Episode 116: Sticker Shock at the Pharmacy: What’s Driving Costs—and What to Do

In this episode, Sandy Kibling discusses the high costs of prescription medications and offers insights into why they are so unaffordable. She explains the role of drug manufacturers, insurance companies, and the complexities of formularies and tiers. 

Sandy provides practical strategies for reducing prescription costs, including exploring generics, alternative medications, and patient assistance programs. She also highlights the benefits of using Canadian pharmacies and online options for obtaining medications at lower prices. 

Takeaways

• Prescription medications are often unaffordable due to manufacturer control over pricing.
• Patents can prevent the availability of cheaper generic options for many years.
• Insurance plans can vary significantly in how they cover medications, leading to different costs for the same drug.
• Understanding drug tiers and formularies is crucial for managing medication expenses.
• Deductibles for prescriptions may be separate from medical deductibles, impacting out-of-pocket costs.
• Asking about generic versions and preferred alternatives can lead to significant savings.
• Discount cards and apps like GoodRx can help reduce medication costs, but may not count towards deductibles.
• Canadian pharmacies can offer substantial savings on medications, but caution is advised when choosing a provider.
• Regularly reviewing healthcare plans is essential to ensure coverage for necessary medications.

Sound Bites

• "Patents can last for 20 plus years."
• "Always ask if there's a generic version."
• "Check out the show notes for resources."

Chapters

03:01
Understanding the High Costs of Medications

12:11
Navigating Insurance and Formularies

14:04
Strategies for Reducing Prescription Costs

22:24
Exploring Alternative Options for Medications

28:37
Special Considerations for Medicare Recipients

31:01
Using Canadian Pharmacies and Online Options

Resources:

GoodRx

SingleCare

Optum Perks

Mark Cuban Cost Plus Drugs

Episode 111: Getting Safe Prescription Medications Across the Border

Want to be a guest on Get Savvy...Demystifying Healthcare? Send Sandy Kibling a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/getsavvydemystifyinghealthcare