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Photo credit: Rebecca Anne, "Flora's Cup" | Creative Commons License, Flickr.com

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Crippling Prescription Drug Costs: What We Did, and What You Can Do, about Saving Money on Medications | Cheaper Prescriptions

By Vicki McClure Davidson

 

Generic prescription drugs, instead of costlier brand names, will save you a huge amount of money. | Photo credit, Dani Simmonds, MorgueFile.com
Generic prescription drugs, instead of brand name,  will save you a huge amount of money. | Photo credit, Dani Simmonds, MorgueFile.com

The ongoing rise in fuel, food, and other necessities makes paying for equally-rising medication costs a nightmare for so many people. However, there may be relief for those expensive prescriptions. You may be able to save money.

When my daughter was 16, she was diagnosed with depression. Even though she was an honors student, I had seen her become more and more reclusive. She had struggled with extreme self-esteem and self-image problems for years and was becoming more of a shadow of herself. She had even stopped seeing friends and being involved with school activities.

Concerned, I scheduled her to a session with an on-site counselor at the high school (funded by the Scottsdale Prevention Institute, so no cost to our family). Her counselor later told me he was alarmed about how deep her depression was. After a year of diligently working with her, Daughter had made strong progress. However, the counselor told me that he'd taken as far as he was qualified to and recommended that Daughter see a recommended therapist who specialized in teen issues. He had also suggested for several months that anti-depression medication would likely help her. Not having insurance, and worried about the many publicized adverse effects of anti-depression medication, I fervently resisted going that route.

Her new therapist was absolutely wonderful. They hit it off immediately. After two sessions, the therapist recommended that we take Daughter to visit our family physician and be prescribed anti-depression medication. We did, and he instructed us to schedule a visit with a psychiatrist before any mental health medication would be prescribed.

Once that was accomplished, our doctor gave her several months' worth of free vendor samples of Lexapro®, first at 10 mg, then increased the dosage to 20 mg following his monitoring of her reactions. The results at this level were promising, although Daughter still had frequent bouts of depression.

And then, after a few months, the free samples ran out. A trip to the drug store was shocking. It cost us a horrific $93 out-of-pocket for a 30-day supply. Gulp.

With no insurance and my husband working but not bringing in a reliable income (he is in the mortgage loan industry), I had to act fast. Our fragile family budget could not withstand too many months of these medication costs. This was the equivalent of more than a week's worth of groceries for us.

I researched Lexapro, and found that because it is still a young drug, there are no generic (cheaper) versions. I studied lists of anti-depression medications to seek out alternatives, but really didn't understand much of the pharmaceutical jargon. The side effects of many them were downright scary. For teens and some young adults, anti-depression medication can sometimes do more harm than good. Suicidal tendencies can become more pronounced. Lexapro was one of the better ones for prescribing to teens because the side effects were less frequent.

In desperation, we called the doctor, explaining our financial crisis and our struggle to afford the medication, and we received another few months of Lexapro samples. Sigh of relief until they ran out again. I called the doctor again for more samples, but were told they were out. Frantic, I called the psychiatrist who had seen her several months earlier. From him, we received a few more free months of vendor samples. However, we were told that if we wanted more samples after these ran out, our daughter would have to see the psychiatrist again, which cost $200 for a session. That made no sense to me and made me frustrated, because I'd been told she wouldn't need another psychiatrist evaluation for a year. Now, because we didn't have the resources to pay for the expensive medication, we would be penalized by having to pay instead for a capricious psychiatrist visit months earlier than a year.

When we had exhausted our "freebie" meds sources, we were resigned to buy the Lexapro at full price. It had now jumped to $101 for a 30-day supply. I called a number of pharmacies to see if I could find a lower price, to no avail. I checked online drug sites, but the cost was comparable with shipping and handling included.

We asked the doctor if he would investigate changing Daughter's medication to a drug less expensive. He said he was hesitant to change her medication because she was doing so well on Lexapro and wanted us to wait a while. I was ready to cry. The cost was impacting us terribly.

Discovering Generic Medication

I remembered a media blitz from some months earlier that Wal-Mart had launched a revolutionary concept to help consumers. They would be selling several hundred generic medications for just four US dollars ($4 USD) for a 30-day supply. It sounded too good to be true. I investigated, and it was true. However, Lexapro was not on the list because, being a brand-name drug still under patent, there is no generic alternative for it at present.

There was a significant number of other anti-depression generic medications on the list. And I wondered why one of those couldn't be a suitable alternative.

What Exactly Is a Generic Drug?

According to the US Food and Drug Administration, a generic drug is meant to be identical, or bioequivalent, to a brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use. Although generic drugs are chemically identical to their branded counterparts, they are typically sold at substantial discounts from the branded price.

According to the Congressional Budget Office, generic drugs save consumers an estimated $8 to $10 billion a year at retail pharmacies. Even more billions of dollars are saved when hospitals use generics.

But are they safe?

Health professionals and consumers are assured that FDA-approved generic drugs have met the same rigid standards as the innovator drug. To gain FDA approval, a generic drug must be compliant with the following:

FYI: Spending in the US for prescription drugs was $200.7 billion in 2005, almost five times more than the $40.3 billion spent in 1990. The Wal-Mart $4 Prescription Program lists generic medications for a host of medical needs: thyroid, asthma, blood pressure, cholesterol, heart, viruses, and many more.
As the summer marched on, my daughter turned 18, and so was not as vulnerable to the negative effects of anti-depression medications. However, studies show that caution and scrutiny must be diligent for anyone taking anti-depression medication who is under 24 years old.

We asked our family doctor to evaluate the possibility of Daughter using a different medication. It took several calls for this to happen. But ultimately, he decided that Paxil® would be a good choice for her. The cost of it was about half that of the Lexapro, at $51 for a 30-day supply. Paxil is a name brand, and so it was not on the Wal-Mart generic list.

