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BLOG: Take steps to ensure patients get the medications they need
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In my last blog post on this topic, we discussed the astronomically rising cost of generic drugs in the U.S. and why this is happening. Certainly it’s a frustrating problem for patients and doctors alike. Here are some tips that may be helpful in navigating the system:
1. Partner with a pharmacy. In the past few years, my practice has approached neighboring pharmacies both large and small with a list of eye medications that we most commonly prescribe (such as those used after surgery). We’ve asked them to give fair treatment to our patients on the cost of both generic and brand-name drugs and not to charge a second co-pay when we ask them to dispense two bottles for a single course of treatment (which is increasingly necessary with gel formulations and smaller bottle sizes). In general, these pharmacies have been more than happy to work with our patients, and we have listed them as recommended pharmacies on the back of our prescription pad. Although our practice gets nothing in return for this, our patients certainly get better service and the confidence that they are getting a reasonable price.
2. Coach your patients on shopping smart. When we prescribe perioperative medications, we know some patients will have a high out-of-pocket cost if they fill all of the medications we recommend, most of which are brand-name products. We want to maintain control of the drugs they take after surgery because our surgical result could be adversely affected by a switch to a less ideal medication. On our prescription for preoperative medications is a note to the patient, saying: “If your pharmacy asks you to pay more than $200 out of pocket for these medications combined, please do not fill this prescription, but first call your surgical counselor.” We understand the high cost of medications is prohibitive for some patients, and we will do what we can to suggest appropriate alternatives to reduce your cost.”
This allows us to substitute samples, generics or other medications. Most importantly, it gives control back to us rather than a pharmacist making capricious generic substitutions.
3. Samples are the best alternative to high cost drugs, so cajole your reps for plenty of them. Truly, the squeaky wheel gets the grease. When our pharmaceutical representatives ask us to prescribe their drug, we ask them for samples. They understand and they deliver, knowing that in this world they have partial responsibility to help patients who cannot afford to pay out of pocket for drugs costs.
4. Shop around. GoodRx.com is a website that provides a list of local pharmacies with their pricing for any medication that you enter. Generally, we have found it to be reasonably up-to-date and accurate.
If you have found other ways of coping with the rising cost of generic and other drugs in the U.S., please write your comments below.
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