Strategies to cut prescription costs for Medicare recipients

Robin Wulffson MD's picture
Prescription meds can financilly impact seniors

Many seniors on Medicare take one or more prescription medications. Not uncommonly, they are hit with sticker shock when they present their prescription to the pharmacy. Some meds are relatively inexpensive; however, many costs hundreds––and even more than a thousand dollars for a one month’s supply. Because of these costs, some seniors cut back on their use of the drug or fail to fill the prescription altogether. A variety of strategies are available to curb the high cost of prescription medication; however, some are fraught with hazard and could be detrimental to one’s health. They include substituting a generic, enrolling in a Medicare Part D plan, and purchasing drugs on the Internet.

A basic strategy for the purchase of any prescription medication is to shop around. Do not assume that your friendly neighborhood pharmacy has the best price. A few months ago, I filled a prescription for generic eye drops that cost $120 at Rite-Aid. The identical product (same manufacturer) was available at Costco for $22.

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Generic equivalents are generally less expensive than the name brand; however, they only become available when the original manufacturer’s patent expires. Eventually, all patents expire. If a generic is available, it often is a better alternative; however, some precautions should be taking. Many are not aware that all generics are not the same. The FDA assigns an “AB” rating to a generic when it is considered therapeutically equivalent to the brand (i.e., same active ingredient, same dosage, supporting clinical data, etc.). Without these qualifications it gets a “non-AB” rating, which is essentially everything else. For some medications, such as pain killers, the lack of an “AB” rating is of much lesser importance. However, having the same therapeutic equivalent is essential for certain medications such as blood thinners. If the dosage is too low, the patient could experience a blood clot; if the dosage is too high, hemorrhage could occur. This danger occurs when the doctor, pharmacist, and/or patient are not aware of that distinction, and the generic prescription does not measure up to the brand. Fortunately, most generics on the U.S. marketplace have an “AB” rating; however, it would be prudent to check before you make the purchase.

Currently, U.S. and foreign consumers favor generic drugs. Phoenix Marketing International, which claims to be one of the top 40 digital market research firms in the nation, has released a survey showing off medication preferences (generic vs. brand-name) in the United States––as well as UK, France, and Canada--with some interesting results about consumer perception. The survey found that 70% of U.S respondents had taken a generic in the past few years, while 24% had not (the remainder did not know). The stats were similar for France (73% vs. 20%) and Canada (54% vs. 30%). The Brits favored the name brands (36% vs. 42%).

Phoenix Marketing International uncovered the following perceptions among U.S residents regarding generic drugs:

  • Use of generic medications helps hold down the cost of healthcare: 57%
  • I have no concerns about taking generic medications: 60%
  • I prefer to take brand-name medications, but am willing to take generic medications: 22%
  • I prefer to take generic medications when they are available for my illness: 37%
  • The quality of generic medications is not as good as brand-name medications: 14%
  • I wouldn’t be comfortable taking a generic medication for a serious illness, but they are all right for less serious conditions or illnesses: 7%
  • I would refuse to take a generic medication: 3%

Future segments of this series will cover how to make the most of your Medicare Part D coverage and the hazards associate with purchasing medications over the Internet.