Even though a 50-percent savings was helpful, I was certain we could indeed find a medication that would work for my daughter at the Wal-Mart $4 price. And I did. Paroxetine is the generic version of Paxil; Paroxetine was on the generics list.

Umpteen calls to the doctor and the pharmacy later, we were approved to switch her new prescription of Paxil to Paroxetine. But then I found an even lower price. One of our local grocery stores that has its own pharmacy has priced generic drugs at $3.99 for a 30-month supply. But, if three-months' worth were bought during one prescription filling, the price dropped to just $10, or $3.33 for a 30-day supply. Staggeringly unexpected good news.

We had gone from $101 to just over $3 for a month's worth of medication. I later found out this same "$10 for 3 Months" discount is offered at Wal-Mart and many other drug stores in our community.

Quote from Wal-Mart's website:

"The list of eligible drugs in the $4 Prescriptions Program—available at Wal-Mart, Neighborhood Market, and Sam's Club pharmacies nationwide—represents up to 95 percent of the prescriptions written in the majority of therapeutic categories. The affordable prices for these prescriptions are available for commonly prescribed dosages for up to 30-day or 90-day supplies. Ask your pharmacist or physician about switching to 90-day prescriptions for appropriate medications."

Wal-Mart has also recently launched a $4 (or lower) over-the counter program on more than 1,000 products was updated on August 13, 2008; a hefty portion of these products focus on women's health to help single mothers. Click here for more information.

What You Can Do to Save Money

If you are paying high costs for medication out-of-pocket, you can potentially lower your cost. If you or your spouse recently lost a job or lost medical benefits, you may have never thought about buying genric drugs because your company medical plan covered your meds costs, minus the obligatory co-payment.

Ask your physician if there is a generic drug that you can take instead of the name-brand medication. However, your doctor may need to be prodded a bit (like ours) because he or she may not know the information about generics without conducting some research; that takes valuable time for him or her to do. So, if necessary, be gently persistent. Also, be aware that there may be unique medical reasons why you cannot take a generic medication. Follow your doctor's advice, should he or she advise against it (generic thyroid medication, for instance, is arguably one of the medications that causes great concern for many physicians).

You can conduct research on the Internet to find out if your medication has a generic equivalent. | Photo credit: MS Office
You can conduct research on the Internet to find out if your medication has a generic equivalent. | Photo credit: MS Office

You can also conduct research on your own. There are many sites on the Internet (www.drugs.com and www.WebMD.com are just two of many informative websites) to see if your medication is listed. Because of their R&D costs, pharmaceutical companies have exclusivity for the life of the patent (currently is 17 years), in which time they must charge high prices to offset their development costs in bringing the new drug to market. After that, other drug-manufacturing companies are allowed to manufacture generics, following the strict guidelines. Be sure to consult with your doctor.

Don't be shy about asking your physician for vendor samples of your medication. These "freebies" are distributed by drug company sales reps (usually for the newer, expensive meds for trial purposes, as opposed to cheaper medications) and cost your doctor nothing to give to you. Be aware that not all doctors have samples of all medications, but it doesn't hurt to ask.

If you or a family member is taking several medications, it is extremely important for your physician to be sure that there are no negative effects from the combination. Many of us know of people who, after being prescribed several medications, start to do worse. My aging father-in-law was one of these people; he was on death's door for months and no one knew why. Lo and behold, it was discovered by a new doctor that all his meds were fighting with each other and were severely impacting his health. A few adjustments and the elimination of a couple of prescriptions, and he was a new man and lived five more years.

Wal-Mart started the trend to offering cheaper prescriptions, and now more and more drug outlets are following suit with their own $4 generic meds. You will want to research those in your area to find which ones do.

Prescription Drug Discount Cards

Another cost-cutting prescription alternative that I started investigating was that of prescription drug discount cards that are now available in many countries throughout the US. The National Association of Counties (NACo) recently teamed up with Caremark to make this available. This was designed for uninsured and underinsured county residents. There are no enrollment fees, no forms to fill out, no medical restrictions, no age or income requriements.

On average, the discount cards reportedly save up to 20 percent on prescriptions. They are free to that specific county's residents. In some cases, the discount card can also be used for pet medications that are filled at regular pharmacies. A national network of more than 57,000 retail pharmacies honor the discount card.

Below is a link for you to check for your county, should your medication not qualify for the $4 generic prescription cost. At present, not all counties participate in this program, so be sure to check to see if yours is, at The National Association of Counties website.

Partnership for Prescription Assistance

Another option is the Partnership for Prescription Assistance. It brings together America’s pharmaceutical companies, doctors, other health care providers, patient advocacy organizations, and community groups to help qualifying patients who lack prescription coverage get the medicines they need through the public or private program that's right for them. Many will get them free or nearly free. Its mission is to increase awareness of patient assistance programs and boost enrollment of those who are eligible. Through this site, the Partnership for Prescription Assistance offers a single point of access to more than 475 public and private patient assistance programs, including more than 180 programs offered by pharmaceutical companies. To access the Partnership for Prescription Assistance by phone, you can call toll-free, 1-888-4PPA-NOW (1-888-477-2669).

For our family, the cheaper generic version saved us from financial hardship. We had dreaded spending more than $1,200 this year on anti-depression medication that we couldn't afford, and now, it will cost only $40.

This turn of events was beyond frugal. It was our financial salvation. And, with the options you now know are available, perhaps it can be for you or someone you know, too.

Websites to Visit for More Information

US Food and Drug Administration - Office of Generic Drugs
Wal-Mart's $4 Prescription Program (pdf)