Why Do My Prescriptions Cost So Much and What Can I Do?

Prescription medications are an important part of health and wellness.  There have been a multitude of advances in prescription medications in the past 50 years leading to better treatment of diseases, prevention of medical conditions and ultimately improved wellness and life expectancy.  In the United States, more than half of the population regularly takes a prescription medication and 36% of older Americans take at least five prescription medications at the same time (Rochon, p. 2).

Why are Prescription Costs Rising?

While the advances in medications has led to had a positive impact on well-being, like most everything this has come with a price; namely the price of prescription medications. Despite the ever increasing availability of unbranded generic drugs, and the fact that the U.S. does the best job of any advanced economy in deployment of low-cost generic drugs, Americans continue to bear more and more cost for medications. Prescription drugs are the fastest growing and third-largest component of U.S. national health care spending (Roy, p.2).

Increases in prescription drug costs have affected not only insurance companies but also out-of-pocket costs for consumers.  The advent of the Affordable Care Act (ACA) of 2010 has been a key driver in the exponential increase in drug costs to consumers. The expanded insurance coverage and Medicaid expansion has led to an increase in insurance costs for employers and individuals.  Median household health insurance premium costs in 2016-17 were $2200 with the highest household premium cost being in excess of $8000 (Hayes, p.3). Further, increases in High Deductible Health Plans (HDHP) has also affected consumer costs.  From 2007 to 2017 enrollment in HDHPs increased 350% with the average family deductible in 2018 ballooning to $2788. (Hoffman p.2).

Are Generic Medications Cheaper?

While it is true that the number of medications that are available as generics has increased, that doesn’t mean that ALL generic medications are inexpensive.  In fact, the average price level for a 30 day supply of generic medication was $29.69 (Conti,et.al. p1).  This means that half of generic prescriptions cost below approximately one dollar a day and half were ABOVE one dollar a day.

What is Medication Non-Adherence?

With all this increase in cost, consumers are forced to take measures to reduce their out-of-pocket expenses; sometime to the detriment of their health and well-being.  As a part of this equation, many choose to forgo needed medications or try to “stretch” their medication supply by not following the prescribed dosage.  Also, a large part of maintaining health is appropriate medication therapy and adherence to prescribed regimens.  It is estimated that approximately 30% of hospital admissions of older adults are drug related with more than 11% attributed to medication non-adherence (Dorman Marek p.1).

How Can I Find Lower Cost Medications?

Armed with all of this less than encouraging cost information, what can a person do to continue to be able to afford their sometimes life-saving medications?  Fortunately there are a number of things that can help with drug expense.

• For branded medications, manufacturers typically have cost reduction programs in the form of co-payment discounts for those with prescription insurance (excluding Federal or State funded insurance) or patient assistance which can provide greatly reduced cost or free medication for those who qualify.
• For generic medications, pharmacies have joined in the effort by publishing and maintaining lists of medications that are priced at four to five dollars for a month supply and by establishing membership loyalty plans (CHI Health has an extensive list of 4.99 generic prescriptions).

How CHI Health Pharmacies are Helping with Lower Cost Prescriptions

At CHI Health Pharmacy, we are uniquely sensitive to the barrier of medication cost for patients since our core mission is to keep people healthy, prevent hospital admissions and reduce the overall cost of care.  Our pharmacists are engaged in partnering with your physician or other health care provider to use our training and expertise to assist with finding the most cost effective therapies.

Prescription Discount Card

As a novel way to help with the ongoing problem of medication cost we have developed a program that is designed to provide a discounted price (up to 50% of the typical cash price) for patients without insurance, or for medications not covered by insurance.  The CHI Health Preferred Discount Card is offered free of charge and can be obtained at any CHI Health Pharmacy or online.  Stop in at any of the twelve CHI Health Pharmacy locations to talk with a pharmacist about your medications and how we can help save you money and improve your health.  Good Happens HERE!

References

1. Roy, Avik S. A., “Prescription Drug Prices A Key Driver of High Health Care Costs, FREOPP.org, January 29, 2019.
2. Schondelmeyer, Stephen W., Purvis, Leigh, “Trends in Retail Prices of Brand Name Prescription Drugs Widely Used by Older Americans: 2017 Year-End Update. AARP Public Policy Institute, September 2018.
3. Rochon, Paula A., Schmader, Kenneth E., Givens, Jane, “Drug Prescribing for Older Adults”. Wolters Kluwer, August 15, 2019
4. Hayes, Susan L., Collins, Sara R., Radley, David C., “ How Much U.S. Households With Employer Insurance Spend on Premiums and Out-of-Pocket Costs: A State-by-State Look” The Commonwealth Fund, May 23, 2019.
5. Goodman, John C., “High-Deductible Health Insurance: The Good, The Bad and The Ugly., Opinion, May 11, 2018.
6. Dorman Marek, Karen, Antle, Lisa, “Medication Management of the Community-Dwelling Older Adult”, Evidence Based Quality: An Evidence-Based Handbook for Nurses., April, 2008.