Lower-cost prescription drugs - on call

Inside MS, Oct-Dec, 2002 by Seana O'Callaghan

As prescription drug prices continue to climb, the question hits all of us: how will we pay for our medication?

The answer: in every way possible.

Resources for prescription drug assistance are less scarce than they seem, and most people have access to at least some of them. To obtain the greatest savings, combine as many methods as possible, and be creative!

Insurance, public and private

Medicare. Most of us know that Medicare, the federal insurance program for seniors and people with disabilities, does not provide drug coverage for prescription drugs taken at home. At least, not yet. However, being enrolled in the program does make you eligible for other forms of assistance. (See "Cards, cards, cards" p. 65.) To find out if you are eligible for Medicare, call the Medicare number listed in the U.S. government section of the phone book, or go to: www.medicare .gov/Basics/Overview.asp.

Medigap. Medigap, also known as Medicare supplemental insurance, is a federal program administered state by state, that authorizes private insurers to sell coverage plans that add to Medicare's coverage. Since you must pay high premiums for the Medigap plans with prescription drug coverage, the benefits may not outweigh the cost. A good Web resource is: www.medicare.gov/ MGCompare/Home.asp.

State programs/Medicaid. According to the AARP Public Policy Institute, 12 states offer pharmacy assistance programs for people with disabilities living on low incomes who are under 65 years of age. State Health Insurance Programs (SHIPs) can help you find government and private prescription drug coverage resources in your state, as well as Medicaid prescription benefits that may be available. For a listing of SHIP Web sites for each state, go to: www.medicare.gov/Contacts/Related/ Ships.asp or www.qdrug.com/sf/. Call the Social Services number listed in the County section of the phone book.

Formularies. Some insurance plans publish lists of preferred medications, called "formularies". These name drugs for which the company has negotiated reduced prices. Make sure that your doctor has a copy of the formulary from your plan, and ask that he or she prescribe from the list whenever possible.

Cards, cards, cards

Manufacturers' rebate cards. Major prescription medication manufacturers offer free discount cards for Medicare recipients. You may find yourself with a wallet bulging with plastic, but the following cards can save you significant sums.

Although some of the following Web sites' home pages say that the cards are for seniors, anybody enrolled in Medicare is eligible for the programs.

Pfizer offers the Share Card for Medicare recipients who have no prescription coverage and whose gross income does not exceed $18,000 for individuals or $24,000 for couples. The card entitles the holder to a flat rate of $15 for each 30-day supply of any Pfizer prescription drug (except Celebrex), including Zoloft and Neurontin. Pfizer can be contacted at 800-717-6005 or www.pfizerforliving.com.

Eli Lilly's LillyAnswersCard has identical income requirements to Pfizer's. The card entitles holders to a flat $12 for a month's supply of a Lilly prescription medication, excluding medicines administered by a doctor or in a hospital or controlled substances. Contact Eli Lilly at 877-795-4559 or www.lillyanswers.com.

GlaxoSmithKline offers the Orange Card. The income allowances are $26,000 for singles and $35,000 for couples. Holders save 30% to 40% on all GlaxoSmithKline medications that are not administered by a doctor or in a hospital. GlaxoSmithKline can be reached at 888-672-6436 or www.gsk.com.

Novartis offers the Care Card, which entitles holders to savings of 30-40% off selected outpatient products. The income allowance is approximately $26,000 for individuals and $35,000 for couples. Novartis can be contacted at 888-NOW-NOVA or www.novartis.com.

The Together RX card is offered by a consortium of drug manufacturers--including GlaxoSmith Kline, Novartis, and five others. As with the other cards, you must be enrolled in Medicare to participate and have no other prescription coverage. The Together Rx card has income allowances of up to $28,000 for singles and $38,000 for couples and offers savings of 20% to 40%. Call 800-865-7211 or go to www.together-rx.com.

Pharmacy rebate cards. Many chain pharmacies also offer discount cards that can be used when purchasing anything in their stores; however, many exclude pharmacy purchases. Others offer only slight discounts (about 10%). Still, if your pharmacy offers a discount card that applies to prescriptions, it is usually worth the trouble of signing up, especially if those cards can be used in conjunction with other discounts.

Manufacturers' rebates. Income-based assistance is available from the manufacturers of almost all prescription medications, if the person and/or his or her doctor apply for them. Each manufacturer has its own program and processes and you must file a separate application for each medication. This slow, one-by-one approach may be the single best way to reduce spending on prescription medications. Drug manufacturers may even find you eligible for free medication. The organizations below can help you find the programs and applications.