The high cost of prescription drugs in the U.S. causes sticker shock, challenging seniors’ budgets and sometimes even leading to avoidance of doctor-recommended treatments – not the best choice for positive health outcomes. Alexandra Robertson of Visory Health suggests ways to reduce prescription drug costs.
The rising cost of prescription medications is one of the biggest financial and health challenges facing older adults today. For seniors living on fixed incomes, even small increases in drug costs can lead to difficult choices, whether to skip doses, delay filling a prescription or stop taking medication altogether; none of which are ideal. These decisions come at a price: poorer health outcomes and higher medical bills.
Nearly one in four Americans say they struggle to afford their prescriptions; and for older adults the challenge is even greater. Between 2021 and 2022, more than 20% of adults aged 65 and older reported not taking their medications as prescribed due to cost concerns. About 4% of seniors can’t afford their prescriptions at all, leading them to delay refills and/or take less than what’s prescribed. In fact, across all age groups, half of patients say cost keeps them from following their prescribed treatment. This situation is becoming a serious crisis, not helped at all by economic uncertainty and rising daily living costs. But, there’s good news! With information and a little planning, seniors and their families can find ways to lower costs, manage prescriptions more effectively, and take back control at the pharmacy counter.
The reality of medication affordability for seniors
For most older adults, prescription medications are a daily reality. According to the CDC, nearly 89% of adults aged 65 and older take prescription drugs. While many have some level of insurance coverage, around 17% are without prescription insurance, often leading them to skip or incorrectly take their medications due to cost.
The stakes of missing medication are high. Not taking medications as prescribed can worsen chronic conditions, cause avoidable hospital visits and lead to skyrocketing healthcare costs. A $20 prescription skipped today could turn into a $2,000 emergency room visit tomorrow. For seniors juggling multiple medications, understanding costs and having access to affordable options is essential for maintaining health and independence. Research shows that when people pay more out-of-pocket, they are more likely to abandon their prescriptions altogether. In fact, 27% of all prescription abandonment is linked to cost and access challenges.
Prescription “sticker shock” is becoming more common as drug prices continue to climb. Several factors contribute to this, including the high cost of brand-name medications. Even when effective generics are available, many commonly prescribed drugs remain expensive due to their brand-name status.
On top of that, changes and differences in insurance coverage, like formularies and copays, can leave many seniors paying out of pocket unexpectedly. Medicare and supplemental plans each have different benefit structures, which can be confusing in trying to figure out what is covered and what isn’t. This can also lead to unplanned costs at the pharmacy counter. These challenges can leave seniors unsure about their healthcare options. By understanding these contributing factors, the right steps can be taken to manage their healthcare expenses better.
4 strategies to reduce prescription drug costs
These tips can help address healthcare expenses.
1. Ask about generics and alternatives
When saving money on prescriptions, one of the best options is to ask about generic medications. They contain the same active ingredients as brand-name drugs but are on average between 80% to 85% less expensive. Many seniors may not realize they can ask their doctor or pharmacist about switching to a generic or lower-cost alternative. It’s a simple step that can make a big difference in a budget without sacrificing the quality of care.
2. Review Medicare and insurance coverage annually
Like a check-up with a doctor, reviewing Medicare and insurance coverage each year is important. Health plans can change yearly, adjusting which medications are covered and how much is required to pay out of pocket. During open enrollment, it’s worth comparing plan options. Even small changes, like switching to a different plan, and understanding which medications you take may or may not be covered can lead to significant savings, making it easier to stay on top of medications.
3. Explore prescription discount programs
Prescription discount cards, like Visory Health, are a powerful tool for reducing medication costs, especially for seniors. These cards, often available for free, can significantly save on many medications, with certain cards cutting costs up to 80+%. In addition to discount cards, patient assistance programs can help lower retail prices for branded medications. Seniors should always ask their pharmacist to compare prices using these discount tools before paying out of pocket. Many pharmacies accept discount cards so exploring these resources can lead to substantial savings, helping make medications more affordable.
4. Talk openly with healthcare providers
Seniors must take an active role in their healthcare, especially regarding medication costs. Don’t hesitate to discuss financial concerns with doctors and pharmacists. By advocating for oneself solutions such as lower-cost prescriptions, alternative dosage forms, or access to support programs become available. Healthcare providers are often willing to work with you to find more affordable options, so be sure to share your needs and ask questions. Taking charge of your healthcare can make a big difference in your ability to access the medications you need at affordable prices.
Building a support network for medication management
Managing medications doesn’t have to be a solo effort. Family members can play a vital role in helping review medications, compare insurance options and ensure medications are taken as directed. Pharmacists are also trusted advisors who can explain drug interactions, recommend alternatives and provide guidance on savings programs.
Remember, asking questions isn’t a sign of weakness; it’s a smart way to take charge of your health. By involving providers and loved ones, seniors can reduce the ‘sticker shock’ at the pharmacy and feel more confident protecting long-term health and finances for years to come.
