The cost of prescription drugs in the US accounts for roughly 10% of all healthcare-related spending in the US. That’s a scary statistic for anyone who is finding themselves in need of medication, especially when it’s vital to their health and wellbeing.
If you’re one of the millions of Americans who is struggling the cost of your medication, relief may be in sight. While the current administration is exploring different avenues to bring down drug prices, there is actually something you can do about it today.
Before we get into our tips to lowering the cost of your prescriptions, let’s first take a deeper dive into the issue facing so many Medicare beneficiaries living on a fixed income.
The average cost of prescription drugs with Medicare coverage can be still astronomical. However, if you are receiving extra help from the program through Medicare and the Social Security Administration, your costs could be as low as $3.50 for generic drugs and $8.50 for premium prescriptions.
There are also Part D plans that offer additional assistance through the prescription drug coverage gap. Keep in mind some of these plan's premiums might be higher than the average cost of Medicare Part D premiums.
With the exception of certain extraordinary circumstances, it’s never a good idea to be without some form of healthcare coverage. However, if you find yourself in a situation where you need to pay for your medication entirely out of your own pocket, you may be shocked at just how expensive drug costs can be.
It’s hard to determine the exact cost of prescriptions without coverage since everyone’s needs are different. While some people may need something to treat arthritis, others may need heavier doses of pain medication which can quickly add up. Here’s a look at the top 10 most popular prescription drugs in the US right now, along with their retail price which you may end up paying without good coverage (please note, prices may vary).
There are quite a number of factors that contribute to the skyrocketing of prescription drug prices in the US. What’s even more alarming is the disparity in prices between the US and other developed nations. For example, let’s take a look at the popular drug HUMIRA, which is often used to treat arthritis and psoriasis. According to Vox, in the United Kingdom, HUMIRA may cost an average of $1,362 and is even cheaper in Switzerland where it costs an average of $822. However, in the United States, that same prescription will cost an average of $2,669.
What gives? The answer isn’t necessarily a simple one, but let’s start at one of the biggest contributing factors to the recent rise in prescription drug prices, our regulatory system.
Most other developed nations have their government heavily involved in their healthcare system. That includes setting up task forces to negotiate what prices should be set. These task forces will also take a detailed look into whether or not any new drugs bring any improvement on old drugs, and decide whether they should hit the market.
The US is a bit different. As long as new drugs are proven to be safe for people, they will be allowed to flood the market. Additionally, big pharma (drug companies) are given full discretion in regards to pricing. Which means, they can set whatever price they want for their products, which is a huge reason we’ve been seeing a spike in prescription drug costs.
In other countries, they can collectively decide that new drugs don’t provide enough benefit to make it to market. What happens if the drug is beneficial and expensive? Those countries can bargain with drug manufacturers to set a price for said prescriptions. Since the US healthcare system relies on a mix of private insurers and government programs, you end up with less bargaining power, which allows drugs to be sold at outrageous prices.
Of course, there are other factors that need to be taken into account as well. The US also allows for forms of monopolies to carve out sections of the market. Essentially, the US patent system gives drug companies the right to be the only manufacturer for new drugs they patent for 20 or more years. That means there is virtually no competition to help drive down drug prices.
Lastly, the FDA doesn’t do a great job at approving generic alternatives to brand names. This results in a more expensive brand named drugs to stay on the market without facing as much competition. Once the generics to hit the market, doctors and pharmacists are legally obligated to get a patient’s consent before switching over to the more affordable, generic counterpart.
If you are on a limited income, you can ask the Social Security Administration if you qualify for Extra Help. It is a program for those with Social Security who have limited resources. If accepted in the program, you will pay less for your Medicare Part D premium.
Also, you will pay no more than $3.50 for generic drugs, and $8.50 for name brand premium drugs. You can ask the doctor for samples or if your prescription might be available in a generic brand instead of premium.
A stand-alone drug plan is a Medicare Part D. The premiums for Medicare Part D are often lower than the premiums for other Medicare Parts, such as Medicare Part C (Advantage). Medicare Part D will only cover the costs of your prescriptions, it will not cover the cost of any doctor's visits.
You will be covered for physician's office visits under traditional Medicare. What this means is you only get the prescriptions covered, not the office visits like with Medicare Advantage. If you are on a tight budget, a Part D plan might be right for you.
Discount drug cards are becoming increasingly popular due to their ease of use and inexpensive price. These are cards that assist in the cost of your prescriptions but should not be considered insurance.
These prescription discount cards are often free of charge or require a small fee which is worth it for the savings you’ll get. They are often not available to use with your Part D plan, but if you are in the donut hole and have no coverage for an expensive drug, you might benefit from having one of these handy. These cards can be found at a number of sites, and some of the most popular include:
If you’re looking to save money on your prescription drug costs, then look no further than FirstQuote Medicare. With our easy to use quoting tool, you’ll cut your shopping time in half. The best part? FirstQuote Medicare is completely free to use, and there’s no obligation to you. To get started, enter your zip code and see how you can start saving today.
