Benefits
By Stephen Horvat
Mar. 18, 2019
The escalating cost of prescriptions is a hard pill to swallow for employees. That’s because it’s becoming more common for prescription drug plans to shift the cost to participants. Then there’s the behind-the-scenes double Rx whammy: pharmaceutical companies increase prices and pharmacy benefit managers obscure the true cost of medications, causing more headaches for employees.
Employees also feel blindsided when the PBM adjusts its formulary or the plan sponsor moves participants to a high-deductible health plan. Rx sticker shock is on the rise. Consider the employee whose monthly copay of $20 for a generic drug skyrockets to 10 times that per month under an HDHP.
Employees have a hard time paying for important maintenance medications. As prices keep rising, patients are less likely to fill new prescriptions or continue taking maintenance drugs, which can cause more health issues and cost medical plans even more down the road.
Unfortunately, many employees don’t know that the pharmacy they frequent may not always offer the lowest price for their medications. There are more options for finding low-cost prescription drugs than there were even five years ago, but it doesn’t necessarily follow that employees know they actually can price-shop prescriptions.
Also read: What to Ask Your Pharmacy Benefit Manager to Control Spike in Prescription Spending
Employers can work with their insurance brokers to educate employees about better ways to find reasonably priced prescription medications.
In the meantime, here are three Rx buying tips you can share today with your employees.
Some large retail stores, including Target, Walmart and many grocery store chains, offer discounts on popular brand name and generic medications at low or no cost without insurance simply to drive traffic to their stores. These loss leaders attract shoppers who are likely to buy a few items when they pick up their medication at the in-store pharmacy. The prices of brand name and generic drugs that are discounted vary from store to store. It pays for employees to investigate where they can get the best deal for their medications.
ShopRite, a grocery store chain in the Northeastern United States, has been dispensing free diabetes medications since 2009. Similarly, grocery chain Publix offers the generic type 2 diabetes drug metformin at no cost. The grocery chain also offers 14-day supplies of several prescribed antibiotics at no cost. Walmart offers several drugs at $4 for a 30-day supply and $10 for a 90-day supply. The key to this strategy is to keep “impulse purchases” to a minimum.
Not surprisingly, the web now makes it easier to track down the cheapest generic prescription medications. Two examples are GoodRx and Blink Health, which both provide medication prices and direct customers on buying options.
GoodRx collects drug prices from thousands of pharmacies to show where a specific medication can be purchased at the lowest price. They also aggregate coupons and discount programs from manufacturers. Blink Health partners directly with drug manufacturers and negotiates lower prices for medications. Blink Health conveniently lets consumers pick up medications at a pharmacy or order them by mail. Importantly, coupons on these sites often make the price of a medication lower than the copay through the prescription plan.
Prescription drug manufacturers often offer discounts and coupons for their drugs. If a medication costs more than $50, for example, the manufacturer may cover part of the balance. To access a coupon, just contact the manufacturer to enroll in the savings card program.
Some manufacturers will cover the balance of the drug cost and contribute the balance toward the employee’s deductible. After just a month or two of a higher-priced prescription drug and a manufacturer’s discount, an employee may satisfy their deductible and pay only the copays for the rest of the plan year.
Educating employees about free and discounted drugs starts during open enrollment, but it shouldn’t end there. Emails, postcards and announcements from the HR team are good reminders for employees. Some HR departments develop targeted communications that list expensive prescription drugs and how to save. Helping employees learn how to shop for the best prescription prices can help to keep them healthy and help you contain costs.
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