More than one in three Americans has a chronic health condition such as diabetes, high blood pressure or arthritis – by age 65, it’s 95 percent – and 33 percent of you (around 44 million) face a stark financial choice: food or medicine.
That’s the conclusion of a troubling new Harvard Medical School study that checked the health records and daily habits of almost 10,000 women and men living with ongoing health problems such as asthma, chronic obstructive pulmonary disease, heart disease or the aftermath of a stroke or cancer treatment.
It’s a dangerous reality. Stopping or skimping on meds lets chronic conditions become worse, boosting your risk for ER visits, hospital stays and higher health costs. Case in point: People with high LDL cholesterol, high blood pressure and/or diabetes who don’t take all their medications as directed can increase their yearly out-of-pocket health care costs by more than $600! And while noncompliance with prescribed medicine regimens happens for many reasons, personal financial constraints are a major contributor to the $100 billion to $300 billion extra it costs the U.S. health care system annually to handle the repercussions of missed or lax treatment.
Soaring drug prices, even for some generics; increased deductibles, co-pays and co-insurance rates that are too high, an issue for some people even with new insurance plans; and a lack of insurance – still the situation for 13 percent of Americans – are all to blame. And so is the taboo about talking with your doctor about the cost of prescribed drugs. Just one in three docs brings it up, and at least half of us aren’t comfortable discussing our financial hardships with our physician or office staff. It’s time to break the ice, and get the care you need and deserve. We hope these six steps can help:
1. Talk about your budget: Take a deep breath next time your doc mentions your meds, then ask: “Is there a lower-priced alternative that would work for me?” And if you’re already stuck with a pricey prescription, call your doc with this question or ask your pharmacist. If you discover at the pharmacy that a drug costs too much, don’t just walk away. Your pharmacist can check with your doc and may be able to substitute a more affordable generic on the spot.
2. Ask about generics: Generic drugs can cost 30 percent to 95 percent less than brand versions, and in most cases the medications are equally effective. Also, many chains such RiteAid and Walgreens offer a large assortment of generic meds at rock-bottom prices.
3. Double-check your health plan’s drug coverage: Before you go to the pharmacy, check with your health insurance provider to see if it covers the brand name or generic meds you need and how much each costs.
4. Beware freebies: Don’t let your doc lock you into brands that offer freebies and samples. Drug samples and drug-company coupons are short-term money-savers when there’s no affordable alternative. But when it comes time to give you a longer prescription, they may cause your doctor to overlook less-pricey alternatives and generic versions that would be just as good for you.
5. Be choosy about discount cards: While some drug discount cards offer true savings, last year the federal government cracked down on several that were scamming Medicare members. Before signing up for a card, find out about fees and limits on benefits, and ask your pharmacist if it covers the medications you use, at a savings.
6. Look into assistance programs: If you don’t have any drug coverage, or if you need an expensive medication you just can’t afford, several organizations can help you look for assistance programs. Most are run by pharmaceutical companies. Three we like are Partnership for Prescription Assistance (pparx.org), RxAssist (rxassist.org) and Needy Meds (needymeds.org). Some states also have pharmaceutical assistance programs; contact your state’s department of health for more information. If you’re on Social Security and/or Medicare, you may quality for “Extra Help.” Go to medicare.gov for more information.
Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Dr. Mike Roizen is chief wellness officer and chairman of the Wellness Institute at Cleveland Clinic. Tune into “The Dr. Oz Show” or visit sharecare.com.