Category: the business of health care

How to Lower Your Prescription Drug Costs

Even with adequate coverage, medication affordability remains a challenge. It’s best to start by consulting with your healthcare providers for alternatives, then consider utilizing co-payment cards, and exploring non-profit resources. Additionally, safety regulations surrounding imported and compounded medications are important to consider.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

This information is not intended for diagnosis or treatment. Before making health decisions, discuss with your physician or other qualified healthcare provider to decide what is right for you.

This content is for your “information and inspiration”, and does not imply my endorsement or recommendation.

Does my insurance cover this?

When I was in practice, patients often asked this question. Patients wanted to know if insurance would pay if I ordered a test, imaging study, or a referral.

But patients most often asked if their insurance would pay when I prescribed a new medication.

Most of the time, I could not answer their question. Sometimes I would prescribe a generic drug or an older brand-name drug that I thought any insurance would cover, but it didn’t.

Sometimes it depended on the deals the insurance plan made with the pharmaceutical company, or the employer, Medicare, or Medicaid had negotiated with the manufacturer.

Whatever the issue, even patients with adequate insurance coverage might not afford the medications they need, or find them a significant strain on their budget.

In a past post, I discussed sources for health insurance, most of which also cover medications. This post explains how to get extra help paying for prescription drugs.

Talk to your doctor

The first and most important step is to talk to your primary care doctor. Take ALL your meds, both prescription and OTC (over-the-counter, non-prescription), including vitamins, supplements, and anything else.

Ask your doctor to review the reason for each medication and confirm that you need it. If you do, is there an alternative that might be less expensive?

Are you receiving the generic version from your pharmacy?

Is there an OTC alternative (although since they are usually not covered by insurance, may not be less expensive.)?

If you receive care from more than one doctor, you may need to do this with each one.

Learn about generic drugs and how they can lower your costs.

a female physician talking to a male patient

Get help paying for prescription drugs

Co-payment cards are provided by brand-name drug manufacturers to decrease patient out-of-pocket costs for a specific drug. These are found on drug company websites.

These are available to patients with private health insurance taking a brand-name prescription drug without an appropriate alternative medication.

The discounts often have monthly or annual limits and can be withdrawn at any time. If this happens the patient reverts to paying full price, or will need to seek other alternatives.

Check availability at Needy Meds or GoodRX

Non-profit organizations

There are non-profit organizations that provide assistance for medications and other health services.

HealthWell Foundation

Our vision: To ensure that no patient goes without health care because they cannot afford it.

PAN Foundation

We envision a future where equitable, accessible healthcare is a reality for all.

Photo by Karolina Grabowska on Pexels.com

Direct-to-consumer pharmacies

You probably already use these retailers for other purchases. They also sell medications and may provide savings over typical pharmacies. These include Walmart, Costco, and Amazon. (affiliate link)

How to Buy Medicines Safely From an Online Pharmacy

Importing Prescription Medications

In general, the Food and Drug Administration discourages and prohibits the importation of medication from foreign pharmacies. The reason is

The FDA cannot ensure the safety and effectiveness of medicine purchased over the Internet from foreign sources, storefront businesses that offer to buy foreign medicine for you, or during trips outside the U.S.

For these reasons, the FDA recommends only obtaining medicines from legal sources in the U.S.

However, in certain situations it may be permitted. These include

“Product is for the treatment of a serious condition (Prescription Drug Products):

  • The product is for a serious condition for which effective treatment may not be available domestically either through commercial or clinical means.
  • There is no known commercialization or promotion of the product to persons residing in the U.S.
  • The product does not represent an unreasonable risk.
  • The consumer affirms in writing that the product is for personal use.
  • The quantity is generally not more than a three month supply “

Additionally, the prescribing physician must be identified.

Check the FDA website for information about this option.

What about Compounded Medications?

A drug may be compounded for a patient who cannot be treated with an FDA-approved medication. They usually are not covered by insurance. If you are considering using a compounded medication due to cost considerations, here are some points to consider from the FDA.

Compounded drugs are not FDA-approved. The FDA does not review these drugs to evaluate their safety, effectiveness, or quality before they reach patients.

