Saturday, May 19, 2012

. I take several types of pills for my diabetes. How can I reduce the expense?

There are several ways in which the expense of your diabetes  medications can be reduced. Many of them apply to  medications in general. Whenever possible, you should try to use the medications that are on your insurance plan’s  preferred  list or those that  have the

lowest co-pays. These are generally the generic med- ications.   Your  doctor   should   consider  prescribing generic medications whenever possible, always weigh- ing in mind the benefits of saving money versus giving you the  most  effective and  safe  treatment  for your individual condition. If brand-name  medications are necessary, whenever possible your doctor will be will- ing to prescribe the specific brand that is preferred by your healthcare formulary with the lowest co-payment (first or second tier if more than one brand are available that  have little  difference between their efficacy and safety). Many plans will fill mail-in prescriptions for a

90-day supply with the same single co-pay as a 30-day supply at a retail pharmacy. Recently, some retail phar- macies have begun to offer the same programs. Also, some large national chain  pharmacies, such as Wal- mart, have begun to maintain their  own formularies with very low co-pays that discount further from those offered by your medical plan. Walmart,  Target,  and some Ralph’s pharmacies, along with others, will pro- vide a  30-day  supply of  some  generic antidiabetic, blood pressure, and cholesterol drugs for $4. They will honor  these prices even if  you  do not  have medical insurance coverage for your medications. Although the items on these formularies tend to be limited in num- ber and are usually generic, several of the medications commonly used by people with diabetes and  related conditions can be found on them. Some plans cover only  certain  dosage strengths  of medications at  the lowest  co-pay, so these should be prescribed by your doctor when  there is a choice. Finally, a number  of brand-name  medications  are available in a combina- tion formula with a generic medication (for example, pioglitazone with metformin and sitagliptin with met- formin) usually at the same price as the  brand-name drug alone. In this case, the generic medication is free,
as there is only one co-pay for a prescription. However, be sure  that the combination preparation is not in a higher tier (co-pay level) than the individual prepara- tions, as there may then be no saving.

Remember that one way not to save money is to ask your doctor to prescribe more medication than you are actually required to take on your prescription in order to make it last longer. This violates the terms of both the  doctor’s  and  your  contract  with  your healthcare plan and the agreements between the healthcare plan and the pharmacy and could result in loss of coverage.

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