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Paying For Your Medications

We are fortunate to live in a time when so many medical conditions are treatable with medications.  There are some well-known stories about the observation of President Franklin Delano Roosevelt’s well-documented progression of hypertension that led to his death from a stroke.  There was very little available to treat his high blood pressure, and his rise in pressure is well documented all the way up to his massive stroke at the age of 63.  These days, we have many new medicines and by and large, we are able to get the blood pressure under control.  Diabetes, osteoporosis and heart failure are other conditions for which we have excellent medications available.  Unfortunately, costs of these medicines are often very high and have gone up each year.  It is not unusual for someone with multiple medical problems to spend hundreds of dollars per month on medications.  Unless you are independently wealthy, these costs can be a problem.

If you have insurance with prescription coverage your biggest concern is the amount of your co-pay.  Generic drugs, if available, are excellent ways to save money.  Unfortunately, some people do not respond to the medications that are available generically.  Most people with hypertension or diabetes also need to be on more than one medication.  At this point in time, our biggest concern is that most patients on Medicare do not have any drug coverage at all.  Since medication costs are so high we realize that it is a struggle.  Options regarding medication coverage do exist however and you should investigate these.

1.  Ask your doctor or healthcare provider whether you could be treated with less expensive, generic medications.  This is a fair question, and it may be that you were given samples of a medication to start and your doctor's office just may not know that the cost of the medicine is a problem.  If you do change however you may need to go through a period of trial and error, filling the prescriptions and getting re-checked a few times to get the medication or the dosage adjusted.

2.  Utilize local pharmacy or national drug discount cards.  These are available, often times for a fee, and may offer a 10-30% discount.  What you need to do, is figure out the cost of your medications per month and multiply that by twelve and then subtract the discount offered.  For example:  your medications cost $50.00 per month times twelve months = $600.00 per year.  30% discount means you will save $180.00.  If the cost of the card is less than $180.00 per year you will save the difference.  If the cost is over $190.00 per year ($20.00 per month means it costs you $240.00 per year) you won't save any money!  So, the bottom line is-do the math.

3.  Drug companies have recently come up with a great free service which involves cards that can save you money on their brand of drugs.  If you do take multiple drugs you can go ahead and sign up for any or all of the cards.  Most of the cards do require that you don't have any other prescription coverage, and they will ask you for some personal information such as your income level.  Usually if your taxable income is less than $36,000.00 per couple or $27,000.00 per year for single, you will be eligible.  Novartis (which makes drugs such as Diovan, Exelon, LescholXL, Loperessor, Lotensin, Starlix, Tegretol)  has its card called the Novartis Care Card (sm).  To receive this call 1-866-974-CARE.   Glaxo SmithKline ( Avandia,Coreg, Flonase, Flovent, Imitrex, Paxil, Wellbutrin XR and others) offers the Orange Card (sm) to give an average savings of 30%.  This involves filling out an application that is available at your doctor's office.  Pfizer has a plan to offer any of their medications for only $15.00 per month.  They are the makers of such drugs as Aricept, Glucotrol, Lipitor, Neurontin, Norvasc Viagra, Zoloft, Zyrtec and others.  To apply for the Pfizer Share Card ™  call 1-800-717-6005.  Eight large drug companies have banded together to offer the TogetherRx Card™, which will offer 30% or more discount on their medications.  To enroll in the program call 1-800-865-7211. 

4.  Sometimes, seniors are on so many medications, even a 30% discount or $15 prescriptions may be prohibitive.  It your yearly income is low, there are ways to have free medicine sent to the physicians office from the drug companies for you.  This process does involve forms that need to be filled out with personal information such as your yearly income.  They must be processed at the provider's office. Usually three months of medication are sent at a time.  Before the three months is up however the forms will need to be filled out all over again.  Most doctors’ offices have the forms already.   Because of the paperwork and time, your doctor's office may require an office visit or small fee to fill out the forms for you.  You also need to be aware that the doctor's office does not have any control over whether or not you will be approved for the medication assistance.  You do need to personally go to the office to sign forms for each medication before retrieval and each drug may take up to six to eight weeks to be received.

5. Most doctors’ offices also will usually help out with samples of medications if appropriate.  Pharmaceutical companies provide many thousands of dollars of samples each year and unofficially recognize many of the samples are used for patients who have financial trouble with their medications.  The down side of the samples is that often they're not available when you need more refills and usually these medications are the more expensive newer drugs.

In summary, drug costs are a major burden for all patients with medical problems.  It is most noticeable however in the elderly patients with multiple medications.  Unless and until this issue is addressed at a national level, these methods above may be a way of getting some help for the steep costs of managing your medical conditions.  You can check out our website at for more information and links to some of the above companies.

Joseph Moore, PA-C



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Last modified: April 04, 2004