If a compounded drug does not meet appropriate quality standards, is contaminated, or contains too much active ingredient, it could cause serious injury or death. Labels on compounded drugs may not include adequate directions to help ensure the drugs are used safely.

Only use compounded meds under supervision of qualified health professionals.

girl snuggling with cat

Veterinary Meds-not for Human Consumption

During the COVID-19 pandemic, a drug used to treat worm infections in dogs and cats was touted as an effective treatment for COVID in humans. It isn’t, but it can be used in humans for parasite infections, just like in animals.

But that doesn’t mean any medication approved for use in animals can be used safely in humans. Products for animal use are likely to be formulated differently to products for human use.

Animal medicines may be made with different strengths of active ingredients, different dosage forms or different non-active ingredients that could cause allergic reactions in some people.

There can be severe unintended consequences if you use animal medicines to treat your condition. And you may not pay any less.

Find Free or Low-cost Vaccines

Exploring the HEART of Health

I hope you find these suggestions helpful. Whatever you do, going without a medication is not a safe option and should be an absolute last resort, and only with your doctor’s supervision. Overprescribing does happen, so it is worth a doctor visit to see if you can safely stop any meds you routinely take.

Many people take nonprescription supplements and vitamins with little benefit. Stopping those can free up funds to pay for beneficial medication or other health-related expenses.

I’d love for you to follow this blog. I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha

Before you leave, read this related post.

How to Pay for Medical Care: A Guide for Americans

In this post I review how people pay for their healthcare. In the U.S., medical care financing includes employer-provided insurance, Medicaid, Medicare, the Affordable Care Act, and COBRA. Eligibility for these programs varies based on income, age, and employment status. Additional financial assistance exists through Medicare Savings Programs and nonprofit organizations, helping manage medical bills…

Keep reading
Aletha Cress Oglesby, M.D.'s avatar by Aletha Cress Oglesby, M.D.

Can Kennedy’s HHS Restructuring End Chronic Disease?

In this post I look at Secretary of Health Robert Kennedy Jr’s plans to cut 10,000 jobs and close five regional offices in the Department of Health and Human Services (HHS) to tackle the “chronic disease epidemic”. The restructuring intends to reduce HHS’s budget by $1.8 billion while facing significant criticism from Democrats about the potential public health impact.

Secretary of Health Robert Kennedy Jr. and President Trump have established a goal of eliminating the “chronic disease epidemic.” To do so, the Secretary has ordered a massive reduction in the budget and workforce of HHS, the Department of Health and Human Services.

What is Chronic Disease?

Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.

Centers for Disease Control and Prevention

What is an Epidemic?

In the 21st century, epidemics of infectious diseases have threatened humans. Severe acute respiratory syndrome (SARS), avian influenza, and HIV/AIDS have supported the reality of this threat. 

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes.

Late in the 20th century, epidemic was applied to noninfectious diseases, such as cancer epidemics or epidemics of obesity. Using epidemic for noninfectious causes refers to a disease that affects many people, with a recent and substantial increase in cases.

For nonmedical events, journalists use the term epidemic for anything that adversely affects large numbers of persons or objects and propagates like a disease, such as crack cocaine, computer viruses, or severe weather.

Reference: Martin P, Martin-Granel E. 2,500-year Evolution of the Term Epidemic. Emerging Infectious Diseases. 2006;12(6):976-980. doi:10.3201/eid1206.051263.

Here is the Secretary’s plan for HHS to address the “epidemic” he believes exists.

U.S. Department of Health and Human Services to slash 10,000 jobs, close 5 regional offices

By Jennifer Shutt, States Newsroom, March 27, 2025 | 12:26 pm ET

WASHINGTON — The Trump administration announced a sweeping plan Thursday to restructure the Department of Health and Human Services by cutting an additional 10,000 workers and closing down half of its 10 regional offices.

The overhaul will affect many of the agencies that make up HHS, including the Food and Drug Administration, Centers for Disease Control and Prevention, National Institutes of Health, and the Centers for Medicare and Medicaid Services.

HHS overall will be downsized from a full-time workforce of 82,000 to 62,000, including those who took early retirement or a buyout offer.

