Save Money on Diabetes Medications
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How to Save Money on Diabetes Medications
Having diabetes isn’t cheap. That’s why it’s important to be a savvy consumer when buying your medications. Finding the best bargains and understanding your health plan’s pharmacy benefits, deductibles, and copays will go a long way toward helping you save money on your blood glucose-lowering medications and testing supplies. Here’s what experts recommend.
Know Your Health Plan
Under the Affordable Care Act (ACA), prescription drugs are one of 10 essential benefits that all insurance plans must cover. But the law doesn’t require your health plan to cover all medications. Rather, the ACA requires that only one drug per category or class be included in a health plan’s formulary, which is a list of covered medications.
Exactly which drugs are covered is determined by individual states, which can require more than the one-drug minimum set by the federal government. “For example, a state’s benchmark plan may establish that all health plans cover at least two antidiabetic, glucose-lowering drugs, but that does not mean that a particular health plan will cover the drug you take,” says Eva Vivian, Pharm.D., CDE, an associate professor of pharmacy at the University of Wisconsin in Madison.
Vivian says you should always check to see what’s covered by your health plan. Then figure out how much you’ll be paying out-of-pocket for the drugs you take. Drugs are ranked on tiers, with tier-one drugs (often generics) costing the least and tier-three drugs costing the most. Learn where your medications rank to determine the costs.
Get More For Your Money
The goal of diabetes drugs is to lower your blood sugar. But not all drugs have the same impact. Many generic drugs, such as glimepiride, glipizide, metformin, and pioglitazone, have a measurable impact on blood sugar,” says Marty Irons, R.Ph., CDE, a pharmacist in Rutland, Vermont. “But a lot of the new drugs don’t lower it that much.”
If your health care provider prescribes a new drug, ask how much the medication will realistically lower blood sugar, Irons says. “You want to know which one is going to give you the biggest bang for your buck,” he says.
Buy Generic Diabetes Medications if Available
Generic drugs are a low-cost alternative to pricey brand-name drugs that don’t always work better, even if they’re new, says Evan Sisson, Pharm.D., CDE, associate professor of pharmacy at Virginia Commonwealth University and spokesperson for the American Association of Diabetes Educators (AADE). “By law, generics have to be the same as the branded drug they are replacing,” he says. “From a quality standpoint, a patient shouldn’t be afraid of them. Most people won’t even notice a difference.”
Not all blood glucose-lowering drugs are available as generics. If cost is a concern, ask your health care provider for a generic equivalent. According to Consumer Reports magazine, some of the best generics are metformin (Glucophage), glipizide (Glucotrol), and glimepiride (Amaryl).
Consider Pharmaceutical Assistance
If you’re really scrambling to afford your prescription medications, pharmaceutical assistance programs are a source of help. These programs are sponsored by major pharmaceutical companies and provide drugs for free or at a lower cost to people who qualify.
Visit the Partnership for Prescription Assistance at pparx.org or call 888/4PPA-NOW for information on 475 public and private programs that cover more than 2,500 drugs.
Make The Most Of Medicare
Good news for patients who have Medicare: The ACA has made prescription drugs more affordable by gradually closing the Part D coverage gap known as the doughnut hole. Since 2012, 6.1 million Americans with Medicare have saved more than $5.7 billion on prescription drugs, according to the U.S. Department of Health and Human Services.
To be sure you are getting your discount, get a printout of the prescriptions you’ve gotten from your pharmacist and compare it with your plan's explanation of benefits, says Irons. “Patients often get medications that are not covered by Part D, which can lead to confusion. But pharmacists are usually able to provide explanations easily.” If your drug plan already includes coverage in the gap, you may get an additional discount, which will be applied to the remaining amount you owe.
Do The Math On Combination Drugs
Some people think it’s cheaper to take a single pill that’s composed of two drugs, but in reality, not all combinations save you money, says Davis Liu, M.D, a board-certified family physician with the Permanente Medical Group in Northern California and author of The Thrifty Patient – Vital Insider Tips to Save Money (Davis Liu, 2012) “Often combination medications are created to make a more costly product, usually taking two generic medications and calling it something else to charge more,” Liu says. Take Prandimet, a combination of repaglinide and metformin. A 30-day supply from healthwarehouse.com costs $133.80. But if you buy the same amount of repaglinide and metformin separately and in the same dosages, you pay just $21.80.
Avoid Desperate Measures
Between rising prices in the supermarket and at the gas pump, it’s tempting to take shortcuts on your health by adjusting your medications. But you should never take risks with your diabetes care. Evan Sisson, Pharm.D., CDE, advises against saving money in ways that could harm your health:
- Never take another person’s medications.
- Don’t stop taking your drugs or skipping doses without talking to your health care provider first.
- Avoid splitting pills, which can result in uneven dosages that will impact blood sugar levels.
- Don’t shop for your medications in foreign countries, a practice that lacks oversight by the U.S. Food and Drug Administration.