How to tell if the price is right on your next pre­scrip­tion

Austin American-Statesman Sunday - - MONEY & MARKETS EXTRA - By Tom Murphy AP Health Writer

Fill­ing a pre­scrip­tion is no longer the sim­ple er­rand you run after a doc­tor visit.

With drug prices ris­ing and in­sur­ance cov­er­age shrink­ing, it pays to ask ques­tions and do a lit­tle re­search be­fore hand­ing over your in­sur­ance card at the phar­macy counter. Hav­ing cov­er­age of­fers no guar­an­tee that you're get­ting the best price for your medicine.

Cus­tomers of CVS and Wal­greens brought that con­cern to light ear­lier this month when they sued the drug­store chains over prices paid for generic pre­scrip­tions. The law­suits ac­cuse the com­pa­nies of charg­ing in­sured pa­tients more for generic drugs than what peo­ple pay without cov­er­age. It also says the drug­stores don't tell in­sured pa­tients about the cheaper op­tion.

CVS and Wal­greens re­ject the claims and prom­ise to fight them.

Be­fore you fill your next pre­scrip­tion, con­sider these steps to help find the best pos­si­ble price.

TALK TO YOUR DOC­TOR

Start a habit of ask­ing your doc­tor about prices when­ever you get a new pre­scrip­tion.

If you have in­sur­ance, bring in­for­ma­tion about your for­mu­lary, or list of cov­ered drugs, to your visit. Your doc­tor deals with many dif­fer­ent in­sur­ers and may not know the costs tied to your cov­er­age. The list can tell your doc­tor how your treat­ment or any al­ter­na­tives might be cov­ered, said AARP drug pric­ing ex­pert Leigh Purvis.

DO SOME RE­SEARCH

Ap­proach pre­scrip­tion buy­ing like car shop­ping. You don't want to do it without some idea of the prices in your mar­ket.

Web­sites like GoodRx and WeRx can show how drug prices without in­sur­ance will vary by store. Know­ing what's in the mar­ket helps you tell quickly if your fa­vorite drug­store is pricey.

“When we talk about the price of a drug, it's sort of an ar­bi­trary es­ti­mate in­stead of a hard-and-fast rule,” said Caitlin Mor­ris of the ad­vo­cacy group Fam­i­lies USA.

When com­par­ing costs on­line, note that some web­sites may show the cash price without in­sur­ance while oth­ers only show the cost if you use one of their coupons.

QUIZ THE PHAR­MA­CIST

The best deal you can get may be the price you pay through in­sur­ance. This is es­pe­cially true with brand-name drugs. The price without in­sur­ance for those is typ­i­cally much more ex­pen­sive than the co-pay­ment or de­ductible you pay with cov­er­age.

How­ever, most pre­scrip­tions filled are generic. The cash price for those drugs may be cheaper than what a per­son would pay through in­sur­ance, de­pend­ing on your plan.

Ask the phar­ma­cist what your pre­scrip­tion will cost based on your cov­er­age be­fore you have it filled. If the price is too high, ask what it would cost without cov­er­age.

If your re­search turned up a lower price else­where, ask your phar­ma­cist if they would match that price. The drug­store also may of­fer a dis­count pro­gram.

Phar­ma­cists in some states can sub­sti­tute a brand-name drug for a cheaper generic. But check first with your doc­tor about how that may af­fect your treat­ment. UN­DER­STAND THE RISKS Pay­ing cash for pre­scrip­tions comes with some side ef­fects.

Those costs won't help you reach your in­sur­ance plan's an­nual de­ductible or out-of-pocket max­i­mum, after which the in­surer picks up more of the bill.

Pay­ing cash or us­ing dif­fer­ent drug­stores for the best price also means that your in­surer or your reg­u­lar phar­ma­cist won't be mon­i­tor­ing to make sure your medicines don't con­flict and cause a bad re­ac­tion. That re­spon­si­bil­ity will fall largely on you, es­pe­cially if you have more than one doc­tor.

If a pre­scrip­tion is still too ex­pen­sive after all your re­search and ne­go­ti­at­ing, you can walk away and not pay for it. But do­ing so won't help you get bet­ter and it could make your con­di­tion more ex­pen­sive to treat later on.

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