“That’ll be $187.”
I just blinked at the pharmacy technician. “And you ran that through my health insurance?” I asked. “Yep. That new medicine isn’t available in a generic yet.” I mentally started running through ways to carve out an extra $200 a month in the family budget to cover my son’s new asthma medicine without upsetting our carefully planned budget. While in shock over the out of pocket price, I was still thankful that he only had to take medicine for 6 months out of the year. Some families aren’t so lucky. I’ve had many patients over the years who have had to make the hard choice between paying for medications or paying for utilities and groceries. Prescription drugs can be brutal to pay for, even with decent health insurance coverage.
These days, I often find myself providing in-depth lessons on how to get the most out of your medications thanks to the ever-rising cost of healthcare. Here are a few tips I give my patients.
Getting the Most Out of Your Medication
- Take your medication at the same time everyday. Set a timer if necessary and stick to your schedule. Varying administration times affects the level of medication in your bloodstream creating times when you are absorbing too much or too little of your medications that can result in erratic effectiveness.
- Take your vitamins and prescriptions with water only and avoid drinking any juices or caffeinated beverages for an hour before or after taking your medicine.
- Always read the literature that comes with your medication from the pharmacy. Be aware of common side effects and symptoms of life threatening conditions that can occur with any prescription medication, such as an allergic reaction, heart palpitations, or liver damage.
- Know what your pills normally look like and question the pharmacist if anything changes in the appearance of your medications from month to month. Also, count the number of pills in the bottle before leaving the pharmacy. Even pharmacists sometimes make a mistake and you want to make sure you get what you pay for each month.
- Take a liquid multivitamin instead of a pill. Many multivitamins are poorly absorbed, especially if you have any conditions that affect your digestive system, and end up passing through your system intact. This is particularly true for some treated pills, like oyster shell calcium tablets. Some pills can be crushed or dissolved before ingesting to increase absorption, but always check with your doctor or pharmacist first before altering any medication.
- Talk to your doctor about the appropriateness of taking a generic medication versus a name brand drug. Some practitioners prefer patients take name brand medications for serious conditions, while others believe that generic brands are fine. Be sure you know which is appropriate in your case.
- Talk to your pharmacist to see if any of the medications you are taking should be combined with vitamins or minerals for better absorption. Conversely, always be aware of what over the counter drugs and supplements are contraindicated while taking your prescribed drugs.
- If one of your medications is outrageously expensive, talk to your doctor. Often, your physician has several options to choose from when prescribing a medication. Come prepared with a formulary from your health insurance company that shows the cost tiers of common medications to help your physician make an informed choice about prescribing a cost-effective treatment. Your doctor cares about your health and will work with you to find an affordable treatment solution. He or she may even be able to provide coupons for drugs and samples to help alleviate the strain on your wallet.
Getting the most out of your medication includes being an informed consumer and knowing what steps to take to ensure your medications work at peak effectiveness. Be honest with your healthcare practitioner about your need to save money on prescriptions. Most doctors and nurse practitioners are happy to accommodate your budget restraints whenever possible- it means you’re more likely to pay their medical fees on time.
{ read the comments below or add one }
I agree that even with adequate health insurance coverage, prescription medicines can be prohibitively expensive. As you mention, you have many patients who can choose between paying for medications or utilities and groceries. I’m glad I have heard about the affordable medication here in Bendigo. I think this is very convenient for the less fortunate family to avail of the same medicines as another hospital with the same benefit.
$187 really hurts especially if you already are on a tight budget. I agree with liquid multivitamin supplementation over pills. I personally take an powder version that is best when added to fruit juice.
Anyhow thanks a lot for the tips on getting the most out of our medication Jamie.
@Catherine
You misunderstand my post. I’m not arguing in support of supplement use.
