Seniors Often Overlook One Way to Lower Their Drug Costs

The cost of prescription medications is skyrocketing, and this can hit older adults especially hard. Seniors take an average of 14 different medications each year, and taking these drugs as recommended can make all the difference in managing their various health conditions.

Yet more and more seniors report that they split pills, skip doses, or decide not to fill a prescription at all due to the cost—or they must make an agonizing decision between purchasing their medications or buying food.

If you or an older adult you know is having trouble with the rising cost of prescription drugs, here are some things you can do to lower the cost:

• Review your Medicare Part D plan every year to be sure it still covers the drugs that you take. This “formulary” can change from year to year.
• If the doctor later prescribes a drug that your existing plan doesn’t cover, you may be able to get a formulary exception (ask your doctor).
• Low-income seniors may qualify for Extra Help, a subsidy that helps pay prescription drug costs (learn more on the Social Security website).
• Some states have a State Pharmaceutical Assistance Plan that helps pay for drugs (learn more on the Medicare website).
• Some pharmaceutical companies offer Patient Assistance Programs that provide discounts (learn more on the Medicare website).
• Ask your Medicare prescription drug plan if purchasing drugs through a mail order pharmacy would be less expensive.
• Ask your doctor to review all your medications every year to be sure you still need to be taking them all. It’s not uncommon for a senior to visit a doctor one time, walk out with a prescription, and continue renewing it even if it’s not needed anymore.

The other medication review

Here’s an often-overlooked way to lower the cost of your medications: bring up the subject with your doctor!

University of Michigan researchers recently set out to discover whether the topic of cost comes up when a senior’s doctor prescribes a medication. The answer? Not often. Said study author Dr. Preeti Malani, “We already know that cost can keep patients from taking the drugs they need to maintain health or prevent complications, but these new data suggest that many older adults aren’t talking to their doctors or pharmacists about cost and less-expensive alternatives as often as they could. This represents an opportunity for patients, clinicians—as well as health systems, insurers and policymakers.”

Dr. Malani, who is a professor of internal medicine at the University of Michigan Medical School, polled seniors to ask about their drug costs. The poll revealed that while 27 percent of seniors said the cost of their drugs was a serious financial burden, only half had talked to their doctor about the cost of their drugs. Yet of those who did talk to their doctor about cost, 67 percent were successful in getting a recommendation for a less-expensive drug. 37 percent of the people polled had received a similar recommendation from their pharmacist.

Dr. Malani said, “Based on these findings, and other evidence, we encourage patients to speak up during their clinic visits, and when they’re at the pharmacy, ask about ways to reduce the cost of their prescriptions.”

Dr. Malani also had a message for doctors: “But equally, we see a need for health professionals to find ways to more routinely engage with patients about cost—especially through formal medication reviews such as the one that Medicare will cover.” She encourages doctors to make these conversations a regular part of medication review for older patients.

Bottom line, it’s a team effort. Dr. Malani pointed out that doctors usually don’t have access to information about a patient’s insurance plan; it’s up to the patient to bring this information to appointments. The doctor or clinic personnel can then help patients chose a particular drug option that would have a lower copayment and overall price—either from the same drug company, or a generic equivalent.

If a patient doesn’t realize how costly a drug is until they go to fill a prescription, it’s not too late. Contact the doctor’s office at that point. And here again, pharmacists can be a great resource, as they usually have a pretty good understanding of insurance plans, coverages and costs, and may be able to offer information about other ways patients can control prescription drug costs.