Strategies to Help Patients Afford Their Medicines in the US | Clinical Pharmacy and Pharmacology | JAMA

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href="https://cdn.jamanetwork.com/ama/content_public/journal/jama/939503/jpg240036fa_1732559822.9841.png?Expires=1735682003&Signature=ZRi4QjJK64WdoZb9lroSyB-1m6lX3JD~0--0DiHwjDjSHgohVGVw6HtXL1Kru1WcfjeZmcpUpBSCks7XFBhMqU9ThCRU0~HihWGgrVvPW8xOMruOKSbWnkk6iGivyNiAuygciJ6jf4-aNPKlSHL43usjHihypsXYM6nH7XpoyPvELKB2IGh15B7Om7CRyvRox7lcHsxQNYLWAX2O8dVQWnZZet0U754gFvR2jfTv-hsfCYSxI41OpQSArbNJfjZBv4q61LhlVvoS9aF5-XdPUKPGKvDHC~9JOi1~lQ9TOi210SSSxp8FX5mf3q369u9Bi4wMbXYOpDQoa4G6rtiYOg__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA" target="_blank" path-from-xml="jpg240036fa" rel="nofollow"><img data-original="https://cdn.jamanetwork.com/ama/content_public/journal/jama/939503/m_jpg240036fa_1732559822.9841.png?Expires=1735682003&Signature=vu8Se5J~E3Z7ukEQGQ02cw8ps5z7Okwqy2AdSjPlfURrZbzPqF4W6MbIGVDsWEyUY3E0RS5AstL9eWq-3~PZ4-lOMYUgHB1cSCOZxdcQvz~60ZplX1frW0nwX-5O2KQjeFthT-i6uIg3fbVz7DEw9aPan1zvFlrYPrf173xyy5uovzhDadrhRmIeyFBcYib9Rb9xpD7BFlLY99pHnjuVNtn7XKlmpXEdVuxXzetq3aiCTGeVkgTXr97nor9XdnyhGuF3iHfjjRStxoKzWX3NBJ58PUrpScYSp2fL2f7V64Dm0aBnjdsb-KuM4QNv4E5Ggm36XUL~HtVAWF2xyJQiMQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA" alt="Image description not available." class="content-img lazy" path-from-xml="jpg240036fa" /></a></div></div> <a class="article-section-id-anchor" id="250038842"></a> <p class="para">Many patients in the US struggle to afford their prescription drugs. The inability to take medications as prescribed can lead to worse health outcomes.</p> <a class="article-section-id-anchor" id="250038843"></a> <p class="para">Below are 7 strategies that patients can use to respond to high prescription drug costs in the US.<sup><a href="#jpg240036r1" class="ref-link section-jump-link" data-tab-toggle=".tab-nav-references">1</a></sup></p> <a class="article-section-id-anchor" id="250038844"></a> <div class="movable-ad-target bta"> </div> <div class="h3 cb section-type-section "> <div class="heading-text thm-col sb-sc"> <p class="para">Co-Payment Cards</p> </div> </div> <a class="article-section-id-anchor" id="250038845"></a> <p class="para">Co-payment cards are provided by brand-name drug manufacturers to decrease patient out-of-pocket costs for a specific drug.</p> <a class="article-section-id-anchor" id="250038846"></a> <p class="para"><strong>Recommended for:</strong> Patients with private health insurance taking a brand-name prescription drug without an appropriate alternative medication.</p> <a class="article-section-id-anchor" id="250038847"></a> <p class="para"><strong>Benefits:</strong> Can reduce out-of-pocket costs to less than $30 per month for some patients; easily obtained from drug company websites.</p> <a class="article-section-id-anchor" id="250038848"></a> <p class="para"><strong>Limitations:</strong> Available only to patients with private health insurance; exclude patients with public insurance coverage such as Medicare or Medicaid; discounts often have monthly or annual limits; manufacturers can discontinue the co-payment card or change the terms at any time.</p> <a class="article-section-id-anchor" id="250038849"></a> <p class="para"><strong>Access:</strong> Search the drug name and “co-payment card” in an online search engine. Alternatively, <a href="http://www.needymeds.org">NeedyMeds</a> and <a href="https://www.goodrx.com">GoodRx</a> aggregate co-payment cards from drug manufacturer websites.</p> <a class="article-section-id-anchor" id="250038850"></a> <div class="h3 cb section-type-section "> <div class="heading-text thm-col sb-sc"> <p class="para">Patient Assistance Programs</p> </div> </div> <a class="article-section-id-anchor" id="250038851"></a> <p class="para">There are 2 types of patient assistance programs. In one type, drug companies provide prescription drugs for free or at very low cost. In a second type, nonprofit organizations and foundations (usually sponsored by drug companies) provide financial assistance to lower out-of-pocket costs or health insurance premiums.</p> <a class="article-section-id-anchor" id="250038852"></a> <p class="para"><strong>Recommended for:</strong> Patients with financial hardship taking a brand-name prescription drug without an appropriate alternative medication.</p> <a class="article-section-id-anchor" id="250038853"></a> <p class="para"><strong>Benefits:</strong> Usually available to patients who meet financial eligibility criteria regardless of health insurance status.</p> <a class="article-section-id-anchor" id="250038854"></a> <p class="para"><strong>Limitations:</strong> Application process may be time-consuming and often requires proof of income and a signature from the medicine prescriber; nonprofit organizations and foundations have limited annual funding to assist patients.