Recently, I had the good fortune to speak with the chief executive of a national specialty, Monarch Specialty Pharmacy, who has advice for caregivers who may be trying to help manage the prescription drug costs of an older parent or other loved one who has Alzheimer’s Disease. Stephen Cichy’s advice distills down to four tips, one of which is to take advantage of a new discount prescription offering from his company. He talks about Alzheimer’s Disease specifically, but you can see that this can apply to a lot of the chronic medical conditions older adults face. Please give it a read.
“I was recently browsing the internet and came across a published report regarding the problem of medication compliance with persons living with AD. Turns out that when persons living with AD get their prescriptions filled, they take their pills as prescribed only about half the time*. (*Curr Med Res Opin. 2010 Aug;26(8):1957-65).
In addition to the challenge of dealing with multiple daily pills and the persistent problem of memory loss, an important factor contributing to the problem of medication use for persons with AD is the high cost of drugs themselves. Let’s face it, the price of prescriptions continues to soar. In fact, drug prices are the fastest growing chunk of consumers’ healthcare expenses, according to the non-profit Families USA.
If you have health insurance, your plan may or may not pay for prescription medicine. It depends on what kind of insurance you have. For example, if you have private health insurance through your employer, some or all of the cost of your medicine may be covered. If you have the traditional Medicare plan (sometimes called fee-for-service), you’ll need Medicare Part D to make sure your medicine is covered. If you have Medicaid, the Medicaid plan in your state may cover the cost of prescription medicines with certain restrictions.
As someone who cares for a loved one living with AD, you may know first-hand the complexities of dealing with the high cost of medication. What might not be so evident is the risk of not taking medication as prescribed. When a person’s AD goes untreated, they run the risk of their medical symptoms becoming exacerbated and may end up in the hospital emergency room, or worse, get admitted for conditions that could have been avoided had medications been more readily available earlier.
This problem is vexing, although I’ve learned several tactics that are helping persons living with AD pay for their medications, and that may be useful for you:
1. Look Beyond Brand Names
Generic drugs can cost as much as 70% less than brand name prescription. Always ask your doctor or pharmacist if there is a generic equivalent for your prescribed medication!
2. Leverage State and Community Programs
Some state governments offer affordable medicine programs for seniors, people who are disabled and people who have low incomes. Community health centers, Area Agencies on Aging, free health clinics and other community programs may also offer help. Some social agencies, such as the Salvation Army and some private hospitals, offer financial help for people who cannot afford prescription medicines. To use these services, you may need to show that you don’t qualify for private health insurance or that you don’t make enough money to pay for your own medicine.
3. Maximize Prescription Assistance Programs
Patient-assistance programs (also called PAPs) are sponsored by companies that make prescription medicine. Each company has its own rules about who qualifies for its PAP. In many cases, you will need to show that you don’t qualify for private or public health insurance (such as Medicare or Medicaid). You may also need to prove that your income is below a certain level.
Each PAP has its own application process. In many cases, your doctor, nurse or social worker will need to apply for you. For some programs, your doctor or nurse can submit an application online. For others, the application must be mailed in. It’s important to keep in mind that applying for a PAP does not guarantee that you will get your medicine for free or at a lower price.
4. Tap the GoRx Prescription Savings Program
Prescription savings programs are an innovative new approach to access to free savings on prescription drugs for persons without prescription coverage or for persons with prescription coverage who may require significant out-of-pocket expenses for their medications.
One such program is GoRx™ (www.GetGoRx.com). The GoRx prescription savings program is free and available to every person and family living with AD, with no age, income or health restriction. All commonly prescribed prescription medications are eligible for a discount. The discounts are available to consumers who do not have prescription drug insurance or the particular drug they need is not covered by their insurance. The average savings is 32 percent off the regular retail price the consumer would otherwise pay at the pharmacy. A majority of participating retail pharmacies will honor the GoRx Prescription Discount Card.
Simply put, GoRx™ is a simple and easy way to reduce your cost of prescription medication. The program covers practically any drug, including vitamins and supplements, so you don’t have to worry about checking if their prescription medication is part of the program. “
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
