Drugs 101: Reduce out-of-pocket costs

I'd like to share three simple steps which can significantly reduce your drug costs. No, they don’t work all the time (I don’t know what to do with drugs like Lantus, a long-acting insulin, either). But when they do work – oh, you’re gonna love me.

First, let’s debunk some myths.

1. Only one drug works.
2. Insurance offers the cheapest option.
3. Doctors know drug prices.

All false.

If you’re caught at the pharmacy front desk and the drugs are expensive, buy a few days’ worth first.

Then:

1. Call your doctor. Most drugs have cheaper generic substitutes, formulations (taken twice daily instead of once), or sister drugs (different drugs in the same class), which your doctor can easily switch to.
2. Check GoodRx.com. Unless the drug is fully covered by your insurance or is on the generic drug programs of chain stores (like Marc’s, Giant Eagle, Walmart, etc. where they sell a 3-month supply for $10), check GoodRx. It lists discounted prices from different pharmacies around the area. You might be better off paying the retail price using the GoodRx coupon.
3. Check Canadian online pharmacies. Technically it’s not legal. But many people get their prescriptions through Canadian online pharmacies (see my Nov. 29, 2016, column online). If you can find a legitimate pharmacy (start with PharmacyChecker.com), the savings can be huge. Good for brand-name and expensive generic drugs.

Let’s do a real-time example:

Advair HFA (fluticasone/salmeterol) is a popular brand-name asthma inhaler. If I buy it using my insurance card, it costs $1,436 (all prices quoted are for three months). With GoodRx card/coupon, it costs $1,489.

Here come the savings:

1. If my doctor changes Advair HFA to Advair Diskus (same drug and manufacturer, different delivery), it costs $1,134 on GoodRx. But miraculously, it only costs me $75 using my insurance card.  
2. If my doctor orders generics: AirDuo RespiClick costs $837; generic of AirDuo, $99; Wixela Inhub, $358 (all GoodRx prices). (For some reason, my insurance won’t cover AirDuo.)
3. Clicking PharmacyChecker.com (Canadian online pharmacies), I found brand-name Advair HFA starting at $50. Eh!

Is it maddening? Yeah.

Are these drugs that different? No. They will work – they are the SAME drugs with minor differences in delivery systems (inhaler vs Diskus vs RespiClick).

Why are the prices so different? Because of patents, markups and behind-the-door deals – a party you and I are not invited to.   

Why don’t doctors start with the best/cheapest drugs? Honestly, I wasn’t taught practical things like drug prices (or revolving credit) in medical school. What I know now I learned the hard way. What’s the point of prescribing a drug when patients can’t afford it? I got drug-street-smart by working with you.

And, believe or not, websites like GoodRx list alternatives. When I typed in “Advair HFA,” I got three drug/price choices. When I typed in “fluticasone/salmeterol” (the active ingredients), I got more (and cheaper) choices yet.

If you’re like me – I can feel my ancestors flinching in their graves when I pay anything close to full price – do your research.