Increasing Drug Costs -- What Can Employees Do?

The cost and efficacy of prescription drugs vary widely with newer drugs costing more, often significantly more, than older ones. In addition, new drugs may be no more effective, no safer, and possibly less safe than older drugs. For example, researchers now say that diuretics are often the top choice for combating high blood pressure in light of new findings from a landmark study published in the December 18, 2002 issue of The Journal of the American Medical Association. Newer blood pressure drugs like Zestril and Norvasc were reported as less effective in preventing strokes and heart attacks than the generic diuretic hydrochlorothiazide. Researchers analyzing the study estimate that approximately $250 to $650 per patient per year could be saved by using diuretics. Examples of widely prescribed new drugs that have been recalled for safety reasons are Redux (dieting), Propulsid (heartburn), Rezulin (diabetes), Seldane (allergies), and Baycol (cholesterol).

What can employees do to help reduce their out-of-pocket costs and lower the rate of increase in the cost of prescription drug benefits while maintaining or even improving the health benefits of their medications? Consider the following tips:

1. Ask the doctor if there are generic alternatives to medications that are currently being taken or when a new drug is prescribed. If a generic is available, work with the physician to see if the generic is right. Generic drugs cost the employee and health plan less.

2. If the benefit plan has a list of “select” or preferred drugs, ask the physician to prescribe from the plan’s list. These drugs have a lower copay.

3. Be an informed consumer. Understand that newer drugs are not necessarily better drugs. Resist requesting an advertised prescription drug without knowing what condition the drug is used to treat and side effects and safety concerns. Understand that the physician may choose a generic or brand alternative that is more cost-effective, safer, and therapeutically equivalent to a drug that has been advertised.

4. Ask the physician for samples or a 30-day trial prescription of a newly prescribed maintenance drug before placing an order for a 90-day mail-order supply. Purchased but unused drugs add to both the employee and plan costs.

5. Ask the physician about lifestyle changes like smoking cessation, improved nutrition, weight loss, and exercise, that can improve health and help avoid or reduce the need for prescription medications.

Prescription medications–used correctly and safely–can have a significant impact on
improving medical condition(s). Talk to the doctor to help ensure appropriate, cost-conscious, and effective prescription drug use.

Next Article: 2004 Medical Premium Rates