Uncategorized

There’s Safer Ways To Cut Costs Than Skipping or Stopping The Medicines That You Need

There’s Safer Ways To Cut Costs Than Skipping or Stopping

The Medicines You Need

As the economy sours and health care costs soar, cost-cutting measures are creeping into the medicine cabinet. We split pills in half or take the drugs every other day to stretch our doses. We stop filling the prescriptions for our most expensive drugs. We seek out herbal remedies and over-the-counter medicines as prescription substitutes.  We buy prescriptions from online pharmacies with questionable credentials.

Numerous studies show that as patients pay more for their prescription drugs—whether it’s through higher insurance co-pays or shouldering the full costs—many people decide to opt out of taking the drugs altogether.
But there are safer ways to cut costs than skimping on—or skipping —the medicines you need. Getting your pharmacist involved, asking for generics, seeking out patient assistant programs and working with your physician to eliminate drugs you don’t need can keep money in your pocket without harming your health.

There’s Safer Ways To Cut Costs Than Skipping or Stopping

The Medicines You Need

As the economy sours and health care costs soar, cost-cutting measures are creeping into the medicine cabinet. We split pills in half or take the drugs every other day to stretch our doses. We stop filling the prescriptions for our most expensive drugs. We seek out herbal remedies and over-the-counter medicines as prescription substitutes.  We buy prescriptions from online pharmacies with questionable credentials.

Numerous studies show that as patients pay more for their prescription drugs—whether it’s through higher insurance co-pays or shouldering the full costs—many people decide to opt out of taking the drugs altogether.

But there are safer ways to cut costs than skimping on—or skipping —the medicines you need. Getting your pharmacist involved, asking for generics, seeking out patient assistant programs and working with your physician to eliminate drugs you don’t need can keep money in your pocket without harming your health.

Dropping a prescription can be a risky move: More emergency room visits, severe and uncontrolled asthma attacks, and an upswing in heart attacks and strokes are just some of the poor health outcomes that have been associated with skipping a prescription due to its cost.

Patients who take medicines for chronic conditions are often the ones to drop the drugs when they become too expensive. For a disease like high blood pressure where the symptoms are not obvious, skipping the drug may seem like no big deal, according to Rebecca Snead, executive vice president of the National Alliance of State Pharmacy Associations.

People “often say, ‘I don’t feel any different than I felt yesterday,’” Snead says. “If you don’t get that immediate gratification from a prescription, people immediately stop. They think that medicine should have that antibiotic, pain-reliever type of effect.”

But, “We don’t want someone who can’t afford a medicine to become someone who can’t afford bypass surgery,” warns John Michael O’Brien, a prescriptions cost expert at College of Notre Dame of Maryland.

That’s exactly what happened with to Karen Merrill, who has heart disease. She felt worse when she stopped taking her prescriptions for a while after her heart attack, “and I ended up back in surgery for a bypass,” she said.

Left untreated, a simple case of high blood pressure can morph into serious health complications. But patients are not always receptive to the idea that prescriptions are tools used to head off more serious problems. Physicians “need to be very frank” about that notion, Snead says. “They need to put time frames on it—if you don’t take your hypertension medicine now, in a year from now, you’ll see these changes in your health.”

When patients decide to stop taking a prescription or otherwise alter their doses without informing their doctors, they may put themselves at risk for overdose or harmful medicine interactions. “A doctor may think a patient is taking a drug when he really isn’t, and may prescribe another drug when it appears that the first drug isn’t working,” says Michelle Fritsch, a pharmacist and chair of the clinical and administrative sciences department at the College of Notre Dame.

Savings Plan

But maybe your insurance doesn’t quite stretch to cover a brand-name antidepressant, or maybe you are stuck in Medicare’s Part D “doughnut hole,” waiting for your annual cap on prescription coverage to roll over. Maybe you have no insurance and no cash to spend at the pharmacy. How should you handle the costs?

The first step, says O’Brien, should be a talk with your pharmacist—not necessarily with your doctor. Some surveys suggest that physicians can be uncomfortable talking about a patient’s finances, and those who do bring up prescription costs may not know much about co-pays or overall drug costs. A newly released report from Consumers Union found that only 4 percent of patients discussed price with their physicians when they received a prescription.

“It is hard for prescribers to keep track of existing meds and health plans and what they cover and don’t cover,” says Snead, “but people are acutely aware of drug prices because they often pay the out-of-pocket costs.”

“Every time you fill a prescription, talk to your pharmacist about lowering your drug costs,” O’Brien advises. “Your pharmacist can explain your options and help your doctor choose a medicine that meets your needs.

If you’re fortunate enough to have a good relationship with a pharmacist, one who you have known for a while, this could be good advice. But some people feel their doctor’s office is a more private, comfortable setting to have the conversation about costs. “I don’t know about you, but I know I would have a hard time standing in line with my pharmacist and saying, ‘I can’t afford this’” says Merrill, who now works with the American Heart Association as a survivor-advocate.

