Minimizing Your Prescription Drug Costs
Americans spend over $150 billion per year on prescription
drugs. The average American gets 10 prescriptions per year, and
over 10% of their total healthcare expenses are for
prescriptions. Starting in 2006, no plans that are qualified to
work with health savings
accounts may cover prescription drugs as an insured benefit
until after the deductible is met. So for HSA owners, one of
your biggest health expenses could be for prescription drugs.
Here are some ways to reduce those costs.
Generics
A report was published this week by Express Scripts Inc., a
pharmacy benefit manager, indicating that increased use of
generic drugs would save consumers $24 billion in 2005. Generic
drugs cost an average of $60 less per month, than brand name
drugs.
It is important to understand that brand name drugs often have
little or no benefit over older generic versions. A prime
example is Prilosec, a heartburn medication whose patent was
scheduled to expire in April of 2001. Prilosec consists of two
"isomers", a right-hand version and a left hand version. Studies
showed an 87% success rate for this drug. AstraZeneca, the
manufacturer, decided to offer a newly patented single isomer
version called Nexium, which showed only fractionally better
results with a 90% success rate.
A $500 million marketing campaign ensued, aimed at both
physicians and consumers, to convince them that Nexium is
"state-of-the-art". AstraZeneca now sells over $3 billion worth
of pills annually, at $120 per box. This is a drug that is
essentially only a repackaged version Prilosec, which sells for
about $20 per box.
When your doctor is prescribing a drug, make sure to ask him if
there is any benefit to taking a brand name over a generic, and
let it be known that you'll be paying for the prescription out
of your own pocket.
Drug Discount Programs
Pharmaceutical prices are a lot like hospital prices - very few
people actually pay the listed retail price. There are numerous
drug discount cards available on the market, which provide
savings that average 15% to 40% below retail at participating
pharmacies. Typically, most of the chain pharmacies (CVS,
Eckerd, Walmart, Kroger, Costco, etc.) participate in these
plans.
Many insurance companies include discount cards as an additional
benefit that comes with their coverage. Because these cards are
not considered to be insurance, they can be offered with an
HSA-qualified plan. Insurance companies that provide Rx discount
cards with their HSA plans include American Medical Security,
Anthem Blue Cross Blue Shield, Assurant, Golden Rule, Imerica,
Unicare, and World. We also know of one HSA administrator - HSA
Trustee Services - that provides a drug discount program to
people who use them.
Stand-alone drug discount plans are also available to anyone
with access to the internet. We've found the average cost of
these discount plans to be around $7 or $8 a month. HSA for
America has secured for its members (and readers of this
newsletter) a free discount Rx card through a company called
Drug Card America. To enroll online, simply visit:
http://drugcardamerica.com/index.aspx?affid=104&agent=1&rxgrp=SAS
104&affguid={458151a2-8511-4e15-! 9c22-d335be23527c}. You may
want this card in addition to any other cards, since the card
that offers the best deal usually varies, depending on the drug.
If you're looking for a plan that has co-pays for prescription
drugs rather than only discounts, American Health Care Options
offers a four-tiered prescription card program where you pay
$10, $20, $50, or a special discount price for generic and brand
name drugs. You can check the tier of any drug you're interested
in, and apply online at http://www.ahco.biz/index.cfm?id=14593.
The cost of this plan is $19.95 per month for an individual, or
$29.95 for a family.
Mail Order
If the need for a prescription is not urgent, or if you are on
long-term medication, mail order is almost always a less
expensive way to buy prescription drugs. It is generally cheaper
to get a 90-day supply because of a volume discount. I recommend
asking your physician to write the prescription for a 3-monthly
supply plus three refills. This will get you a year's worth of
drugs, with only one shipping fee.
One company that has good prices is Save Now Discount Pharmacy.
They have a 'no insurance' business model, and have been able to
reduce their prices by eliminating the cost of dealing with
insurance companies. They also post prices online, so it's easy
to compare. Unfortunately, they are only licensed in 13 states
at present, but they will apparently be expanding soon. You can
check them out at www.savenowdrugs.com.
Importing Prescription Drugs from Canada (or wherever)
The city of Boston, the city of San Francisco, the state of
Wisconsin, and the State of Minnesota all use a company called
Total Pharmacy Care to give their citizens access to
international mail-order pharmaceuticals.
Officially, re-importation of prescription drugs by anyone other
than the drug's manufacturer is a violation of federal law. But
FDA enforcement guidelines allow agents to exercise discretion
for drugs imported for personal use. According to the
guidelines, "FDA personnel may consider a more permissive
policy" in cases where an individual seeks to import no more
than a three month supply of a product that does not appear to
pose an unreasonable risk, if the individual affirms in writing
that it is for personal use and provides the name and address of
the U.S. doctor supervising their treatment.
Advocacy groups cite these guidelines as proof that
re-importation is legal. But in a February 2003 letter, the
FDA's Associate Commissioner, Thomas Hubbard, said the
guidelines have been misinterpreted. They were meant to allow
FDA agents discretion in allowing U.S. citizens access to
medicines for serious conditions that were unavailable or hard
to find in the states, not to allow international comparison
price shopping.
Nevertheless, thousands of U.S. citizens have found they can
save money by buying their drugs from outside the country. Drug
price comparisons from several countries (Canada is not always
the cheapest!) can be found at
http://www.crossborderpharmacy.com/Total-Care-Pharmacy/totalcarep
harmacy.html. Keep in mind that since this importation is
technically illegal (though rarely enforced), it may not be
proper to use your HSA to pay for prescriptions purchased this
way. Talk to your accountant if you decide to go this route.
Avoiding Prescription Drugs
The people who spend the least on prescription drugs are those
who rarely take them. The need to take an antibiotic for an
acute infection may seem fairly expensive, but it is nothing
compared to the cost of taking a medication for the rest of your
life. Unfortunately, by age 45 over half of all Americans are on
a regular prescription medication, and by age 65 nearly half are
on three or more prescriptions during any given month. Most of
this is entirely preventable.
Some of the biggest selling drugs are to treat elevated
cholesterol, hypertension, and acid reflux. A paper published
this year in the American Journal of Clinical Nutrition entitled
Origins and evolution of the western diet: Health implications
for the 21st century, explains how these and other common health
issues did not exist for our hunter-gatherer ancestors, and how
diet is the root cause of so many of the health problems people
in our culture experience.
The author is Dr. Loren Cordain, one of my professors at
Colorado State University. In a nutshell, he shows why the
healthiest diet is one based on fruits, vegetables, fish, and
lean meat. Foods to be avoided or limited include added sugars,
shortening and other processed vegetable oils, grains, and
legumes. These are all foods that did not exist in our diet
prior to about 10,000 years ago, and are thus foods that we are
not genetically adapted to eat. If you're interested, you can
download a copy of this paper at:
http://www.thepaleodiet.com/published_research/.
Remember that all qualified expenses, including prescription
drugs, can be paid for tax-free, from your HSA. If you've still
got a traditional health insurance policy and would like to
investigate a health savings account, please visit HSA for
America us and we'll be happy to help you.
To your health and wealth,
Wiley Long
President
HSA for
America