We have an extremely confusing system for getting medications. There have been many controversies regarding the pricing of drugs and availability. Getting a generic medication should not be difficult. This is where Goodrx.com helps.
There’s a great disconnect between the prices pharmaceutical industry charge and what the insurance companies or consumers want to pay. Unfortunately, medical providers and offices are getting stuck in the middle.
Anusol HC is a medication we commonly prescribe, it used to be covered well by insurance and then suddenly was removed from insurance formularies. I had a patient get this medication for $10 (noninsurance price) one month and then 6 months later was being charged out of pocket 15X this price…In a free market, medications that cost pennies to make shouldn’t go from $10 one month to over $150 the next!
Prior Authorizations (PA) are becoming more common. When a patient is prescribed a medication that isn’t on their insurance formulary, the pharmacy or insurance asks our office for medical information on why this medication is necessary. My staff needs to spend anywhere from 20 minutes to an hour per PA. This PA is reviewed by someone who has little to no medical knowledge and follows a checklist to commonly deny the PA. (Oh the Frustration!) We then have to reword the PA and eventually it gets approved with the patient being responsible for a large copay. This used to happen with new Brand Name drugs at first. It was a way for them to make us think twice about prescribing a medication we felt was of most benefit to our patients. This roadblock cost us time and manpower and made the patient upset with us because at the pharmacy they were told that we were not approving the medication.
Now we are getting prior authorizations for generic medications! (Makes my head spin!)
We came across this website/company, GoodRX.com that is fantastic (We have no affiliation with them). I’m sure there are other companies that do this but they help with the costs of generics. They have negotiated prices with pharmacies for generic medications and pass the benefits on to the consumer. Often we’ve found that the cash prices are better than the copay that patients have to pay. Just go to the website, put in the medication you are curious about and your zip code and you’ll find the big box pharmacies (CVS, Walgreens, etc.). Print out a coupon and take it to the pharmacy with your prescription.
You could save yourself or a loved one a whole bunch of money!
Find out more about what Rancho Wellness can do for you here.