Free enterprise is a noble concept so long as everyone, regardless of income level, can afford the true necessities of life. In the U.S., where drug manufacturers have traditionally had free rein in setting their prices for maximum profit, prescription medications are notorious for being the least affordable of necessities. Brand-name prescriptions cost over three times as much in the United States as in other countries with similar economic and technological environments.
New Legislation, Imminent Changes
As of late 2022–early 2023, advocates and lawmakers have made significant progress toward rectifying the overpriced-medications problem, plus other health issues affecting people with disabilities and/or limited incomes:
- The Inflation Reduction Act of 2022 added shingles shots to the immunizations fully covered by Medicare.
- Out-of-pocket costs for Medicare-covered insulin are now limited to $35/month.
- By 2024, Medicare will cover all prescription-drug costs beyond $7,050/year; by 2025, anything beyond $2,000.
- Also beginning in 2024, increases in Medicare Part D premiums will be limited to 6 percent each year.
- The Inflation Reduction Act gives Medicare negotiating power to get better prices from drug manufacturers.
- The 21st Century Assistive Technology Act updated funding and access provisions to cover needed equipment.
- For people needing assistive technology to remedy mild-to-moderate hearing loss, hearing aids (which long required a medical exam and prescription) can now be purchased over the counter.
- The U.S. Department of Agriculture and the Social Security Administration have pooled their resources to streamline the process of applying for Supplemental Nutrition Assistance Program (SNAP) benefits, making it easier for seniors and people with disabilities to eat healthy.
Staying Frugally Healthy
Whatever the legal details or available options, though, much responsibility for finding best prices still rests with the end user. This is no less true if you’re financially well off: people with middle-class and higher incomes tend to buy familiar brands on autopilot, grumbling when prices go up, but giving little thought to actively seeking lower-priced alternatives. Every dollar saved on medication is a dollar more to invest elsewhere.
Many doctors also go on autopilot with prescription writing, and default to the best-known brand without considering less expensive but equally effective options. If you’ve been in the habit of accepting first recommendations without question, maybe it’s time to sit down with your doctor or pharmacist and review all options in detail.
Even once you have the prescription, prices can vary between pharmacies. Insurance specifications, coupons, and store overhead can all affect what you ultimately pay.
A Perspective on GoodRX
Tara Rocha, Digital Learning Specialist at BridgingApps, reflects on her use of GoodRX:
- When I first started using the app, searching for best prices almost turned into a scavenger hunt, and I covered so many different locations for different prescriptions that driving expenses started to offset the savings. I learned to look for price averages and choose just a few places to go to most: H-E-B on average is the cheapest.
- I love searching prices from home to help plan the prescription-pickup outing.
- When I have a prescription filled, I ask for the insurance price before giving my personal information, so I can compare with the GoodRX price before the final ring-up. (GoodRX coupons cannot normally be combined with insurance.)
- Do keep shopping around and Googling prices. Neither GoodRX nor any other app I know of covers all options. I recommend keeping track of price changes through regular search-and-compare, noting all current coupons and financial assistance options before having a new or intermittent prescription filled.