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 copays for the prescribed drugs and your insurance carrier covers the rest. Right?
The truth is, the amount you pay for a prescription drug if far more complicated than that. But we’ll give you a hint: Sometimes, your insurance company pays nothing at all. Nada. Zip.
Insurance Copays vs Cash
In fact, sometimes your insurance copay is more expensive than what an uninsured person pays for the exact same drug. 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 copay on those $4 generics is $11. That just doesn’t add up.
So what is 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 copay. 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 largely on their own studies and data—information that does not have to be made public. Bottom line? Pricing regulation and transparency is desperately needed in the pharmaceutical industry as a whole.
Pharmacy Benefits Manager (PBM)
Between the drug manufacturer and your insurance company, there is a middleman known as a Pharmacy Benefits Manager (PBM). That person not only helps your insurance carrier decide which brand-name and generic drugs it will cover (also known as its formulary) but also how much they will pay the manufacturer for those drugs. The PBM also works with pharmacies to help them control their drug spending, too—and they have a major incentive in the form of rebates (popularly known as clawbacks) to favor higher-priced drugs over ones that are more cost-effective ones. That helps explain why the price of the same drug can vary by two to three times 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?
Prescription Discount Apps and Cards
The good news is you can save yourself the time and effort of transferring your prescriptions to pharmacies all over town in the name of pricing research. All you have to do is download the myRxMedSaver app to your phone or print a card for your wallet. myRxMedSaver gives you the power to instantly unlock the power of prescription drug cash pricing and start saving money instantly.
Just present your myRxMedSaver to your pharmacist at checkout and quickly compare the cash price of the drug with your insurance copay. When the cash price is less than your copay, pay cash and pocket the difference! myRxMedSaver even works on pet medications, too, and the discount never expires.
myRxMedSaver is totally free and is accepted at more than 65,000 pharmacies. And there’s no waiting period. You can go ahead and start using it today to save upwards of 85% on all of your prescriptions.
myRxMedSaver has helped thousands of people—with and without insurance—save millions of dollars in prescription costs. What are you waiting for? Download myRxMedSaver now and never overpay for prescription medication again. Available at the Apple App Store and on Google Play.