faced with a disastrous economy, its not atypical to see a patient come
to the pharmacy and pay $100 out of pocket - even after their pharmacy
benefit's manager has pitched in their contribution.
If you're one of those people paying - in more ways than one - for your
health, or if you're a health professional assisting patient's with
their drug therapy, consider the following tips to keep everyone out of
the red. Ask your pharmacist and/or prescriber these questions:
1. "Is there a generic available?"
Generics...Generics...Generics: Ask your prescriber if the medication
they want to prescribe for you is available in "generic". You might
frown at the idea of getting "non-brand" anything. But rest assured:
generic medications are not your ordinary knock-offs. The Federal Drug
Administration (www.fda.gov) oversees all prescription medications in
the US and states the following on their webpage:
"What are generic drugs?
A generic drug is a copy that is the same as a brand-name drug in
dosage, safety, strength, how it is taken, quality, performance and
intended use.
Are generic drugs as safe as brand-name drugs?
Yes. FDA requires that all drugs be safe and effective. Since generics
use the same active ingredients and are shown to work the same way in
the body, they have the same risks and benefits as their brand-name
counterparts."
In order to receive a generic medication when it is available, your
doctor must not indicate "Dispense As Written" on the prescription. If
they do check this box, the pharmacist must dispense exactly what your
doctor writes.
2. "What are these medications, how many days will they last me, and is
this exactly what the prescriber ordered?"
It might seem obvious, but make sure you're getting what you want before
you pay. Pharmacies are very hesitant about taking back medications
that have left their stores, and for good reason: it assures the quality
and safety of all patients who could potentially receive that
medication. If a price seems too high, ask if you received generic,
what quantity you received, how much insurance picked up, and ASK THE
PHARMACIST. Technicians can be very savvy, but they can also be very
incorrect. BEWARE: When a drug is not available because of backorder or
because they're out of stock, I've personally seen pharmacists give
patients brand medications simply because they want to make a sale. If
that pharmacy doesn't have the medication in stock, ask for the pharmacy
to call around and find a store that does have the item or ask them to
order it for you. In most circumstances, you can get exactly what you
want within 1 business day.
An example as of late was Metoprolol Succinate ER. A particular chain pharmacy's supplier,
Ethex, recalled the medication and this reduced the availability of
Metoprolol Succinate (generic for Toprol-XL). HOWEVER, Ethex is not the
only manufacturer of Toprol-Xl; in fact, the brand manufacturer makes an
almost identical generic. That company, Par, supplies other drug
companies with the generic for Toprol. But, because of what seemed to
be for business reasons and the financial interest of the pharmacy chain since
Par is not a preferred supplier and because the pharmacy chain doesn't make as
much off of that particular manufacturer's generic, the chain drug
company was not acting in their patient's best interest to seamlessly
continue the supply of that medication. Instead, they were telling
patients that THEY needed to contact their doctor and ask for a
different, non-extended release form of Metoprolol. Rather than
telling the patient this, pharmacists were sometimes changing the patients over to
the much more costly brand medication and telling their patients - often
unknowing seniors - that the medication costs more now and may look a
little different because the drug is on backorder. Case in point:
always check before you buy and ASK QUESTIONS.
3. "Is it cheaper for me to get three months at a time if my insurance
will allow it, or would it less expensive if I paid without using my
insurance?"
Ask this question when you drop off your prescription to save you and
the pharmacist/technicians valuable time and stress. See if you can get
a 90 day supply of your meds. Oddly enough, sometimes insurance
companies will charge the same copay for a month supply that they would
for three. Also, some medications that are taken weekly, like Vitamin D
50000 Units, can be cheaper for you to purchase out-of-pocket (without
your insurance). In the case of Vitamin D, 12 pills - a three month
supply - is roughly $17 up front. Since many insurance companies have a
mandatory minimum copay ($10 maybe), you might have to pay $10 each
month for three months. That's $30 over the course of 90 days.
4. "Will you price match?"
Chains like Supervalu (Albertson's/Osco) will price match other
companies on your medications even if you don't know the cost at large
chain stores like Walgreens, Walmart, Target, or CVS. They can look
them up online and will gladly - from what I've observed - give you the
best cost because they genuinely care about your physical and financial
wellbeing.
5. "Is there a therapeutic equivalent?"
A therapeutic equivalent is different from a generic. Therapeutic
equivalents can achieve the same effect of another medication and help
you reach similar health outcomes (like lowering blood pressure or blood
glucose). For example, Lipitor - the top-selling cholesterol lowering
medication - does not have a generic available yet, but it belongs in a
family of medications called "statins". There is a generic statin
called simvastatin (Zocor) that can be just as a effective as Lipitor.
It may, however, require a higher dosage or perhaps need to be taken
more frequently. Doctor's may prescribe a brand like Lipitor because
they've read some recent study on its efficacy, spoke to a drug rep, or
want to deliver the most effective therapy for their patients. But if
the price of a medication isn't working for you financially, it can
greatly impact your health because of the added economic stress or
feelings of entrapment ("I have no other option...I must take this exact
medication...this price is the burden I have to pay for my poor health
and there is no alternative). These thoughts are not true and, by
dialogging with your pharmacist - your personal medication expert - and
doctor, you can find a medication that will work for you in every aspect.
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