Advertisements for prescriptions are everywhere these days. They advertise the latest and greatest medications. New innovative treatments. Promising cures, or at least improvement, in mental health, skin conditions, low energy and everything else. However, these breakthrough treatments don’t come cheap.
Prescription drugs are a key driver contributing to the increase in health insurance premiums. Since 2014, prescription drug prices have increased 33% overall, and 60% for brand name drugs. Even though brand-name drugs account for only 10 percent of the prescription drug market, spending on such drugs account for almost 80 percent of total prescription drug costs. High prescription drug prices are sustained by the fact that treatments for serious disease are not luxury items but are needed by vulnerable patients who seek to improve the quality of life or to prolong life.
You can be proactive in controlling your medication costs by switching to generics whenever possible and advocating for yourself. Have a conversation with your doctor annually to make sure you are taking medications which align well with your health needs and your insurance plan. Some insurance plans allow doctors to see your cost for medications so they can take that into account when prescribing. Look for discount programs and coupons. GoodRx.com is a great resource.
Insurance companies are adapting to the price increases as well. One approach is to pare down the drug formulary (aka list of covered medications). A smaller drug formulary provides more cost control and allows the insurance company to steer insureds to the medications which are proven to have the best balance of treatment efficacy and price. If a patient has a proven need for a particular medication that isn’t on the formulary it is possible to get an exception granted so this needed medication is still covered for that individual.
Another way to lower your prescription costs is to create a preferred pharmacy network. Prescription costs aren’t the same at every pharmacy. Prices for the same medication can vary significantly even within the same town. By steering members to certain pharmacies, insurance companies can ensure their members are filling prescriptions at the most cost-effective locations.
One insurance company has taken an innovative approach to cover medications they deem as Preventive Medication free of charge. These free medications aren’t just the $4 generics, but even include name brand drugs. We’ve heard from some clients it’s saving them hundreds of dollars per month. While this approach can be counter-intuitive in the short term, the insurance company is betting on the long-term payoff. People are much more likely to regularly take their medications if they are free. They will in turn be healthier compared to someone who doesn’t take a medication due to cost.
The bottom line is that you have options to consider when it comes to lowering what you pay for your prescriptions. Got questions about this? Our ComPro Team is here to help you. Located at 1040 N. Cotner Blvd. in Lincoln, 402-488-5100. Helping you connect the dots of your health insurance.
By Kayla Northup – Agent, Employee Benefits Manager