Prescription Drug Price Trends
July 2, 2019
Reviewed and Updated by Troy Frink,
About one in four people say they have a tough time affording their prescription drugs. Prescription drug prices have been on the rise since 2017. According to Rueters, drug companies announced price increases for more than 250 medications in 2019.
According to the Centers for Medicare and Medicaid (CMS), prescription drugs already account for 20 percent of Medicare’s spending, and with the prescription drug price trend increasing, that number will only increase in the near future. That may mean that your vital medications will cost you more.
How to Get Prescription Drug Discounts
Rising prices shouldn’t mean that you have to stop taking your needed drugs. Wouldn’t it be great if you could get a discount for your necessary medications? You can with this free discount drug card!
This discount card is not an insurance plan. However, you can use your discount card to receive up to 75 percent off your prescriptions at more than 68,000 pharmacies. Simply download, print and show your card to the pharmacist when you check out to save money on your important medications.
Why Are Prescription Drug Costs Rising Rapidly?
The prescription drug price trend may be going up due to a lack of competition for pharmaceutical companies, and mergers and acquisitions in the pharmaceutical industry.
Lack of Competition for Pharmaceutical Companies
Many major pharmaceutical companies own patents for their drugs. That means other manufacturers cannot legally create generic equivalents, and the patent holders can charge whatever they want for their products.
Usually, manufacturers will produce generic drugs once a brand name patent expires. Some drugs are expensive to develop even with an expired patent, so that often means the original manufacturer is the only company producing their drug.
Mergers and Acquisitions in the Pharmaceutical Industry
Drug manufacturers make deals to expand their product bases. Unfortunately, when pharmaceutical companies merge, they get a lot of bargaining power. The pharmaceutical companies can demand that pharmacy benefit managers (PBM) – people responsible for contracting with pharmacies and getting drug discounts – set prices higher. Those costs get passed on to the government and ultimately to you.
Sometimes, pharmacy benefit managers merge with health plans, like in the cases of Cigna and Express Scripts and CVS and Aetna. Those mergers may actually be able to HELP you, by lowering costs due to reduced overhead and improved communication.
Medicare Prescription Drug Price Negotiation Act
One reason the prescription drug price trend is rapidly increasing is that CMS cannot legally negotiate drug prices. The Medicare Prescription Drug Price Negotiation Act is a bill that would require Medicare to negotiate prescription prices with pharmaceutical companies. It was first introduced in the House of Representatives in 2017, and re-introduced in 2019.
Other federal and state entities are making efforts to help reduce drug prices. The Food and Drug Administration is working toward approving more generic versions of brand name medicines. Many states have passed laws requiring drug companies to justify price increases.
Medicare Prescription Drug Plans
As prices rise, you may want to consider a new form of prescription drug coverage. Original Medicare does not help pay for prescriptions, but you can get prescription drug coverage through Medicare Part D, or through certain Medicare Advantage (Part C or MA) plans.
You can still use your discount drug card along with your insurance plan. When you go to the pharmacy to pick up your prescriptions, the pharmacist can determine your cost with each option.
Medicare Part D
Medicare Part D plans are also called prescription drug plans (PDPs). You can use PDPs to cover your medication costs. Many people who have PDPs also purchase Medicare Supplement (Medigap) plans to help pay for items such as coinsurance and copays.
Even though Medicare Supplements and Medicare Advantage plans sound similar, they are actually very different. Medigap plans “fill in” the gap between what you owe and what Original Medicare covers. MA plans help pay for medical expenses. If you have questions, one of our highly trained, licensed agents will be happy to help. Your agent can help you find the right plan for your budget and lifestyle.
PDPs typically use formularies that divide medications into tiers according to their copays. For example, one plan may feature four tiers with varying expenses. The first tier may only include generic drugs and cost $5 per prescription. Tier two may include preferred brand name medications and cost $15 per prescription.
Medicare Advantage Prescription Drug Plans
Medicare Advantage plans are privately owned insurance policies that cover everything Original Medicare covers, but they can offer additional services including vision, hearing, and dental. Certain MA policies called Medicare Advantage Prescription Drug (MAPD) plans offer medication coverage.
Like PDPs, MAPDs use a formulary that lists every covered drug and separates them into tiers. The difference is that MAPD plans come with only one monthly premium for your covered services, and it includes prescription drugs.
Medicare Over-the-Counter Drug Coverage
Many people use over-the-counter (OTC) drugs along with their prescription medications. Like with prescription medications, Original Medicare does not cover OTC drugs. However, certain MA plans help pay for OTC medications. Some plans feature a pre-paid card that allows you to purchase covered items such as bandages and cold medicine.
How We Can Help You With Rising Prescription Drug Prices
The prescription drug price trend may continue to rise. You can save money by downloading the discount drug card or enrolling in a Medicare plan that includes prescription drug coverage.
Your agent can help you find a plan that not only includes all of your prescriptions, but covers the additional services you need. Call us at 844-431-1832 or contact us here to learn more today.