</p> <a class="article-section-id-anchor" id="250038855"></a> <p class="para"><strong>Access:</strong> Some organizations like <a href="http://www.needymeds.org">NeedyMeds</a> and <a href="https://www.rxassist.org">RxAssist</a> combine information about patient assistance programs from multiple manufacturers. The <a href="https://www.healthwellfoundation.org">HealthWell Foundation</a> and the <a href="https://www.panfoundation.org">Patient Access Network Foundation</a> are among the foundations that provide patient assistance.</p> <a class="article-section-id-anchor" id="250038856"></a> <div class="h3 cb section-type-section "> <div class="heading-text thm-col sb-sc"> <p class="para">Pharmacy Coupons</p> </div> </div> <a class="article-section-id-anchor" id="250038857"></a> <p class="para">Pharmacy coupons provide discounts on drugs purchased at local pharmacies without health insurance.</p> <a class="article-section-id-anchor" id="250038858"></a> <p class="para"><strong>Recommended for:</strong> Patients with difficulty affording a generic prescription drug, including drugs not covered by insurance.</p> <a class="article-section-id-anchor" id="250038859"></a> <p class="para"><strong>Benefits:</strong> Available to all patients regardless of health insurance status; provide access to generic drugs that are expensive or not covered by health insurance; easily accessible to patients and clinicians.</p> <a class="article-section-id-anchor" id="250038860"></a> <p class="para"><strong>Limitations:</strong> Coupon prices change frequently and vary by pharmacy and zip code; most useful for generic (not brand-name) drugs; for individuals with insurance, payments made using these coupons do not count toward health insurance deductibles or annual maximums.</p> <a class="article-section-id-anchor" id="250038861"></a> <p class="para"><strong>Access:</strong> <a href="https://www.goodrx.com">GoodRx</a>, <a href="https://www.rxsaver.com">RxSaver</a>, and <a href="https://www.singlecare.com">SingleCare</a> are among the third-party organizations that offer pharmacy coupons.</p> <a class="article-section-id-anchor" id="250038862"></a> <div class="h3 cb section-type-section "> <div class="heading-text thm-col sb-sc"> <p class="para">Direct-to-Consumer Pharmacies</p> </div> </div> <a class="article-section-id-anchor" id="250038863"></a> <p class="para">Direct-to-consumer pharmacies are online or in-person pharmacies that sell prescription drugs directly to patients without health insurance.</p> <a class="article-section-id-anchor" id="250038864"></a> <p class="para"><strong>Recommended for:</strong> Patients with difficulty affording a generic prescription drug, including drugs not covered by insurance.</p> <a class="article-section-id-anchor" id="250038865"></a> <p class="para"><strong>Benefits:</strong> Available to all patients, regardless of health insurance; provide access to generic drugs that are expensive or not covered by health insurance.</p> <a class="article-section-id-anchor" id="250038866"></a> <p class="para"><strong>Limitations:</strong> Most useful for generic drugs; pharmacies may not sell all drugs, and prices may vary among pharmacies; some pharmacies are online mail-order only; payments made using these coupons do not count toward health insurance deductibles or annual maximums.</p> <a class="article-section-id-anchor" id="250038867"></a> <p class="para"><strong>Access:</strong> Examples include <a href="https://pharmacy.amazon.com/rxpass">Amazon</a>, <a href="https://www.costco.com/cmpp">Costco</a>, <a href="https://www.healthwarehouse.com/pharmacy/">Health Warehouse</a>, <a href="https://costplusdrugs.com">Cost Plus Drugs</a>, and <a href="https://www.walmart.com/cp/4-prescriptions/1078664">Walmart</a>.</p> <a class="article-section-id-anchor" id="250038868"></a> <div class="h3 cb section-type-section "> <div class="heading-text thm-col sb-sc"> <p class="para">Public Assistance Programs</p> </div> </div> <a class="article-section-id-anchor" id="250038869"></a> <p class="para">Public assistance programs provide drugs to low-income patients at reduced costs.</p> <a class="article-section-id-anchor" id="250038870"></a> <p class="para"><strong>Recommended for:</strong> Patients with financial hardship who are eligible for a local, state, or federal program.</p> <a class="article-section-id-anchor" id="250038871"></a> <p class="para"><strong>Benefits:</strong> Provide access to generic or brand-name prescription drugs for free or at very low cost.