A prescription from the doctor often comes with a common concern once you get to the pharmacy.
"I hope my insurance covers this,” said South Windsor resident Sharon Neiberg. “They're so expensive."
Neiberg is not alone – Americans spent more than $300 billion on prescription drugs last year.
According to research firm IMS Health, one of the most popular drugs last year was Nexium. In 2013, it was the second-highest grossing prescription drug with just over $6 billion in sales.
A new version of the drug, Nexium 24 HR, started selling in pharmacies over the counter in May – no prescription needed.
C. Michael White with the UConn School of Pharmacy says the OTC version of the drug may or may not save consumers money.
"Be honest with your physician and also with your pharmacist that the cost of medications is very important to you,” said White.
We asked White about Nexium and other medications, and ways to find savings at the pharmacy. He says the Food and Drug Administration's approval of the over-the-counter version, called Nexium 24HR, is to treat what’s commonly known as heartburn.
“That’s what the FDA believes it would be safe for you to do OTC without referring to your physician,” said White.
White says the prescription strengths remain in place for more serious problems like ulcers that Nexium is approved to treat, but shouldn't be treated without the supervision of a doctor.
We compared prices at a national chain pharmacy and found a 28-day supply of Nexium 24HR available over the counter for $22.99. At that same pharmacy, a one-month supply of a Nexium prescription of a similar strength is close to $250 if you're paying cash.
But if your insurance covers Nexium, the prescription could cost you as little as $5-$15 depending on your plan. That's less than the over-the-counter Nexium 24HR price, meaning having a prescription could actually pay off.
“The problem is, you can't say with 100 percent surety if you buy the over the counter you're going to save money," White said.
But White says a generic version of Nexium is on the horizon and will almost certainly cost less.
When it comes to prescriptions, consumers almost always save by using generic medications instead of their name-brand counterparts, White said.
He pointed out that many options are available to treat some of the most common diseases. And in some cases, you can save money by getting a prescription for medications you wouldn't think of.
For example, Aleve is a commonly sold over-the-counter pain medication. We found it on the shelves for $10.99 for 100 pills. The same size generic version is $8.49.
We also priced a prescription for a higher-strength dose of the generic drug naproxen. It's the same active ingredient, with each pill double the dose of the OTC versions. With many insurance plans, 180 pills cost only $10.
On a cost-per-pill basis, Aleve costs $0.11 per pill, while the generic brand runs at just over $0.08. But White recommends taking the higher prescription strength and cutting the pill in half, so you’re paying just over $0.05 per dose.
Always talk to your doctor before splitting pills, White says, explaining that it's a simple way to save money on many medications.
White also suggests shoping around and using mail-order pharmacies if you know that you'll be taking a medication long-term. But he warns against buying medications from foreign online pharmacies, because you don't always know what you're getting.
“Very often they're not coming from the U.S.,” said White. “The United States doesn't have quality control over the way that they were manufactured, the way that they were packaged, the way that they're being stored."
Above all else, White says communicating with your doctor and your pharmacist and being your own best advocate can help cut costs.
“Ultimately the patient is the most important member of the healthcare team," he said.
Here are a few more of White's recommendations on ways to save at the pharmacy:
- Ask to take individual medications instead of combination pill, or vice versa, depending on which option is more cost effective (combination drugs can be significantly more expensive)
- Request a 90-day supply of your prescription, which is oftentimes a cheaper copay than a 30-day supply with refills
- If you've never taken the medication before, you may want to start out with a smaller supply so you aren't left with extras if you have negative side effects and need to stop taking it
- Ask to split higher-dose pills in half
- Shop around at different pharmacies to find out how the cost varies, then ask your regular pharmacy to match the lowest price
- Review your insurance options (your old plan may no longer be the best option when you factor in new medication)
- Find out if you qualify for Medication Assistance Programs (such RxAssist) or community-based programs
- Work on reducing your body weight and/or changing your diet, which can bring down your blood pressure and blood sugar, and minimize some types of arthritis pain.