Impatient

Helping make the health care system work for you

Doctor's orders: The value of comparing drug prices

"You forgot to tell me the biggest side effect of my medication," Dr. Sharon Orrange recalls a patient telling her: "The cost."
"You forgot to tell me the biggest side effect of my medication," Dr. Sharon Orrange recalls a patient telling her: "The cost." AFP/Getty Images

Dr. Sharon Orrange recently heard me on KPCC's AirTalk discussing the wide variation in the cost of back MRIs, as part of our #PriceCheck collaboration.

Orrange, an internist at the Keck USC School of Medicine, reached out to me via e-mail to say that the lack of transparency with imaging costs is similar to what's happening with the cost of prescription drugs. 

I was intrigued. I recently read that one California hospital charged $10 for a blood cholesterol test, while another charged over 1,000 times more. But I didn't know the price craziness extended to prescription drugs.

Price problems

Orrange and I recently spoke by phone. Traditionally, she told me, doctors have been "abysmal" at talking to patients about the cost of the drugs they're prescribing. And patients, she said, were embarrassed to ask about the price.

She recalled that she had her "aha" moment when a patient finally said to her: "You forgot to tell me the biggest side effect of my medication…the cost."

The patient was on to something, Orrange said.

More than a quarter of Americans did't fill prescriptions throughout one year, because they couldn't afford them, according to a Kaiser Family Foundation poll conducted in September 2013. Almost half of uninsured respondents said they hadn't filled prescriptions because they couldn't afford them.

The organization also found that 30 percent of people were "very worried" about not being able to afford the prescription drugs they need.

Shopping smarter

As with the medical procedures in our PriceCheck project, the problem is that it is difficult for consumers to shop around to find the cheapest price for their drugs, said Orrange.

She said brand name drugs tend to have a set price, but the price of generic drugs can vary greatly by pharmacy.

Orrange tipped me off to one service that tackles that problem: GoodRx is essentially an Orbitz.com for generic drugs, she said. Consumers can enter their drug and zip code, and compare the cash prices and available coupons at local pharmacies. GoodRx also offers a free discount card. Full disclosure: Orrange blogs for GoodRx.

Orrange said she now uses GoodRx and its app to help patients search for the best deal on their prescriptions. She said it's benefiting people at all points on the insurance spectrum. 

Some have discovered that the cash price for a generic drug is cheaper than their prescription drug co-pay, noted Orrange. Sometimes, uninsured patients learn that their local pharmacies offer drugs at an equivalent – or cheaper – price than the county hospital's pharmacy. Some people have discovered that they can save money by getting a larger dosage, and splitting the pill in half, she said.

This Los Angeles Times article has several other tips for reducing your medication costs. It also refers to other websites intended to help people access prescription medications they can't afford. They include:

  • Rx Outreach, a non-profit, mail-order pharmacy for lower-income people;
  • NeedyMeds, a non-profit that offers information about programs for people who can't afford their medication or care. It also offers a free discount card to people at any income level and insurance status.
  • RxAssist, which helps consumers find information about free and low-cost medicine programs. It also offers a drug discount card.

Everyone benefits

Orrange is excited about this new focus on the cost of drug prices. She feels it's promoting better drug compliance, and preventing complications and hospitalizations, and "there's no downside to that."

Do you shop around for prescription drugs? Have you been surprised by the wide variation in prices, even between local pharmacies? Tell us your stories and give us your tips in the comments section below, or e-mail us at Impatient@scpr.org. 

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