By Patricia Prewitt

My Personal Rx Adviser

Recently I was asked by someone, “When does it make sense to start searching for savings for generic prescriptions? Is it $50 a month out-of-pocket? $100?” It’s a fair question, and one that doesn’t have a clear answer. Why? Everyone’s situation is unique. We all have different living expenses, different incomes, different health plans, and different medications. There are simply a lot of variables. Plus, many prescription plans are using a tier ($-$$$$)pricing system, even for older generic medications that are no longer patent protected. The tier may greatly affect the price of the medication.

Here are some benchmark scenarios I encourage people to think about:

Scenario One: One generic medication used for a chronic condition

If you are paying $0 (yes, some plans have certain medications that have a zero cost) to $5 a month for a prescription, I encourage you to recognize this as an amazing value. Doing a bit of math, this likely means a 90-day supply could be $10-$15 for 3 months. When compared to the average cost of a gallon of milk ($4.19), one cup of premium coffee ($3.85) or a gallon of gas ($3.45) in today’s market, it’s hard not to see the value of this pricing for needed medications.

Scenario Two: Multiple (three or more) generic medications used for chronic conditions

Taking three or more medications, let’s say at $15 each, so $45 total, starts to feel a bit more problematic for some people. If the out-of-pocket costs for multiple medications are beginning to impact your budget, it may be worth the time to look at savings cards offered by GoodRx, WellRx, and others. Sometimes, the savings card price may be less than using a traditional prescription plan.

You won’t know unless you check! This takes time and patience, since savings coupon prices for generic medications often change. The range of savings often varies by as much as 35% for different savings cards, pharmacies, and even by zip codes.

Additionally, when finding a lower price using a savings card coupon, it may be necessary to transfer the prescription to a different pharmacy. This also takes time and effort. The savings achieved must be meaningful to the individual. Some people will make changes to save as little as $2, while others may want to achieve a savings of at least $20 or more before making changes.

Checking other options, such as Cost Plus Drugs, may provide opportunities to save on prescriptions. Again, this requires a willingness on the part of the individual to make changes and obtain a new prescription for processing, which can be time consuming.

A caveat to using non-traditional prescription options is understanding that out-of-pocket costs do not accrue to insurance plan deductibles.

Like many things in life, the situation and motivation determine the action taken.

Content provided is for education purposes only, and is not intended as a substitute for advice from a qualified medical professional. The opinions expressed within are those of the author. 

About the Author: Patricia Prewitt is a local Massachusetts resident who spent more than 30 years in  the pharmaceutical industry. Tricia is a consumer education advocate, and loves helping people find ways to save money on their prescriptions. More information and free resources are available on her website at https://mypersonalrxadvisor.com/resources or call her at 508-507-8840. Favorite Quote: “Act as if what you do makes a difference. It does.” – William James