In an otherwise informed effort to make a broader point, you misleadingly asserted that studies show that multivits, specifically, are actually harmful (vs. questionably beneficial or benign). An altogether flawed study along with apparently two as-yet-unpublished studies that evidently show possible mild benefit (a far cry from harmful) do not support your assertion. I’m stating the obvious here, but less obvious is what might compel a physician to make such an unsubstantiated claim.
Look. I’m not trying to nitpick, and I do believe you’re well intended. But you’re pushing misinformation and, from a patient’s perspective, I find that concerning. There’s a gaping distinction between, “evidence supporting their use is scientifically very weak” [arguably substantiated] and “Recent studies show they even increase mortality.” [unsubstantiated and, thus, sounds more like an appeal to irrational fear rather than considered reason]
Further, it seems to me that you yourself must have some measure of confidence that multis are on some level beneficial–vs. harmful–or why else would you plead for donations of multis to mission kids?
Your last post tells me that you’re not actually arguing science, rather personal values. I don’t have any particular issue with that, and I’m in agreement with most of it so far as it goes.
You might find this interesting:
http://www.informationisbeautiful.net/play/snake-oil-supplements/
It’s an interactive graphic generated from collated supplement studies. Included are only published human trials– if you scroll to just below the graphic, you’ll find a link to their spreadsheet which includes links to referenced studies. It’s by no means authoritative or complete, but it is indeed informative and can serve as a handy springboard to more in-depth research.
actually, i think the graph on the link you provided is pretty good. Folic acid, obviously, everyone agrees is a good idea in pregnant or fertile women who may become pregnant. It easily can be taken from your diet but most people have terrible diets so I think it’s a good idea. Vit D is obviously beneficial if you are deficient. Sunshine will get you plenty if you aren’t. Garlic is beneficial- but you hardly need to take it in a supplement. the others are just “promising”. What I am generally against is a broad “multivitamin” that includes a lot of things in untested proportions without any clear benefit to 99% of what it claims to contain. I think focusing on a varied diet of whole foods is a much better use of your money. Individual supplements that are medically indicated are appropriate.
I am far to lazy to do a pubmed search right now to prove my point, but I do think this graph gets the general idea. Omega 3 supplements and zinc, from what i remember, are falling out of favor in recent studies. And yes, I think multivitamins are beneficial in children who suffer from chronic malnutrition and lack of access to fruits and vegetables due to extreme poverty and famine. For the average American kid who gets more than enough calories and nutrients in a day- no. A varied diet will more than cover them if they do not have an identified deficiency that needs supplementation.
Actually, I was referring to that study along with a study that two of my ICU attendings did on multivitamins that has been submitted for publication. They reviewed the data and showed only possibly mild benefit of one or two supplements- Vit D in the deficient and Vit B12 in the deficient.
I am fine with patients taking them if they want and I agree that the evidence either way isn’t perfect, but you must also accept that the evidence supporting their use is scientifically very weak. Why would you spend money on something with so little evidence behind it instead of investing in proven methods of reducing disease burden? Your money is worth more than that and so is your health. If money is tight, buy frozen vegetables and visit your local farmer’s market. Please donate your unused vitamins to a medical mission- I have kids that genuinely need them because they live off of nothing but corn and beans for 5 months of the year. Also, if you must use them please do not take super doses of fat soluble vitamins (A, E, D, K). They can be toxic and vitamins are not regulated by the FDA so you may be getting 1000x the dose of these vitamins reported on the box. You may also be getting heavy metals toxins, viagra, pesticides or any number of ingredients that are entirely untested. For herbals, please order from Germany. They are the only country with a regulating body for herbal medications and the ones in the US are completely unpredictable and possibly toxic.
Catherine: “Recent studies show [multi-vitamins] even increase mortality.”
I assume you’re referring to the Iowa Women’s Health Study published in the Archives of Internal Medicine, 2011. As an M.D., surely you’re aware that this particular study has been widely recognized as intrinsically flawed to a degree which calls into question even correlation much less causality.
