Getting Most Rx Dollar
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Transcript of Getting Most Rx Dollar
How To Cut Rx Costs
Pharmacy Outreach ProgramThe University of Rhode Island
College of Pharmacy
Statistics Estimates for 2011
$227.6 billion in prescription costsOver 3.7 billion prescriptions filled at
pharmacies (2011) People ages 65 and older consume
more prescription and OTC medicines than any otherage group
Does anyone know why drugs are so expensive?
Question:
Why Are Drugs So Expensive?
Research & DevelopmentUsually takes over a decade for one drugNot every drug reaches the marketClinical trials!
Cost of production and manufacturing Advertising
$2.5 billion each year Demand
Drugs not in high demand often cost more
Practical Ways to Save Money
Be your own advocate!Be proactiveCommunicate with your doctor and ask
questionsAsk your Pharmacist!
○ Best resource for prescription and insurance related information
○ Some pharmacies have coupon cards on handResearch different assistance programsDon’t be embarrassed to tell your doctor you
can’t afford your medications
Practical Ways to Save Money
Request formulary medications onlyFormulary: list of drugs covered by insuranceBring your drug formulary list when you visit
your doctor Ask your doctor about less expensive
therapeutic alternatives Ask your doctor for samples or coupons
Samples may not have directions on them, be sure to check with doctor about how to take them!
Let pharmacy know to check for interactions!
Question:Who knows what a generic drug is?
Generic vs. Brand Drugs Use generic medications whenever possible! Generic drugs are copies of brand drugs
Generic drugs are just as safe as brand drugs and work the same!!
Both versions of drugs have the same manufacturing procedures and safety profiles and are equally regulated by the FDA
By R.I. law, generics are automatically substituted for brand name medications unless specified by Dr. or patient
Practical Ways to Save Money
Mail OrderSome insurance plans allow you to receive
a 3 month supply of your maintenance medications for the price of a one month co-pay via mail order
Convenient for someLet pharmacist know if you get some medications through mail order and others at the retail pharmacy in person!
Practical Ways to Save Money Live a healthy lifestyle
Leads to a decreased need for medication, leading to a cost savings for you
Take your medications exactly as prescribed by your physician and as written on the labelSide effects to medications is a leading cause of
hospitalization in the elderly Store your medications properly
○ Not in the bathroom○ Not in the car○ In the fridge (if needed to be refrigerated)
Practical Ways to Save Money
Don’t let direct-to-consumer advertising influence you!Example: “The new purple pill” - Nexium®
(esomeprazole)○ However, Prilosec® (omeprazole) which is available
OTC & generic by prescription may do the same jobExample: Dr. Oz said…
Always ask you doctor or pharmacist questions about what you hear in advertisements
Internet Pharmacies Many of them are not properly
licensed & regulated!! Only use sites that have the VIPPS seal of
approval from the NABPVIPPS = Verified Internet Pharmacy Practice
Site
Importing Medications From Abroad
There are many downfalls to importing medications from other countries, including Canada:It is almost always illegalThe safety & efficacy of these medications is
unknown and not reliableThe medications have not met FDA
standardsThe drugs may be expired, contaminated, or
counterfeitYou have nowhere to turn should a problem
occur
Does anyone know who is covered under Medicare?
Question:
MEDICARE Medicare provides health insurance for people:
Aged 65 years or olderAged 65 years or less with certain disabilitiesAll people with End-Stage Renal Disease (ESRD)All people with Lou Gehrig’s Disease (ALS)
MEDICARE Part D In 2013, enrollees will pay 47.5% of the
total cost of BRAND NAME medications in the gap
Will only have to pay a max of 79% on GENERIC medications in the gap
Additional savings each year through 2020 In 2020 the coverage gap will be closed
2014
Programs to Help With Drug Costs
SHIP - Senior Health Insurance ProgramVolunteers provide seniors with information,
counseling, and assistance in making decisions about Medicare, supplemental insurance, managed care, etc.
