Over the thump of cutting carrots in the industrial kitchen space she runs, Kathy Papineau tells the I-Team’s Casey Geraldo how she’s cut costs in a big way on her prescription drugs.
“This kitchen is about health in my opinion, so I have to take care of my own health,” said Papineau.
That’s what drove Papineau to ask more questions about her healthcare coverage and the costs of her medications. She takes two generic prescription medications. She does have prescription drug coverage, but doesn’t use it. The cost of her drugs in cash is cheaper at a small locally-owned drug store.
“I felt absolutely ripped off,” Papineau said.
Papineau was paying $118 each month for her medications at a major chain retailer. She made a call to a small, local pharmacy. Now she pays $18 a month, saving $1,200 a year.
After hearing from Papineau, the I-Team wanted to figure out how you can get the best prices too.
Hashim Zaibak, the CEO at Hayat Pharmacy, a small, local Milwaukee Pharmacy, tells the I-Team the patients who ask the best questions get the best prices.
“Shop around before you pay for the medication, especially with certain generic medications," he said. "The difference can be significantly high between two different pharmacies."
He said there are three groups of patients, all of whom have different questions they can ask to save the most money.
Cash patients, often uninsured, but don’t have to be, should ask the following:
- Can I get a generic?
- Is there a drug in the same family that would be as effective, but less costly?
- Is it cheaper if I get a six month or 12 month supply?
- Are there any manufacturer coupons?
Commercial insurance patients, who usually get insurance through work should ask:
- What’s the cash price? That cost may be lower than your insurance co-pay or payments toward your deductible.
- You can also ask the same questions as cash patients, even when going through insurance, and may find a drug with a lower co-pay.
Medicare and Medicaid patients:
- If you are in a coverage gap, you should ask the same questions as a cash patient.
- But, you aren’t eligible for manufacturer coupons.
- You may be eligible for a patient assistance program.
The I-Team also compared the prices of several popular medications on an online pharmacy, CVS, Walgreens and at local Hayat Pharmacy. The largest discrepancy we found was a difference of $307 when buying brand-name Nexium at the online pharmacy versus the local pharmacy.
That’s what Papineau believes needs to change.
“It bothers me for everyone,” she said.
That’s why she said it’s important people learn to ask questions.
“You can call the pharmacy and say I have this type of insurance or I don't have any insurance, what is my price?” she said. “You could find that without insurance, your price for that drug is lower.”
CVS tells the I-Team half of their prescriptions filled cost four dollars or less, while 75 percent are 10 dollars or less. The company explains "Due to varying business models and operational costs, there may be greater price differences for some medications" between retail pharmacies and warehouse stores.
CVS explains they have their own tool to help patients find better prices saying: "last year we implemented a comprehensive approach to help patients save money on their prescription medications, including an Rx Savings Finder service in our retail pharmacies through which our pharmacists can evaluate prescription savings opportunities for individual patients right at the pharmacy counter."
Watch Casey's full interview with Thomas Goetz of GoodRx below: