In 2019, approximately 4.38 billion retail prescriptions were filled in the United States. If you have prescription drug coverage through your health insurance plan, you’re responsible for your co-pays for the prescribed drugs, and your insurance carrier covers the rest. Right?
The truth: the amount you pay for a prescription drug is far more complicated than that. But we’ll give you a hint: Sometimes, your insurance company pays nothing at all. Nada. Zip.
Insurance Co-pays vs. Cash
Sometimes your insurance co-pay is more expensive than what an uninsured person pays for the exact same drug. So yes, people without insurance at all are paying less than you are. And remember, you pay extra for that prescription drug coverage benefit in the first place.
Consider this: almost 90% of all prescriptions filled in the United States are for generic drugs, some of which cost as little as $4.
However, according to a study done by the Kaiser Family Foundation, the average co-pay on those $4 generics is $11. That just doesn’t add up.
So, what’s driving prices at the pharmacy counter anyway? It turns out there are multiple factors that affect the price of a prescription drug and, in turn, your co-pay.
Let’s start at the beginning.
Prescription Drug Prices
Prescription drug prices in America are some of the highest in the entire world. That’s because drug manufacturers are allowed to set prices as high or low as they want. Some drug companies claim that the high cost of one drug is used to offset the research and development costs of another, but that explanation feels a bit self-serving at best.
Other times, manufacturers justify a high price based on the value it brings to the market, but those claims are usually based mainly on their own studies and data—information that does not have to be made public.
Bottom line? Pricing regulation and transparency are desperately needed in the pharmaceutical industry.
Pharmacy Benefits Manager (PBM)
Health insurance prescription drug plans are typically managed by a pharmacy benefits manager. PBMs are companies that manage prescription drug benefits on behalf of health insurers. By negotiating with drug manufacturers and pharmacies to control drug spending, PBMs have a significant impact in determining total drug costs – and they have faced growing scrutiny about their role in rising prescription costs and spending.
An essential role of the PBM is helping the insurance carrier decide which brand-name and generic drugs it will cover (also known as its formulary).
Unfortunately, PBMs have a significant incentive in the form of rebates to favor higher-priced drugs over more cost-effective ones. That helps explain why the price of the same drug can vary by two to three times or more from one pharmacy to another.
To further complicate things, it’s near impossible to compare prices at competing pharmacies without a valid prescription for the particular drug on file with them. How frustrating is that?
The good news is, by utilizing the myRxMedSaver Prescription Discount Program, you save yourself the time and effort of transferring your prescriptions to pharmacies all over town in the name of pricing research.
myRxMedSaver Prescription Discount Program
Go to the Get myRxMedSaver tab and get the prescription discount program your way. myRxMedSaver is free and accepted at more than 35,000 pharmacies. And there’s no waiting period. So go ahead and use it today and start saving upwards of 80% on all your prescriptions.
Getting the best price on your prescriptions has never been easier.
Use one of our online pricing engines for real-time price comparisons and coupons for an exact prescription at pharmacies near you. First, select the best-suited pricing engine for you. Then, print out or text yourself the appropriate discount coupon to present at your chosen pharmacy.
If you prefer a general use discount card, we have those available in print and digital form. Just show one of them to your pharmacist to price your prescription while you’re at the store.
If you’re an app user, we have one of those too.
- Download our myRxMedSaver app and show its self-contained general use discount card to your pharmacist to obtain an in-store prescription price.
When the cash price is less than your co-pay, pay cash and pocket the difference! myRxMedSaver even works on pet medications, too, and the discount never expires.
myRxMedSaver has helped thousands of people—with and without insurance—save millions of dollars in prescription costs.
So, what are you waiting for? Get myRxMedSaver now and never overpay for your prescriptions again.