Many Americans are soon going to find prescription medications making less of a dent in their wallets, with 19 brand-name drugs losing patent protection this year or next, and more than two dozen others by 2015. Before long, "eight out of 10 prescriptions can be filled with a generic," notes Steve Miller, chief medical officer for Express Scripts, a pharmacy benefit management company in St. Louis.
Among the bestselling drugs, cholesterol reducer Lipitor lost its patent protection last week, while the blood thinner Plavix loses exclusivity in the spring of 2012. As other firms manufacture generic equivalents, prices should drop "by 60 percent to 80 percent," Miller says.
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For example, before the cholesterol drug Zocor went off patent in 2006, it sold for about $150 for a 30-day supply. Six months later, as more generic manufacturers entered the market, the price dropped to less than $20, according to Express Scripts.
Obviously, consumers would be wise to pay attention to which of their medications are moving to generic, but there other steps they can take to save on prescriptions.
Talk to your healthcare provider. If drug costs are an issue, "tell your doctor," says Ira Wilson, chairman of Brown University's Department of Health Services, Policy, and Practice. Too often physicians prescribe the newest drug, even though an established medicine may work better and cost less. A published study of 17,000 seniors by Wilson showed that patients are about five times more likely to be switched to a lower-cost medicine if they discuss costs with their doctors. Even when generics aren't available, doctors have other lower-cost options, such as prescribing another drug in the same therapeutic class or even within a different class.
Get a medication review. Ask your doctor or pharmacist to review your medications, suggests Nicole Brandt, associate professor at the University of Maryland's pharmacy school. "The first question is whether a medication is still indicated," she notes. "Clearly, you'll save a lot of money if you can stop a medication." Some medicines intended for short-term use, such as sleeping pills or drugs that many hospital patients get to relieve stomach distress, unwittingly become long-term habits. Drug reviews also can lead to dose reductions for certain medicines—common among older adults, as the aging body metabolizes drugs differently—or reveal that patients are taking similar medicines prescribed by different doctors. Under Medicare, certain beneficiaries may qualify for a free annual medication review, Brandt says.
Look for 3-for-1 deals. Mail-ordering drugs can save you money on medications that you tolerate and take for a chronic condition, but not for one-time prescriptions. You also can get a 90-day supply for a single copay, rather than three monthly ones. Some local pharmacies do this, too.
Check your health plan's formulary. You'll pay more for brand-name medications that are excluded. However, if a particular drug is necessary for you and not covered under the formulary, then "appealing is a good thing to do," says Cheryl Fish-Parcham of the advocacy group Families USA.
Check with your health plan about how to pursue the appeals process or consult your state's Consumer Assistance Program These resources can also hook you up with pharmaceutical assistance programs if you are having problems affording your medicines.