A Prescription for Transparency
By Ellen Phillips, PharmMD & Founder of believeRX
So many times in my career I have had patients asking me why their copay was what it was. I wanted to share a few things that I know about behind-the-scenes of retail pharmacy, as well as what you can do about it when you are charged an unexpected price.
First, I recommend that a patient shop around until they find a pharmacist they can trust and stay there due to the dangers of duplicate therapies and drug interactions. If something costs a little more than you expected, talk with your pharmacist and make an appointment to sit down and talk about your situation. If you have government funded insurance, you are not eligible for most advertised drug discount cards that allow patients to pay a certain amount for their prescription if they use the drug card put out by the manufacturer.
Most discount cards put out by manufacturers always have a limit on what they will pay. A card may advertise that the copay will be a certain amount, but it depends on the commercial insurance plan’s copay. In other words, if a patient has not met their deductible, they may end up paying the difference between the maximum amount the discount card pays and what the insurance company pays. If a patient is a cash patient, they are sometimes not eligible for a drug discount card because eligibility criteria for the majority of manufacturer cards is that the patient must have commercial insurance.
As far as free discount cards that you can print off the Internet, sometimes the price listed under each pharmacy is not correct. Free discount card companies do not set pharmacy prices. The price you pay is based on how much the pharmacy paid for the drug, and it can vary from each distributor.
Most pharmacies do not match prices from wholesale businesses like Sam’s or Costco. Most of the time the price they advertise is part of being in a yearly subscription to their clubs.
As far as being an independent pharmacist, we actually look for the cheapest prices as long as we can receive quality medications. We are not big corporations, and we choose to be where we are so we can honor our patients the way they deserve.
Communication is key. You can call around and check prices all day long with the big chains, and you may even find a pharmacy that gives you the price that you are looking for. However, it is so important to sit down with the pharmacist you have and go over your medications and out-of-pocket cost. If not, you put yourself in possible danger by having your medications at more than one place. The software we have can only pick up what it knows. If you are a cash patient, it only picks up what we have filled.
We are your advocate! We can tell you if there is an equivalent that might save you money, and we can help point you in the right direction. We might even discover a medication that you do not even need anymore. We can find discount cards for you and can connect you with help if necessary. We are in this for you, and it is my pleasure to save you money and help you remain or get healthy. That is what I am here for. Call or come by for a consultation.
9627 Countryside Center Lane
Knoxville, TN 37931