6 Tips to Help Reduce Patient Medication Costs
So far this year, several drug makers have announced list price increases for nearly 450 drugs. Undoubtedly, many patients will continue to struggle with affording medications, which can reduce medication adherence. In order to help patients decrease medication costs without sacrificing important medications, VHAN’s pharmacy team suggests using the following strategies when possible:
- Eliminate unnecessary medications. Providers can eliminate unwarranted cost and side effects by deprescribing medications without current indications (e.g. PPIs for resolved GERD). Likewise, look for opportunities to optimize regimens where additional agents are being used to treat avoidable side effects. For example, if meclizine was treating dizziness caused by diuresis treating swelling from amlodipine, a simple switch of amlodipine to an alternative could avoid two additional agents.
- Prescribe lowest tier medications. Payers often prefer specific agents within a therapeutic class. Payers may provide members medication formularies with a breakdown of tiers and coverage. Generally, new medications are higher tier and more costly. Some formularies are available online, including Navitus (for VHAN members), Healthspring MA, Wellcare MA, and Medicaid. In addition, some electronic medical records have “real-time benefit check” capabilities to determine medication cost. Check with your organization.
- Use low-cost alternatives. If clinically reasonable, switching to a different medication or class may help reduce drug spend (e.g. switching Januvia to a sulfonylurea, converting between single and combo agents).
- Use patient assistance programs. Several assistance programs are available based on varying income requirements, including manufacturer programs (see manufacturer websites for details). Medicare beneficiaries can also apply for Extra Help with medication costs. Visit Needymeds.org for help identifying assistance programs.
Try discount cards and coupons. Many discounts are available for specific medications or general use. See medication websites or needymeds.org for medication-specific cards and coupons. Retail pharmacies may also have discount cards available on site. In many cases, medication-specific discounts cannot be applied to Medicare or Medicaid plans, though there are exceptions. Cash-paying discount cards such as GoodRx can be used in lieu of insurance, however, at the patient’s discretion or for uninsured patients. Of note, coupons reduce a patient’s copay but do not lower the plan cost for medications. They may also have limited duration. Thus, they are most appropriate when a lower cost alternative is not available.
- Use free and over-the-counter medications. Some pharmacies offer low-cost chronic medications (e.g. Publix free medications). Likewise, Relion brand insulin (R, N, 70/30) is available over-the-counter at Walmart and can be substituted for more expensive insulin regimens in some cases.
While there is no one-size-fits all solution for every patient, these strategies will help decrease patient cost, increase adherence, and improve care. In addition, our pharmacists and technicians are available to help navigate any complicated cost situations for VHAN patients. Reach out to your Population Health Associate, Care Coordinator, or call us directly at (615) 936-2828 for assistance.