What to do when your medicine costs more than you can pay

How can I reduce my medication costs?

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Last updated:
10/05/2021

It’s likely that at some point in your life, you’ll find yourself trying to decide how much to spend on prescription medication. And it may not be an easy decision.

Many people are anxious about the cost of their prescriptions and wonder whether or not a lower-priced or generic drug will work just as well for their health needs as a more expensive original drug.

But remember that prices for prescription medication can vary greatly, from the cost of a single pill to the price of a month’s supply. So you should be aware that higher costs for prescription medication are not just an issue for people who can’t afford the drugs they need; they are also a reality for people who have health insurance.

How much does the average American spend on medication per year?

On average, Americans spend $1,700 annually on medicine. That’s about six percent of their family income, according to an analysis by the Employee Benefit Research Institute. And it does not include the amount that people spend per prescription.

How can I reduce my medication costs?

Medicine prices vary widely because of the number of factors that go into each prescription. You may decide to try a less expensive or generic version, but you have to consider a wide variety of factors when making that decision, including:

  • The type of medicine you are taking—You may have to pay more for a generic version than you would for an original medicine. Not all generics are equal, however. Taking a brand name generic instead of an original medicine can save you as much as 75 percent on your prescription drug costs. For example, the price difference between the original cholesterol-lowering medicine Lipitor and its generic equivalent is about 25 to 50 percent.
  • The cost of your prescription and any co-pay or deductible you might have—If your insurance plan doesn’t cover the total cost of a more expensive drug, you will need to pay full price for it. You may have to pay a co-pay for the medicine, which is extra money that you pay each time you fill a prescription.
  • Your health needs—If your physician recommends a medicine for your condition and you decide not to use it, it will cost you more than if you had used the drug or another medication.
  • How many refills you can get—You may be able to get a 90-day supply of medication at once or only when it is almost out of your system. That kind of flexibility can make a difference in the price you pay for a prescription.
  • Your health status—If your health is unstable, your doctor might suggest another type of medicine that you are less likely to develop serious side effects from. For example, a blood thinner such as Plavix taken by people with unstable angina can cause side effects such as internal bleeding if they stop taking it suddenly.
  • The extent of your medical visits—Medicines that require more frequent doses, such as inhalers for asthma, are more expensive than those that only need to be taken once a month.
  • How much you use the medication—When you are taking a controlled substance for an addiction or mental illness, your doctor may prescribe it as little as possible to control symptoms. You won’t be able to fill a prescription for refills until the one you have runs out.
  • How long you take the medicine—Some medicines continue to work longer than others. Most blood pressure pills, for example, continue to work for 24 hours after they have been taken.

Hardship With Prescriptions

Who does the Affordable Care Act help?

Your ability to buy your medication depends on your financial situation. If you lose your job or have an unexpected expense, you may be unable to afford prescription drugs at the same time as food and rent.

The Patient Protection and Affordable Care Act of 2010 is designed to help those who fall into this category. It provides subsidies to people who buy prescription drugs through a Medicare program. Many states have programs that help pay for prescriptions, too.

You may also see if you qualify to receive medications from a health care system, such as Medicaid or the Children’s Health Insurance Program (CHIP). These programs may provide prescription coverage at little or no cost.

How your insurance plan and doctor can help you save money? Learn here all about Reducing Medication Costs discussing different solutions for reducing medicine costs with lifestyle changes.