MONEY & MEDS

A recent investigation by Clinical Psychiatry News discovered that a month’s supply of Abilify costs $750 at CVS and $13.75 at HealthWarehouse. The narcolepsy medication Provigil costs $724 at Walmart and $35 at Costco. Insurance companies, pharmacies, and middlemen negotiate complicated deals among themselves that can lead to dramatic variation in medication costs. But a little bit of work navigating this system can sometimes save you hundreds of dollars on expensive medications.

1) USE GOODRX

GoodRx.com (goodrx.com) is a pharmacy price comparison website for cash-only purchases. If you enter your prescription, it will tell you where you can get it at the lowest cost. Sometimes even if you have insurance, GoodRx’s cash-only price will be less than your insurance co-pay. You’ll need to print out their coupon or get a GoodRx benefit card from your doctor before you can make it work. This is probably the easiest way to save money on medications and should be the first thing you try.


2) FIND THE MOST EFFICIENT WAY TO DOSE YOUR MEDICATION

Some medication costs vary with dose. A month's supply of doxepin 6 mg costs $446; a month's supply of doxepin 10 mg costs $10. If you notice your medication costs much less at a different dose, ask your doctor whether that dose might be appropriate for you, or if you could compensate by taking it on a different schedule.

Sometimes you can save money by cutting down on pills. Instead of taking three Cymbalta 20 mg tablets each morning, ask if you can take one 60 mg tablet - it will bring your costs from about $60 a month to about $20. Instead of taking a drug two or three times a day, see if there's an extended release version you only have to take once. Effexor 25 mg three times a day costs $40; Effexor XR 75 mg once per day costs $10. Consider asking your doctor if there's a way to make this work with your medication.


3) WORK AROUND YOUR INSURANCE'S POLICIES

Some insurances charge a certain co-pay per prescription you pick up, regardless of the price of the prescription or the number of pills you get.

If you're in that situation, consider asking your doctor for a 90-day supply at a time instead of a 30-day supply. You'll still pay the same co-pay, but you'll only have to pay it a third as often.


4) USE PHARMA COMPANIES’ PRESCRIPTION ASSISTANCE PROGRAMS

Most big pharmaceutical companies have patient assistance programs to help customers who can’t afford their drugs. For example, Trintellix is made by Takeda Pharmaceuticals, whose site includes an application for patient assistance. Generally, people are eligible if they have no/limited insurance and an income less than four times the poverty line. Trintellix’s US site also offers “TAccess”, a savings card program that promises $100 off Trintellix prescriptions.

There are lists of the different patient assistance programs available at the Partnership For Prescription Assistance, and NeedyMeds.


5) TALK TO YOUR DOCTOR

Many patients need very specific medications to help with their condition, and there isn’t much that their doctor can do.

But sometimes, if your doctor knows you’re having trouble affording your medications, they can help switch you to a different medication that is better covered and less expensive. For example, although a month’s supply of the antidepressant Trintellix costs $350, a month’s supply of the older antidepressant Prozac can cost as little as $5; there is no evidence that Trintellix will work better than Prozac for the average patient.

Your doctor may also have other ideas for how to help you with medication cost issues. Most importantly, try not to go off medications or decrease the dose unilaterally because of cost. If you find something is unaffordable, ask your doctor if they have ideas for how to make it work.

Disclaimer: The posts on this blog are for informational purposes only and do not replace direct care from your mental health care provider. Contact your mental health care provider for specific questions or concerns about your own mental health. All posts are copyrighted, and the views expressed on this blog are representative of the opinions of Pacific Coast Psychiatric Associates (PCPA) as an organization.

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