By Patricia Prewitt
My Personal Rx Adviser

I am surprised by how many people with traditional commercial insurance plans don’t realize that manufacturer-sponsored programs are an easy way to save on out-of-pocket Rx costs. Monthly costs for brand name medication is often $25-$35 (Tier 3) $50-$75 (Tier 4) or more for specialty prescriptions.
Overview of pharmaceutical manufacturer savings programs
Most pharmaceutical companies offer manufacturer brand-name savings cards or programs for people covered by commercial insurance, currently about 48% of the population here in the U.S. It is estimated that only about 22% of eligible consumers opt-in, although that number is growing as more people learn how these programs function.
These are the patent-protected advertised products that you may see on television, or in magazines, or promoted in digital media or on the radio.
Copay cards/brand programs are marketing efforts designed to both help make newer (expensive) medications more affordable to patients. Prescribers may be more willing to try a newer medication if they believe it treats the medical condition more effectively than an older product. Loyalty to a brand medication can be created when a product works well and is affordable for the consumer. Years ago, a physician’s office might hand you a physical card or coupon voucher. In today’s world, those with internet skills can find these cards/programs by visiting the company’s website.
Explain, please? Simply find the website of the specific brand-name medication (for example, Eliquis) and look for “savings/patient programs” among all the product information. Double check the website to make sure you are not being redirected to a copycat site, or the website of a competitor product. Follow the links to see if you may be eligible, complete the form, and wait for the brand-name card to be delivered electronically to your email, phone, or digital device.
This card is registered only to you, specifically for that medication. Bring it with you to your pharmacy, and ask that it be added to your prescription record for that medication. Enjoy a reduced out-of-pocket price at check out.
Why was my friend’s savings amount different from mine? We take exactly the same product. Her new out-of-pocket amount was only $5 a month; mine was $15. We had both been paying $25 a month.
All insurance plans negotiate pricing, rebates, and fees, which impacts the price paid by the consumer. There are hundreds of different plans, all with different rules. How those savings are applied, and how they accrue toward any deductible is based on the rules of the insurance plan. These are not standardized.
My prescription insurance plan requires that I use a mail-away pharmacy. Can I take advantage of these savings programs? Most of the companies have a paper-based process that will allow the patient to still save money. Register for the specific product copay card on the website, look for instructions that appear in teeny type to submit documents to a physical processing address for savings. Always keep a copy of your submission; proof of payment receipts are required.

Once approved, and calculated for the rules of your plan, the patient typically receives a rebate check in six to eight weeks via U.S. mail.
If I choose to enroll, how long will the savings last? Each company or product will have its own rules. Sometimes it’s for a one-time trial, others are good for up to 12 months. Most companies will reset these offerings annually, based on their negotiations with insurance plans for formulary inclusions, tier placements, and other negotiations that occur behind closed doors.
What’s the catch? In order to obtain and utilize these programs, you choose to opt-in with personal data, and privacy rules will vary. The company will likely auto-enroll you for product information. Some patients will find this information quite helpful; others may find it annoying.
These programs may be rescinded at any time.
What else? Do not confuse these pharmaceutical programs with general savings cards (not insurance) from GoodRx, SingleCare, etc. Manufacturer cards are specifically tied to brand-name products, and the cards work in conjunction with standard traditional prescription insurance plans. These programs cannot be used by enrollees of Medicare/Medicaid or other government prescription plans.

Content provided is for educational 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