when filling a prescription. 

The USA Rx Prescription Discount Card 

An excellent option for a prescription discount card is from USA Rx. The card is available online and you can sign up for one in just a few minutes. Given the high cost of prescription drugs, how exactly does a prescription card work to save you money?

USA Rx has a partnership with organizations within the pharmaceutical industry known as the Pharmaceutical Benefit Managers (PBMs). The PBMs decide what drugs are in high demand and should be stocked in hospitals, clinics and commercial stores. They also work with pharmaceutical companies to set the price on prescription drugs so they play an important role in determining whether certain drugs are eligible for discounts. The partnership between USA Rx and the PBMs allows discount cardholders to avail of wholesale discounts on certain drugs that are covered under the card. If the discount card is presented at a pharmacy that also has a partnership with PBMs for a certain drug, you can save even more from the benefits of a prescription. In this way, you can get the maximum possible savings on prescription drugs by signing up for a discount card through USA Rx. The application is free and takes just a few minutes to fill out online. Take this card with you to the pharmacy the next time you need to fill a prescription. If you are unsure of whether your pharmacy accepts the discount card, you can find a list of participating pharmacies on the USA Rx website. Even if your pharmacy is not listed here, there is a high chance that the card will be accepted so it’s worth the time to sign up for the free card. Finding ways to ease the financial burden of prescription drugs, even without health insurance coverage of medication, is now possible with the pharmacy discount card. Sign up today to start saving. 

Published March 27th, 2020 by Chris Riley
Fact Checked by Chris Riley

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