How To Cut Rx Costs

Pharmacy Outreach ProgramThe University of Rhode Island

College of Pharmacy

Statistics Estimates for 2011

$227.6 billion in prescription costsOver 3.7 billion prescriptions filled at

pharmacies (2011) People ages 65 and older consume

more prescription and OTC medicines than any otherage group

Does anyone know why drugs are so expensive?

Question:

Why Are Drugs So Expensive?

Research & DevelopmentUsually takes over a decade for one drugNot every drug reaches the marketClinical trials!

Cost of production and manufacturing Advertising

$2.5 billion each year Demand

Drugs not in high demand often cost more

Practical Ways to Save Money

Be your own advocate!Be proactiveCommunicate with your doctor and ask

questionsAsk your Pharmacist!

○ Best resource for prescription and insurance related information

○ Some pharmacies have coupon cards on handResearch different assistance programsDon’t be embarrassed to tell your doctor you

can’t afford your medications

Practical Ways to Save Money

Request formulary medications onlyFormulary: list of drugs covered by insuranceBring your drug formulary list when you visit

your doctor Ask your doctor about less expensive

therapeutic alternatives Ask your doctor for samples or coupons

Samples may not have directions on them, be sure to check with doctor about how to take them!

Let pharmacy know to check for interactions!

Question:Who knows what a generic drug is?

Generic vs. Brand Drugs Use generic medications whenever possible! Generic drugs are copies of brand drugs

Generic drugs are just as safe as brand drugs and work the same!!

Both versions of drugs have the same manufacturing procedures and safety profiles and are equally regulated by the FDA

By R.I. law, generics are automatically substituted for brand name medications unless specified by Dr. or patient

Practical Ways to Save Money

Mail OrderSome insurance plans allow you to receive

a 3 month supply of your maintenance medications for the price of a one month co-pay via mail order

Convenient for someLet pharmacist know if you get some medications through mail order and others at the retail pharmacy in person!

Practical Ways to Save Money Live a healthy lifestyle

Leads to a decreased need for medication, leading to a cost savings for you

Take your medications exactly as prescribed by your physician and as written on the labelSide effects to medications is a leading cause of

hospitalization in the elderly Store your medications properly

○ Not in the bathroom○ Not in the car○ In the fridge (if needed to be refrigerated)

Practical Ways to Save Money

Don’t let direct-to-consumer advertising influence you!Example: “The new purple pill” - Nexium®

(esomeprazole)○ However, Prilosec® (omeprazole) which is available

OTC & generic by prescription may do the same jobExample: Dr. Oz said…

Always ask you doctor or pharmacist questions about what you hear in advertisements

Internet Pharmacies Many of them are not properly

licensed & regulated!! Only use sites that have the VIPPS seal of

approval from the NABPVIPPS = Verified Internet Pharmacy Practice

Site

Importing Medications From Abroad

There are many downfalls to importing medications from other countries, including Canada:It is almost always illegalThe safety & efficacy of these medications is

unknown and not reliableThe medications have not met FDA

standardsThe drugs may be expired, contaminated, or

counterfeitYou have nowhere to turn should a problem

occur

Does anyone know who is covered under Medicare?

Question:

MEDICARE Medicare provides health insurance for people:

Aged 65 years or olderAged 65 years or less with certain disabilitiesAll people with End-Stage Renal Disease (ESRD)All people with Lou Gehrig’s Disease (ALS)

MEDICARE Part D In 2013, enrollees will pay 47.5% of the

total cost of BRAND NAME medications in the gap

Will only have to pay a max of 79% on GENERIC medications in the gap

Additional savings each year through 2020 In 2020 the coverage gap will be closed

2014

Programs to Help With Drug Costs

SHIP - Senior Health Insurance ProgramVolunteers provide seniors with information,

counseling, and assistance in making decisions about Medicare, supplemental insurance, managed care, etc.

Free! RxAssist.org

Web based resource for patientsGet access to discount programs

offered by○ Retail pharmacies○ Pharmaceutical companies

Question:

Does anyone here have RIPAE?

