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You can't avoid the rapidly rising costs of prescription drugs. Even if you have insurance coverage, costs are increasingly being passed on to consumers as employers raise premiums, drop insurance coverage or shift to high-deductible plans without drug coverage.
The battle to control drug costs will escalate even further as drug companies introduce cutting-edge remedies into the market that promise astonishing results at truly jaw-dropping costs. That new cancer drug that could prolong your life might not do you much good if the insurance company won't cover its $100,000-a-year price tag.
Contrast the bright hopes that such medical breakthroughs promise patients with the many new, but only slightly improved, brand-name drugs that offer treatment for ulcers, high blood pressure and allergies at many times the cost of generic or over-the-counter medicines that produce almost the same results. No wonder consumers are confused.
It's easy to blame the drug companies, the government and retail drug outlets for the hype, high costs and misleading information about prescription drugs. But you can fight back.
"Any patient on maintenance medication needs to openly communicate with his or her physician not only about the prescribed drug and what it is supposed to do, but also about your ability to pay," says Mike Patton, executive director of the Illinois Pharmacists Association. "Too often, these conversations don't happen. But consumers really need to take control of their own health care and find out if there are more affordable alternatives."
Opening a dialogue with your doctor is just the first step. You also need to discuss potential alternative medications with your pharmacist and take advantage of Web sites and services that help you compare the costs of prescription drugs from one outlet to the next. Studies estimate that shopping around can save you anywhere from 30% to 50% on your prescription-drug costs.
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While the percentage increase in the cost of prescription drugs is slowing somewhat, drug prices are still rising faster than overall consumer prices. Between 1995 and 2003, the cost of prescription drugs rose at double-digit rates from year to year, according to the Kaiser Family Foundation, a nonprofit foundation that provides health-care information and analysis.
Factors behind cost increases include a jump in the number of prescriptions being written, the increased use of brand-name drugs and sheer price markups on the part of drug makers, says Chris Robbins, CEO of Arxcel, a prescription-benefit management firm.
"Higher drug utilization has driven new drugs to market, drugs have fewer side effects, people are getting older and we are treating illness more aggressively."
Drug companies spend an average of $802 million to bring the typical drug to market, according to the Tufts Center for the Study of Drug Development. Costs are also affected by drug-company sales, advertising and marketing efforts and pharmacy markups. Recent breakthrough biotechnology drugs can cost insurers and patients from $2,000 to $3,000 per month, Robbins says.
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These factors have spurred insurers to bump up prescription drug benefit co-pays in an effort to shift more costs to consumers.
"For years, health care in the U.S. was very paternalistic and there was no discussion between doctors and patients in terms of which drug was best not only for treatment but cost," says Devon Herrick, Ph.D., a senior fellow with the National Center for Policy Analysis and author of "Shopping for Drugs." "But now tiered co-payments provide an incentive for consumers to ask questions about cost, because if they can get a generic instead of a brand name, their payment will be lower."
Continued: Types of drugs available
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