Jane Morse needed to fill a prescription that was going to cost her about $300. She's on Medicare but doesn't have a prescription drug plan so she's learned to shop around.
She started by visiting websites that help consumers find low price retailers. There, she found the medication listed for $135 at Publix but when she went to fill it, the discount was no longer offered.
She asked the pharmacist for the AARP price but it wasn’t as good as the website’s price so she pulled out her AAA card. That price wasn’t cheaper either.
"And I said, 'What is the lowest price that you sell this medicine at and what do I have to do to get it?’” Morse said. “And they said 'We don't know.’”
Frustrated, she went home and tried two more pharmacies. Neither would give her prices over the phone.
She went to the pharmacies in person where she repeated the routine and got various responses. Eventually, a discount card she got in the mail from the drug manufacturer lowered the price to $67.
"Walmart did have the significantly lower price, that particular moment on that particular card -- the one that came in the mail," Morse said.
Not everyone is so diligent or has the ability to search for the lowest price. But, some say that may be what it takes. Between discount cards and coupons from drug manufacturers, online pharmacies and fluctuating prices at your neighborhood store, finding the cheapest price can be a daunting task.
Paying with insurance can be just as hard: Different plans cover different drugs. Some plans push patients to preferred pharmacy networks. Many charge patients co-insurance and co-pays.
"It's an incredible burden on consumers to try to figure out what makes the most sense and I think it's going to continue to get more complicated as these drugs continue to be super expensive,” said Katie Keith, a consumer advocate and contributor to a recent report on providing better access to prescription drugs.
She says many pharmacists won't provide drug prices over the phone, because they don't know the cost until insurance and discounts are entered into the computer.
Keith says consumers can go directly to drug makers to find the kind of discount cards that Morse used. But, she warns, those cards aren't helping to bring down the overall cost of prescription drugs.
"You're making it easier for people to get the drugs, which is something we all want but it doesn't necessarily help on the price pressure," Keith said.
Drug companies also offer rebates and incentives to insurance companies but those are not always passed on to consumers who buy the drugs. A recent study by PhRMA found that nearly 50 percent of insurance plans require patients to meet their deductibles before they become eligible to receive the rebates or incentives.
PhRMA spokeswoman Caitlin Carroll says with more people using high deductible plans, many are missing out on rebates that can cut drug prices by up to 50 percent.
"Why are patients being asked to pay more than the insurer is paying for a medication?” Carroll said. “We believe those savings should be passed on to consumers."
Insurance companies argue that the savings are being passed on in the form of lower premiums.
Consumer advocate Katie Keith says the rebates from manufacturers, much like the discount card that Morse used, are not addressing the overall problem of high prices.
And when patients are priced out of their medications, she says, they don't take them. That could lead to more costly treatment or hospital visits.
“It's better for everyone if folks are taking the medications they need and we should be making it easier to do that, not harder," Keith said.
After all, she says, healthy people lower the overall cost of healthcare.
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