You’re certainly entitled to your opinion that multi-vit supplements are not only ineffective but harmful, but there exists no body of evidence to support that opinion.
Advice from a doctor:
1. multivitamins buy you nothing but expensive pee unless they are medically indicated (you have a proven Vit D deficiency etc.) Recent studies show they even increase mortality. Eat your fruits and vegetables and save your money
2. I second the WalMart 4$ list and bringing your insurance info to the doctor. A lot of times the second best choice that is much cheaper is more or less equivalent to the medication we chose first. Cost isn’t always our first priority and we need patients to remind us of what they can afford.
3. Exercise, lose weight, eat whole foods, quit smoking, don’t drink too much and practice some form of relaxation therapy (yoga, meditation, something else that helps you cope with stress) and you will save a TON on medications. the vast majority of people I see would not require medications if they made better lifestyle choices. Also, please read “The Worried Well”. Hypochondria, anxiety, somatization and unreasonable expectations would eliminate another 10%-15% of my patients.
Whenever I am put on medication, I always make sure I take it at the same time daily. I didn’t know this actually had some benefit but glad it does. I used to do it purely for disciplinary reasons though, as I’d forget to take the medication otherwise. The high costs of medicines these days makes it very important to be thorough while making your purchases. Yesterday, I went to buy some wart medication and I made sure the solution bottle was sealed as well as checking for the correct number of pills.
-Jean
Hi Jamie,
Here in Spain and Europe is the free market; so many times you can order the medicine over the Internet from other state pharmacy cheaper than in the country you are in.
Always see what the active ingredient is in the pill. Here in Romania we have pills that do the same thing (let’s say based on Ibuprophen) and they have various costs. If I take something ‘simple’ and unbranded it can sometimes cost 5-10% of the price I pay for a ‘brand’ pill that’s based ON THE SAME ingredient and does the same thing. As a general rule here most pharmacists and doctors are paid commission by the pharma companies to ‘push’ their more expensive medicine, so most of the time, if you ask your doctor: what else can I take since it’s too expensive, they can give you the ‘non-brand’ medicine that does exactly the same thing.
But, as you say: BE INFORMED, this is what matters. The moment you have more information and knowledge, you can really get better deals and services than one who just takes everything for granted.
Always ask your doctor if your prescription is available in generic and if they say it isn’t, check with your insurance for the list of drugs that they consider generics for the prescription. Then, call your doctor and ask if any of those drugs are suitable. I have had this work for me multiple times. In the end one of the generics was perfectly fine and a fraction of the price.
Also, in my experience small neighborhood pharmacies are much more willing to put the time and effort in than the big chains to help you find a generic and then call the doctor to have the prescription rewritten.
This is an important post. Particularly as we all find ourselves caring more and more for our elderly parents – lowering medication costs will become a normal part of our financial lives.
A few thoughts on lowering the cost of medications:
– Provide Information: You need to prepare your doctor with costing information (your point #8). Doctors are experts in medicine, but not in the pharma industry. They also aren’t familiar with the costs that your specific insurance carrier will cover
– Speak Up: Doctors are helpful knowledgeable people. Your financial situation is not the number 1 thing on their mind however. It can be intimidating to push back a bit on your doctor but they will likely respond positively and try to work with you.
Additional things I would like to know:
– What are good resources to research generic drugs?
– What are the tricks and approaches to extracting the best medication coverage out of Medicare Part D and Medicaid?
– What are the basic to getting a formulary form from your insurance carrier? How can this process be made simple for people?
This topic is worth a lot more energy and focus. Looking forward to researching more.
See if you can get an Rx for double strength pills (not capsules) and split them. Splitters are cheap in Walmart, etc etc. and last a lifetime. Search for Canadian pharmacies and save big buck$.
Ask the doctor if they have samples of the medicine (explaining of course your money constraints). Sometimes he can give you a three month supply this way, saving you a ton.