Free! RxAssist.org
Web based resource for patientsGet access to discount programs
offered by○ Retail pharmacies○ Pharmaceutical companies
Question:
Does anyone here have RIPAE?
RIPAEState program which helps elderly pay for their
medicationsProvides coverage throughout the deductible and
coverage gapBUT, it is not creditable coverageRIPAE is only be available for those enrolled
in a Medicare part D planMust send in copy of enrollment
letter or card
Programs to Help With Drug Costs
RIPAEProvides extra benefit for those who don’t
qualify for Extra Help from MedicareOnly covers generic drugs
○ unless there is no generic available or the doctor specifies brand
Applicable to all expenses that person is 100% responsible for, including:○ Deductible○ Coverage gap (“Donut Hole”)○ Drugs not covered under your Part D Plan
Only certain ones!Visit RIPAE for a list of covered meds
Programs to Help With Drug Costs
RIPAE To be eligible must be:
Over 65 years, or aged 55-64 receiving disability (SSI)
Coverage level based on income
Programs to Help With Drug Costs
Practical Ways to Save Money Housing and Urban Development (HUD) Residents
Save the receipts from your daily OTC items (such as vitamins, glucosamine, creams, and Depends)
Turn them into the housing office along with a note from your doctor saying that it is necessary for you to use these items
These receipts will then be counted towards your annual rent deductions
Pharmacy Outreach ProgramActs as a resource for medication assistance
programs, both State and NationalAnswers common medication questions
○ Generic vs. brand name drugs○ Drug formularies○ Therapeutic substitutions
Medication Information Line○ Toll free number: 1-800-215-9001
Programs to Help With Drug Costs
Medigap PlansSupplemental prescription drug
coverage insurance that you can purchase
Offered by many organizations—most popular is AARP
Will help with costs that are not covered by Medicare (copays, deductibles)
Programs to Help With Drug Costs
For Veterans and their spousesYou may be eligible for these programs:
○ TRICARE for Life ○ TRICARE Senior Pharmacy Program
You may also be eligible to receive meds from VA pharmacy clinics
Programs to Help With Drug Costs
Partnership for Prescription Assistance○ Help with more than 2,500 brand-name and generic
medicationsFree or low cost
Make sure you know the names of your medications
Call 1-888-4PPA-NOWVisit www.pparx.org
Trained specialists will answer your questions and help you apply—it is a free service!
Programs to Help With Drug Costs
Medication Discount Cards20-40% discount on certain brand
name medications offered by the drug company manufacturers and 15% savings on generic medications offered by some pharmacies
Only for people who do not have prescription drug coverage ○Not for those that qualify for
Medicaid or MedicareFor RI seniors, RIPAE is usually a
better program
Programs to Help With Drug Costs
www.internetdrugcoupons.comSome specify Med Part D or
Medicaid patients are ineligible AAA discount!
Senior Citizen discountMost pharmacies offer a 10%
discount on cash prescriptions for seniors
Programs to Help With Drug Costs
Pharmacy Savings Programs
Most major chain pharmacies and many smaller independent pharmacies may price match—ask!
Walmart, Target, CVS, Rite Aid, Walgreens, Stop & Shop, KmartAll have prescription savings plansSome require an enrollment feeOnly specific generics coveredSome allow a 3 month supply
○ Even greater savings○ More convenient
Summary and Key Points Be your own advocate! Communicate with your Doctor and your
Pharmacist Look at each medication you are taking &
evaluate its cost Research which programs can benefit you Be an informed consumer & patient Take your medications exactly as your
physician prescribes
Important Phone Numbers
Medication Information Line 1-800-215-9001 Medicare Prescription Card 1-800-633-4227 RIPAE (401) 462-0501 Rx for RI 1-877-743-6779 Medication Discount Cards—various #’s;
Most popular card: Together Rx. 1-800-865-7211 SHIP appointments – contact local Senior Center TRICARE Programs – contact
Sierra Military Health Services 1-888-999-5195
Thank You!!
Pharmacy Outreach ProgramThe University of Rhode Island
College of Pharmacy www.uri.edu/pharmacy/outreach
1-800-215-9001