Generic drugs, price comparisons best way to lower costs

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Mike Scott is an account executive with Barker Phillips Jackson, an associate-owned independent insurance agency.|ret||ret||tab|

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The cost of prescription drugs continues to increase, which is driving the cost of health care and health insurance in an upward trend. Currently, drug costs account for 18 percent to 20 percent of the total claims for most health plans. There are many strategies that you can incorporate into your plan to help curb these costs. |ret||ret||tab|

Many health insurers have made a three-tier plan available. The first, and lowest-cost, tier is for generic drugs. The second tier is for name-brand preferred drugs, or sometimes called name-brand formulary. These are drugs that have been approved by the health plan's medical staff to provide more efficient cost management than some other drugs. The third tier is nonformulary drugs. These drugs commonly are far more expensive than the formulary drugs or are for more severe treatment of a condition. Many times a person must follow a regimen of trials to be able to get a nonformulary drug.|ret||ret||tab|

A lot of people think that when a drug is not covered at a lower cost or the health plan wants you to try something different, it is trying to manage your health care. But it is simply a cost-containment measure so that your insurance premiums will be less than if there were no management of the claim. A few months ago, my daughter needed an anti-inflammatory and the doctor prescribed Vioxx, which is a nonformulary drug on her plan. We called the doctor back to see if there was anything else she could take, his answer was yes, but it would need to be taken twice a day instead of once a day. It was a generic naproxen and the cost was $10.|ret||ret||tab|

Another less common option is to require a deductible that must be met before the plan will pay for prescriptions with a co-pay amount. In this area, we typically see $50 or $100 and even $250 deductibles before the plan will pay any cost of the drug. This has been effective if people understand exactly what drugs cost. I remember a few years ago, a large employer in Springfield asked 10 of its employees what their medications cost. Surprisingly, eight out of 10 told him the cost of the co-pay, not the actual cost. The inclusion of a deductible for the prescriptions will be an eye-opening experience for everyone on the plan.|ret||ret||tab|

There are several more ways to save money on drug costs. One is to ask for samples. Drug representatives give these out to persuade doctors to prescribe the drug, so make sure you ask the doctor for samples, especially when trying a new drug. |ret||ret||tab|

Probably the most important way you can control your costs has to do with your relationship with your doctor, your pharmacist and your own expectations. Having a close relationship with your doctor is paramount in controlling all of your health care costs, not just prescriptions. He or she can determine the best options based on your medical history and prescribe the appropriate medication. They also can alert you to the expectations of the effectiveness of the drugs.|ret||ret||tab|

The relationship with the pharmacist is important, too. They will look out for your best interest, like the doctor, to let you know about potential side effects and can answer your questions about the drugs you have been prescribed. Many times, you will find that some local pharmacies have lower costs than the national chain stores. It pays to shop around. I know of one local, family-owned chain that consistently is less expensive than its big chain competitors. In one instance, it saved a retired person on a fixed income more than $60 a month.|ret||ret||tab|

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