Tuesday, July 29, 2008

How to get medications inexpensively and efficiently

  1. This is a tricky topic, yet you can navigate through the problems and successfully get your medications with lower costs in time and money if you follow these steps.
  2. Prepare for each doctor visit. Proper planning at this step can produce the largest cost and time savings in my experience. For every doctor visit, always bring a list of all of your current medications and for which condition the medication is taken.
  3. Check which of your prescriptions need refills or which prescriptions need to be changed because of your insurance's formulary. Bring a copy of your insurance company's formulary with you to your appointment so when the time during a visit comes to discuss medications, your doctor can review it. Do not expect the doctor's office to have one for your exact insurance. There are an infinite number of combinations and exclusions.
  4. Try to understand why your doctor prescribed a medication or at least for what disease. What is the diagnosis and goal?
  5. Know if it is less expensive or required by the insurance company for you to get "mail-order" prescriptions. These are almost always written for 3 months per refill. The process is automated, centralized, impersonal, but more efficient for at least the insurance companies. Otherwise they wouldn't contract with the Pharmacy Benefit Managers (PBMs), like Medco and Caremark, to do this job. PBM's and insurance companies hide behind face-less and name-less phone trees, automated phone calls, and letters of denial in order to steer you towards their preferred drug list. Otherwise, you end paying more in time and costs. It is okay and better in fact to ask for prescriptions for both regular pharmacy and mail-order at regular doctor visits. PBMs usually take 2 weeks to fill prescriptions, so the only source is local pharmacies. Most doctor offices, including ours, charge a fee to patients for phone calls if patients want prescription refills. The reasons include to refill medications when they have missed appointments and if they have lost prescriptions. Minor point: PBMs do not honor coupons.
  6. While at the doctor's office, ask for coupons and don't forget to use all of them. Statistics are kept. Most experts agree that less than 10% of all coupons are used.
  7. While at the doctor's office, you may consider politely asking for samples. Sometimes offices have them and sometimes they don't. It never hurts to ask politely.
  8. Check the Internet for a website on the medication e.g. http://www.medication. com and print out coupons. Some companies will mail the coupons to you monthly.
  9. You can apply for free medication from the drug companies, 1 application per product, if you do not mind providing your tax return to prove you have a low-income. Applications must be completed annually.
  10. Ask the pharmacist before you pay if they have any point-of-sale coupons. Some drug companies are giving coupons to the pharmacists in an effort to improve sales by reducing the cost to patients. It's worth asking about.
  11. Take all of the medications in old bottles before starting on new bottles and take them as directed. Most people quickly accumulate lots of half-filled bottles of medications.
  12. Caution about buying medications from outside of the U.S. There is no guarantee about quality control. Pharmacies on the Internet, usually outside of the U.S., have been guilty of selling cheaper knock-offs of name brand prescription medications or outright placebo pills. They can not be prosecuted. If you can go to a legitimate pharmacy in another Westernized country, be careful about the names of medications are often different and the dosages of pills too.
  13. Generic brands can save money. Ask your doctor if he or she is aware of any quality issues with the generics for the medication in question.

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