It’s sadly become commonplace for us to hear on the news and from politicians how expensive prescription drugs have become in the last few years. It’s also not uncommon for individuals to find that their formulary no longer covers each of their prescriptions as a preferred brand, or even a non preferred brand.
This results in many people never picking up their prescriptions from the pharmacy due to “sticker shock” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086126/) or families going without essential medications. One example being “Mylan’s 550% list price increases over eight years on EpiPen epinephrine auto-injectors, a must-have product for counteracting allergic reactions.” https://www.modernhealthcare.com/article/20161001/MAGAZINE/310019988/the-solutions-to-america-s-drug-cost-dilemma-and-why-they-won-t-happen
It is a complex argument between the drug companies who pass the blame to insurance providers for high premiums and co-payments who in turn blame the drug companies for their unregulated price increases. No matter how we share the blame, it is the individual insureds who carry the financial burden of increasing prescription costs.
What to do?
While we wait for prescription price regulation or reform of formularies and premiums, there are alternative ways to find lower prices for prescriptions.
During the last several years many insureds have found that it’s cheaper to go outside of their health insurance plan to get their prescriptions for less. It is a sign of a serious flaw in the system that an individual or family pays $500 to $2,000 per month to their health insurance company and also needs to use a 3rd party in order to save money on their prescription drugs.
Nevertheless, companies like GoodRx (https://www.goodrx.com/how-goodrx-works) can “save you as much as 80%” on the cost of your prescription drugs. They also don’t charge you anything to use their discount program. Supported by funding from ad space on their website and app, GoodRx founders saw a way to capitalize on the lack of regulations on prescription costs. Why do insurance companies have a hard time affordably integrating this benefit into their plans — especially for the individual insurance market?