RIPAEState program which helps elderly pay for their

medicationsProvides coverage throughout the deductible and

coverage gapBUT, it is not creditable coverageRIPAE is only be available for those enrolled

in a Medicare part D planMust send in copy of enrollment

letter or card

Programs to Help With Drug Costs

RIPAEProvides extra benefit for those who don’t

qualify for Extra Help from MedicareOnly covers generic drugs

○ unless there is no generic available or the doctor specifies brand

Applicable to all expenses that person is 100% responsible for, including:○ Deductible○ Coverage gap (“Donut Hole”)○ Drugs not covered under your Part D Plan

Only certain ones!Visit RIPAE for a list of covered meds

Programs to Help With Drug Costs

RIPAE To be eligible must be:

Over 65 years, or aged 55-64 receiving disability (SSI)

Coverage level based on income

Programs to Help With Drug Costs

Practical Ways to Save Money Housing and Urban Development (HUD) Residents

Save the receipts from your daily OTC items (such as vitamins, glucosamine, creams, and Depends)

Turn them into the housing office along with a note from your doctor saying that it is necessary for you to use these items

These receipts will then be counted towards your annual rent deductions

Pharmacy Outreach ProgramActs as a resource for medication assistance

programs, both State and NationalAnswers common medication questions

○ Generic vs. brand name drugs○ Drug formularies○ Therapeutic substitutions

Medication Information Line○ Toll free number: 1-800-215-9001

Programs to Help With Drug Costs

Medigap PlansSupplemental prescription drug

coverage insurance that you can purchase

Offered by many organizations—most popular is AARP

Will help with costs that are not covered by Medicare (copays, deductibles)

Programs to Help With Drug Costs

For Veterans and their spousesYou may be eligible for these programs:

○ TRICARE for Life ○ TRICARE Senior Pharmacy Program

You may also be eligible to receive meds from VA pharmacy clinics

Programs to Help With Drug Costs

Partnership for Prescription Assistance○ Help with more than 2,500 brand-name and generic

medicationsFree or low cost

Make sure you know the names of your medications

Call 1-888-4PPA-NOWVisit www.pparx.org

Trained specialists will answer your questions and help you apply—it is a free service!

Programs to Help With Drug Costs

Medication Discount Cards20-40% discount on certain brand

name medications offered by the drug company manufacturers and 15% savings on generic medications offered by some pharmacies

Only for people who do not have prescription drug coverage ○Not for those that qualify for

Medicaid or MedicareFor RI seniors, RIPAE is usually a

better program

Programs to Help With Drug Costs

www.internetdrugcoupons.comSome specify Med Part D or

Medicaid patients are ineligible AAA discount!

Senior Citizen discountMost pharmacies offer a 10%

discount on cash prescriptions for seniors

Programs to Help With Drug Costs

Pharmacy Savings Programs

Most major chain pharmacies and many smaller independent pharmacies may price match—ask!

Walmart, Target, CVS, Rite Aid, Walgreens, Stop & Shop, KmartAll have prescription savings plansSome require an enrollment feeOnly specific generics coveredSome allow a 3 month supply

○ Even greater savings○ More convenient

Summary and Key Points Be your own advocate! Communicate with your Doctor and your

Pharmacist Look at each medication you are taking &

evaluate its cost Research which programs can benefit you Be an informed consumer & patient Take your medications exactly as your

physician prescribes

Important Phone Numbers

Medication Information Line 1-800-215-9001 Medicare Prescription Card 1-800-633-4227 RIPAE (401) 462-0501 Rx for RI 1-877-743-6779 Medication Discount Cards—various #’s;

Most popular card: Together Rx. 1-800-865-7211 SHIP appointments – contact local Senior Center TRICARE Programs – contact

Sierra Military Health Services 1-888-999-5195

Thank You!!

Pharmacy Outreach ProgramThe University of Rhode Island

College of Pharmacy www.uri.edu/pharmacy/outreach

1-800-215-9001