</p> <a class="article-section-id-anchor" id="250038872"></a> <p class="para"><strong>Limitations:</strong> Financial eligibility criteria are based on income or assets; the application process may be time-consuming.</p> <a class="article-section-id-anchor" id="250038873"></a> <p class="para"><strong>Access:</strong> National programs include Extra Help programs from <a href="https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip/index.html#statemenu">Medicaid</a> and <a href="https://www.ssa.gov/medicare/part-d-extra-help">Medicare</a>. Some states have their own <a href="https://www.needymeds.org/state-programs">programs</a>.</p> <a class="article-section-id-anchor" id="250038874"></a> <div class="h3 cb section-type-section "> <div class="heading-text thm-col sb-sc"> <p class="para">International Online Pharmacies</p> </div> </div> <a class="article-section-id-anchor" id="250038875"></a> <p class="para">International online pharmacies sell and ship prescription drugs from international pharmacies directly to patients without health insurance.</p> <a class="article-section-id-anchor" id="250038876"></a> <p class="para"><strong>Recommended for:</strong> Patients taking a brand-name drug for a serious medical condition without any affordable alternative options in the US.</p> <a class="article-section-id-anchor" id="250038877"></a> <p class="para"><strong>Benefits:</strong> Available to all patients, regardless of health insurance; provide access to brand-name drugs that are sold at lower prices in other countries than in the US.</p> <a class="article-section-id-anchor" id="250038878"></a> <p class="para"><strong>Limitations:</strong> Questionable drug quality if purchasing from an unreliable pharmacy; patients can purchase no more than a 90-day supply of prescription drugs at once per the US Food and Drug Administration.</p> <a class="article-section-id-anchor" id="250038879"></a> <p class="para"><strong>Access:</strong> Use <a href="https://www.pharmacychecker.com/">PharmacyChecker</a> to compare prices at trusted online pharmacies.</p> <a class="article-section-id-anchor" id="250038880"></a> <div class="h3 cb section-type-section "> <div class="heading-text thm-col sb-sc"> <p class="para">Real-Time Prescription Benefit Tools</p> </div> </div> <a class="article-section-id-anchor" id="250038881"></a> <p class="para">Real-time prescription benefit tools give clinicians cost and coverage information when prescribing a prescription drug.</p> <a class="article-section-id-anchor" id="250038882"></a> <p class="para"><strong>Recommended for:</strong> Clinicians to use when prescribing prescription drugs electronically.</p> <a class="article-section-id-anchor" id="250038883"></a> <p class="para"><strong>Benefits:</strong> Increase drug cost transparency for patients; improve the chance that patients are able to fill medications that are prescribed to them; can lower some out-of-pocket costs.</p> <a class="article-section-id-anchor" id="250038884"></a> <p class="para"><strong>Limitations:</strong> Cost and coverage information may be inaccurate or unavailable for some patients and some prescription drugs.</p> <a class="article-section-id-anchor" id="250038885"></a> <p class="para"><strong>Access:</strong> Check with your health care practitioner to see if they have such a tool available.</p> <a class="article-section-id-anchor" id="250038886"></a> <div class="para back-extra">The JAMA Patient Page is a public service of <i>JAMA</i>. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, <i>JAMA</i> suggests that you consult your physician. This page may be downloaded or photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, email <a href="mailto:reprints@jamanetwork.com" target="_blank">reprints@jamanetwork.com</a>.</div> <a class="article-section-id-anchor" id="250038887"></a> <div class="h3 cb section-type-acknowledgements has-back-to-top"> <a href="#top" class="section-jump-link back-to-top" data-tab-toggle=".tab-nav-full-text">Back to top</a> <div class="heading-text thm-col sb-sc"> Article Information </div> </div> <p class="parapublished-online"><strong>Published Online:</strong> October 21, 2024. doi:10.1001/jama.2024.21143</p><p class="parafinancial-disclosure"><strong>Conflict of Interest Disclosures:</strong> None reported.</p> <a class="article-section-id-anchor" id="250038888"></a> <div class="h3 cb section-type-references "> <div class="heading-text thm-col sb-sc"> <div class="references">Reference</div> </div> </div> <div class="references"><div class="reference"><a class="reference-number" id="jpg240036r1">1.</a><div class="reference-content">Lalani HS, Hwang CS, Kesselheim AS, Rome BN. Strategies to help patients navigate high prescription drug costs. <i xmlns:helper="urn:XsltStringHelper"> JAMA</i>. 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