By Nomi Health on October 18, 2023
The affordability of prescription drugs is a major healthcare problem in the United States and it’s getting worse. According to a recent study, we spent over $1,126 per year on prescription drugs in 2019, an amount greater than any peer nation. (Their average was half of ours, at only $550 per person.) These figures include spending from insurers and out-of-pocket cost from patients for prescriptions filled at pharmacies.
Some people are so strapped for cash that they are forced to skimp on their medications. A recent US Centers for Disease Control and Prevention report found that while 58% of adults took at least one medication in the past year, close to 1 in 10 of them had skipped or reduced their medication intake to save money.
Patients who skip doses of their medication may not get the full benefit of the drug, or they may experience a relapse of their condition. More alarmingly, it may lead to an increase in the risk of hospitalization, emergency room visits, and even death. Data shows that in 2022, 1 in 6 people with diabetes were rationing their insulin, even though for some of them it was akin to oxygen.
There are safe options for saving money on prescription medications, though, including the use of an alternative pharmacy program.
Starting in the early 2000s in response to the rising cost of prescription drugs, these programs work by negotiating lower prices with drug manufacturers and wholesalers. They then pass these savings on to their members. Those savings can save patients up to 85% on prescriptions and the nation millions of dollars annually.
Here are some of the factors driving the popularity of alternative pharmacy programs:
The rising cost of prescription drugs
The increasing number of uninsured and underinsured Americans
The desire to provide patients with more affordable Rx options
The growth of online shopping
The increasing use of mobile devices
There are three main types of alternative pharmacy programs:
Mail-order pharmacies that deliver prescription drugs to your home. They can often offer lower prices than retail pharmacies.
Discount card programs that offer savings on prescription drugs at participating pharmacies. These programs can be a good option if you only need to fill a few prescriptions each month.
Pharmacy benefit managers (PBMs) that negotiate lower prices for prescription drugs on behalf of employers and health insurance plans. They can be a good option if you have a high-deductible health plan or if your employer offers it as a benefit.
The specific way these programs operate varies depending on the type. For example, mail-order pharmacies typically purchase prescription drugs in bulk, which allows them to offer lower prices. Discount card programs work by negotiating discounts with pharmacies, and then members present their discount cards at the pharmacy when they fill their prescriptions. PBMs negotiate lower prices for prescription drugs on behalf of employers and health insurance plans.
If you’re considering using an alternative pharmacy program, there are a few things you can do to choose the right one:
Do your research: Read reviews of different programs and talk to your doctor or pharmacist to get their recommendations.
Make sure the program is reputable: Look for a program that is accredited by a recognized organization, such as the National Association of Boards of Pharmacy.
Compare prices: Compare the prices of the medications you need at different programs to make sure you’re getting the best deal.
Consider your needs: Think about your needs and preferences when choosing a program. Do you need prescription delivery? Do you need a specific, hard-to-fill medication?
If you’re still hesitant to use an alternative pharmacy program, talk to your doctor. They can help you decide if a program is right for you and can recommend a reputable program.
As a healthcare maverick, we’re seeking to disrupt the traditional retail pharmacy ecosystem. At Nomi Health, we believe that everyone should have access to affordable prescription drugs. That's why we offer a convenient, inexpensive pharmacy solution that can help you and your employees save 85% on your prescriptions.
We believe everyone deserves equal access to care, so our pharmacy makes it so out-of-pocket costs won’t stop anybody from taking their prescriptions as directed just to save money.
That will make all of us happier, healthier, and more productive.