Prescription Costs: How to Be a Smart Consumer

Prescription Costs: How to Be a Smart ConsumerWritten by: Dr. Jonathan Weinstein

Like anything else you would purchase in life, everyone wants the best price. No one goes shopping in Kohls or JC Penney without a coupon. The same applies to prescription medications. Your healthcare provider is not privy to your prescription drug formulary, as there are countless variations, even within the same insurance company.

As a physician and fellow consumer, the best I can do is prescribe generic medications whenever possible. I have been surprised to find out generics can cost significantly more than medication on your insurance company’s preferred drug list.

A great example would be Citranatal prenatal vitamins. Our electronic medical record will often provide generic alternatives to this brand of vitamins but frequently the generic version costs four times as much. Usually, the patient will not find out the cost of medication until they go to the pharmacy. Sadly, it seems customer service is not a priority at most big box pharmacies like CVS and Walgreens. Your pharmacist is not willing to go out of their way to search for the lowest priced alternative because they would need to input each alternative drug into their system and run it through your plan.

Apparently, with the millions of dollars in profits being made on prescription drugs it is not in the pharmacy chains’ best interest to have a system that provides you a list of less expensive alternatives. Pharmacists are not willing to assist in locating a coupon for the drug prescribed, despite the fact, there are manufacturer’s coupons for most branded medications.

I speak to you from personal experience; I have gone to pick up the medication with a charge of $240 dollars and asked the pharmacist if there was a discount coupon, only to be told emphatically that no such coupon exists. I am then obligated to pull off to the side of the pharmacy drive-thru in order to search the internet on my phone to find a coupon that magically drops the price to $35. Then it is back in the drive-thru line for another 15 minutes to show them the coupon on my phone.

So how do you ensure the best deal?

  1. Check your drug formulary; it is often in PDF format on your insurance website. For example, Caremark, which is owned by CVS, has a list that is updated every quarter.
  2. Check websites like, www.goodrx.com, prices for medications are not set and vary from one pharmacy to another. This website will also let you know if coupons are available.
  3. Always know the generic or chemical name for the drugs you are prescribed, for example, Zofran, a commonly used anti-nausea medication, would be Ondansetron.
  4. Ask the cash price; often this price is significantly less than insurance pricing. Go figure?
  5. Type the name of your drug in your web browser with the word ‘coupon’ after it and you will be amazed at the discounts you will find. Many manufacturers have their own coupons.
  6. Be wary of samples given to you in a doctor’s office. These drugs are pushed by the pharmaceutical companies, as the latest and greatest, but often have no proven benefit over medications already on the market. As a result, you may get a month of free samples when you leave the office, only to find out when you go to fill the prescription it costs $300. Consumer Reports magazine has excellent articles that detail these common practices.
  7. If you need a lower-priced prescription from your doctor, do your own research. Check your drug formulary online so you can provide alternatives to your provider. I am amazed at how many times the pharmacy will send our office a note telling us the patient requests a less expensive medication but provides no guidance. Medical providers have no access to a patient’s drug formulary so it is imperative as a consumer that you take the lead.

In a time when out-of-pocket healthcare costs are skyrocketing, it is imperative that you, the consumer take a few minutes to do a little research.

Jonathan Weinstein, MD, FACOG
5575 Warren Parkway, Ste 116
Frisco, TX 75034

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