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Low-cost generic programs help make medication co-pays more affordable
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With the price of food, gasoline and other daily necessities skyrocketing, it is not uncommon for patients to delay or even stop getting their prescriptions filled, especially when the medication is for a diagnosis they can’t “feel,” like hypertension or dyslipidemia.
However, there are several different programs available at pharmacies across the United States that make prescriptions more affordable than ever.
In fall of 2006, Walmart introduced the first of these programs in Florida and rolled it out in all of its stores soon thereafter. In just the first few months of the program, the company’s new prescription volume increased by 2.1 million. Now, Target, Kmart, Walgreens and many chain grocery store pharmacies have made low cost generic prescription programs available to their patrons. (See accompanying table for a complete list.)
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Drug classes included in these programs span the gambit of health care, including allergy, cold and flu, antibiotic, arthritis, asthma, cholesterol, diabetes, hypertension, mental health, women’s health and many others. Walmart’s program also includes many low cost store-brand over-the-counter products. While the specific list of included generic medications varies by program, the lists also change constantly within the programs as new drugs become available in a generic formulation or at a reduced cost. Companies also periodically choose to add new medications to the list, as Kmart did in June, increasing their list from over 300 to over 500 available medications in the low cost program. Patients who plan to utilize one of these programs should be encouraged to print the current medication list from the website for the program of their choice and bring it the doctor’s office to limit the number of call-backs and requests for new prescriptions.
To be eligible for the low cost programs:
- The prescription must be written for a generic medication.
- The original prescription must be filled in person at a participating pharmacy.
- Refills can be requested in person, online or by phone but must be picked up in person.
- Prescriptions cannot be filled by mail order.
For patients with commercial health insurance, if the insurance co-pay for a particular generic medication is less than the low-cost program co-pay, the lesser amount will be charged. For patients without health insurance, who would otherwise be required to pay full price for the medication, these programs can be lifesaving.
For Medicare Part D beneficiaries, these low-cost programs (all but Walgreens) may prevent or delay reaching the gap-in-coverage period, commonly known as the “doughnut hole,” a period known to be associated with reduced medication utilization due to increased out-of-pocket expense.
Rhonda Cooper-Dehoff, PharmD, MS, is Assistant Director of Clinical Programs and Research Assistant Professor, Division of Cardiology at University of Florida College of Medicine, Gainesville.