Patients shouldn’t feel like they are second-guessing their doctor’s orders when they talk to their pharmacists about a prescription, O’Brien says. In many cases, insurance companies reach out to pharmacies directly to notify them about less costly options in a class of cholesterol drugs, for instance, or a new generic version of a drug. This kind of information isn’t always at a doctor’s fingertips.

“And if a generic is available for a drug you’ve been prescribed, you should take it,” O’Brien says.

People who think generic drugs “are like generic toilet paper” can rest assured that the Food and Drug Administration certifies generic medications as having the same dose, strength, safety and efficacy as their brand-name counterparts, Fritsch says.

Free prescription drugs are available for people who can’t afford their medicines through patient assistance programs or PAPs. A Web site called RxAssist.org is the major clearinghouse site for these programs, most of which are run by pharmaceutical companies. The site also hosts a program called RxOutreach that offers some generic medications.

Janet Walton, deputy program director at RxAssist, says the number of site visitors and phone calls about PAPs has increased as the companies have made the programs more visible, but it’s not always the uninsured or the poor who are seeking help.

“People who are underinsured are calling—there are not a lot of options of things they can do to lower their prescription costs,” she says.

The biggest stumbling block for those applying to a PAP “are the forms,” Walton admits. Patients have to fill out separate forms annually to receive each drug from each pharmaceutical company, “and even for the most seasoned of community health people…it’s still very labor-intensive.”

In some cases, doctors may offer free samples of a drug to a patient struggling with costs. Merrill sets aside money in a special health savings account to pay for her prescriptions throughout the year, “but come November, December, I’m in my doctor’s office begging for free samples,” she says.

But samples are only a short-term solution, experts agree. “Samples aren’t a replacement for continuity of care,” says O’Brien, who notes that irregular use of samples can make it difficult for pharmacists to catch drug interactions. Doctor office samples also tend to be expensive brand-name drugs, not generics, “so if you start on a brand-name drug, you’ll soon get a prescription for a brand-name drug.”

Snead and others advise against buying cheaper prescription drugs from Canada, Mexico, and other foreign markets. Although a 2008 study found that “drug safety can be adequately ensured” in countries like Canada with an active regulatory system, “the incidence of counterfeit drugs is rising exponentially,” Snead warns. Your online pharmacy may be stamped with a maple leaf flag, “but how do you know that the Web site is really in Canada?” she asked.

Fritsch has had patients who sought out less expensive drugs from foreign pharmacies, but she says she “always been able to find inexpensive alternatives” in the United States.

Speak Up—and Cut Back

If all of this seems like a hassle, it’s important to keep this fact in mind: your health depends on the prescriptions that you decide to take or to skip.

“It’s the consequences that drive you. We underestimate how complex the effects can be, because it’s just taking a pill,” says Snead.

But do you need to take so many pills? It could be possible to cut back on your costs by cutting down your total number of medications.

“One of the questions that I’ve trained my 77-year old mom to ask is, ‘if I get a new medication, which one of these other medications can I stop taking?’” Snead says.

O’Brien and Snead both recommend a yearly review of all medicines, in consultation with your doctor and pharmacist, to look for drugs that don’t appear to be working the way they should, drugs that overlap in their actions and drugs that may conflict with other medications.
    

Finding Affordable
Rx Drugs

Patient assistance programs or PAPs provide free medications to those who cannot afford their prescriptions. Eligibility varies, but even people with private insurance or Medicare or Medicaid may qualify for assistance in some PAPs. Start with the RxAssist site to explore your options, or look into individual programs below:

RxAssist
www.rxassist.org

Partnership for Prescription Assistance
www.pparx.org

NeedyMeds
www.needymeds.org

SelectCare Benefits Network
www.scbn.org

Help with Medicare Prescription Drug Costs
http://tinyurl.com/yvbjy9

New from Consumer Reports:
Best Drugs for Less
http://tinyurl.com/d657x2

Published by
Health Behavior News Service
Lisa Esposito, Editor

Written by
Becky Ham, Science Writer

Designed by
Brandon Moore, IT/Comm Manager

The Health Behavior News Service, of The Center for the Advancement of Health, does not provide medical advice or consultation. The Prepared Patient is a new series intended to help people make informed choices about their health care.

REPRINTS: CFAH welcomes reproduction of Prepared Patient features, in whole, for educational purposes and feedback only (not for profit), with credit to the “Health Behavior News Service, part of the Center for the Advancement of Health.” Any changes or additions to this feature must be pre-approved by HBNS/CFAH.

© 2009, All Rights Reserved
 
Health Behavior News Service is a Product of the Center for Advancing Health
The Center for Advancing Health is funded by The Annenberg Foundation and the W.K. Kellogg Foundation.

Leave a Reply