More and more of us are experiencing sticker shock at the pharmacy. Medicines that used to cost $5 or $10 a month are now $50 to $100. To make things even worse, these prescription costs often don’t even go toward the deductible.
The cause for out of control healthcare costs in the U.S. is complicated, but the immediate cause of higher copayments, deductibles and drug costs are related to employers’ attempts to reduce their healthcare spending.
The U.S. is the only country in the world with an employer based health care financing system. The system has many failings, such as losing your insurance if you leave your job. The true costs of healthcare has been hidden from the patient because the employer has paid most of the bill – till now.
The average healthcare spending per person in the U.S. is around $10,000 per year. That means insurance companies have to collect more than that to stay in business. With employers increasingly shifting these costs to employees, it is wise to budget about $1000 per person, per month for all healthcare related spending. If you are lucky enough to have premium subsidies, either thorough your employer or the U.S. Government, you may be able to reduce your outlay, but don’t count on it for the future.
Here are some simple steps you can take to reduce the bill at your pharmacy:
- Before you fill (or refill) any prescription, do a search at goodrx.com. You can compare prices, print out money saving coupons and research your coverage.
- Before you fill a prescription, ask the pharmacy how much your payment will be. If it is much higher than you anticipated (or budgeted), call the pharmacy benefits manager at your heath insurance company and ask for a list of alternative, less expensive versions of the medication to discuss with your doctor.
- Shop around! Prescription costs vary widely among pharmacies, even if you have insurance.
- Know your formulary. This is your insurance company’s master list of drugs and how much they will cost you. Better yet, print it out and bring it to your doctor’s appointment.
- Always ask your doctor, “Is this the most cost effective treatment for my condition?” I have (unknowingly) prescribed a drug that cost $1000 for a 60 mg dose, but only $10 if I wrote for three 20 mg capsules. A small change can make a big difference to your wallet.
- Save, save, save! Ultimately, the responsibility for your health rests with you. Don’t get caught short!
Thomas A Grugle MD 