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5 questions for your pharmacist that might save your drug plan and your wallet

It's time to have a heart-to-heart talk with your pharmacist.

Few factors pose a bigger threat to employee benefits plans than the ever-rising cost of pharmaceuticals. If prices grow too high, a drug plan may not be sustainable – and that can force an employer to exclude specific medications, require employees to pay a larger share of drug costs, or simply cancel a plan altogether.

But those who fill the prescriptions can play a key role in the final costs.

Consider asking your pharmacist these 5 questions:

  1. You post your dispensing fees, but what will the final price be? -- I have seen dispensing fees range everywhere from a high of $15 to $3.89, with major retailers using artificially low fees as a way to lure new shoppers into a store. ("Maybe I'll buy a new stereo while I wait for my prescription to be filled ...")

    But the dispensing fee is only one factor to consider in the price of a drug. Every prescription also includes ingredient costs and pharmacy markups, and these fees do not need to be openly displayed.

    The price differences are not simply a matter of greed. Some retailers are able to secure better wholesale prices from manufacturers, while others need to cover steeper overhead costs. And they have all needed to respond to steady cuts in the professional allowances from drug manufacturers.

    Any customer armed with a Drug Identification Number (DIN) and the exact number of milligrams per pill can shop around for a better price. This can be a particularly worthwhile exercise for patients who take ongoing "maintenance" drugs that have to be refilled time and again.

  2. How long will it take to fill this prescription? – There are plenty of ways to pass the time in a drug store. Large retailers offer stations to check blood pressure, aisles filled with groceries and cosmetics, and kiosks for ordering lottery tickets.

    There's nothing wrong with the added choice and convenience, but shoppers may be surprised to learn that at least one major retailer builds a delay into every prescription request, just to give customers the time to browse through the other items.

    The best way to avoid the hidden costs is to come back to pick up the prescription. At the very least, keep an eye on marketing flyers for the real sales rather than being swayed by point-of-purchase displays.

    Customers may not even need to enter a store at all. Significant savings can be realized by asking benefits consultants about reputable central dispensing pharmacies, which can pass along the savings that come with lower overhead and enhanced productivity, yet still offer personalized service and overnight deliveries.

  3. Is there a generic alternative to the brand name drug? – There is a good reason why the patents on new drugs are protected for 20 years. Research and innovation comes at a cost, and it should be rewarded.

    But once approved, generic versions of these brand name drugs can meet the same medical needs at about 1/3 the price.

    In addition to that, many insurance plans will only cover the value of generic medication, except in cases where a brand name drug has been pre-approved because of a patient's unique medical needs. (For example, the patient may be allergic to something in the generic form of the drug.) This leaves the patients who use brand name drugs to pay the difference – on top of the overall percentage they are expected to cover under co-payment agreements.

    Patients can ask pharmacists to contact doctors to see if a less-costly generic drug will meet the same needs.

  4. Are there any therapeutic alternatives? – The affordable pharmaceutical options are not limited to generic drugs. Other therapeutic alternatives may deliver the same results.

    A 90-day supply of Nexium, used to control excess stomach acid, can cost $207. In contrast, a 90-day supply of a therapeutic alternative like Apo-omeprazole might cost a total of $112. And while 90 days of Cymbalata for a major depressive disorder might cost $375, an alternative in the form of Venlafaxine can cost just under $51.

    Pharmacists can contact doctors to discuss the options.

  5. Can you fill the complete prescription? – When taking a maintenance medication to control something like blood pressure or cholesterol, it makes financial sense to order as much of the medication as you can at once. This avoids the extra dispensing fees charged when filling the prescription over multiple visits.

    The opposite strategy applies when taking a drug for the first time. It can make sense to fill a smaller portion of the prescription to try the drug before committing to larger supplies. That way, purchased drugs will not be wasted if the prescription needs to be altered.

Top Tips:

  • Become a smart shopper by looking beyond dispensing fees, and consider the final prices which also include ingredient costs and pharmacy markups.
  • Ask your pharmacist if generic or therapeutic alternatives are available. These drugs can be cheaper than brand name options and still serve the same medical needs.
  • Ask for smaller quantities when trying a drug for the first time (to avoid wasting prescriptions), but larger quantities when taking maintenance medications over the long term (to avoid extra dispensing fees).

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The Buzz Bits
Miscellaneous links to interesting benefits information

Introducing Bill Zolis: Ajax-Pickering Board of Trade's new president: Durham Trade and Commerce

Learn more about generic drugs: choosinggenerics.ca

The Changing Drug Landscape - Biologics: the high cost of breakthrough medicine: Empire Life

Employees want vacations, not raises: Canadian HR Reporter (Includes an interview with Bill Zolis, requires subscription to Canadian HR Reporter)

Ignoring adherence drives up drug costs: Small Biz Advisor

Prescription drug prices vary drastically among pharmacies: CTV British Columbia

Community Ethics, Big City Expertise

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