HHS Secretary Robert F. Kennedy, Jr. released a written statement along with the announcement, saying the changes would benefit Americans.

“We aren’t just reducing bureaucratic sprawl.

We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy said. “This Department will do more — a lot more — at a lower cost to the taxpayer.”  

The U.S. Senate voted to confirm Kennedy as the nation’s top public health official in mid-February.

James H. Shannon Building (Building One), NIH campus, Bethesda, MD
James H. Shannon Building (Building One), NIH campus, Bethesda, MD

Congressional reaction

Democrats immediately reacted with deep concern.

Senate Appropriations Committee ranking member Patty Murray, D-Wash., said that she was “stunned at the lack of thought about what they are doing to the American public and their health.”

Murray said the committee, which controls about one-third of all federal spending, “absolutely” has an oversight role to play in tracking HHS actions.

Wisconsin Sen. Tammy Baldwin, the top Democrat on the Appropriations subcommittee that funds HHS, said she believes HHS has overstepped its authority and expects the panel will look into its actions.

“These individuals who are going to be terminated under this plan play vital roles in the health of Wisconsinites and people nationally,” Baldwin said. “And I believe that they do not have the authority, the Trump administration does not have the authority to do this wholesale reorganization without working with Congress.”

Maryland Democratic Sen. Angela Alsobrooks, whose constituents in suburban Washington likely hold many of the jobs in question, wrote in a statement the HHS’ restructuring plans are “dangerous and deadly.”

“I warned America that confirming RFK Jr. would be a mistake,” Alsobrooks wrote. “His blatant distrust of science and disregard for research and advancement makes him completely unqualified.”

Cuts across department

The announcement says reorganizing HHS will cut its $1.7 trillion annual budget by about $1.8 billion, in part, by lowering overall staff levels.

Staffing cuts will be spread out over HHS and several of the agencies it oversees. The restructuring plans to eliminate

  • 3,500 full-time workers at the FDA,
  • 2,400 employees at the CDC,
  • 1,200 staff at the NIH and
  • 300 workers at the Centers for Medicare and Medicaid Services.
President Donald Trump visited NIH on March 3, 2020 and toured the National Institute of Allergy and Infectious Diseases’ Vaccine Research Center (VRC) to learn about research on a vaccine for the novel coronavirus SARS-CoV-2. public domain photo from flickr

“The consolidation and cuts are designed not only to save money, but to make the organization more efficient and more responsive to Americans’ needs, and to implement the Make America Healthy Again goal of ending the chronic disease epidemic,” according to a fact sheet.

Senate Health, Education, Labor and Pensions, or HELP, Committee Chairman Bill Cassidy, R-La., wrote in a statement that he looks “forward to hearing how this reorganization furthers these goals.”

“I am interested in HHS working better, such as lifesaving drug approval more rapidly, and Medicare service improved,” Cassidy wrote.

Regional offices, divisions affected

HHS did not immediately respond to a request from States Newsroom about which five of its 10 regional offices would shutter or when those closures would take effect.

Its website shows the offices are located in Boston; New York City; Philadelphia; Atlanta; Chicago; Dallas; Kansas City, Missouri; Denver; San Francisco; and Seattle.

HHS plans to reduce its divisions from 28 to 15 while also establishing the Administration for a Healthy America, or AHA.

That new entity will combine the Office of the Assistant Secretary for Health, Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Agency for Toxic Substances and Disease Registry and National Institute for Occupational Safety and Health.

That change will “improve coordination of health resources for low-income Americans and will focus on areas including, Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce development.

Transferring SAMHSA to AHA will increase operational efficiency and assure programs are carried out because it will break down artificial divisions between similar programs,” according to the announcement.

HHS will roll the Administration for Strategic Preparedness and Response into the CDC.

The department plans to create a new assistant secretary for enforcement, who will be responsible for work within the Departmental Appeals Board, Office of Medicare Hearings and Appeals and Office for Civil Rights.

House speaker says HHS is ‘bloated’

U.S. House Speaker Mike Johnson, R-La., posted on social media that he fully backed the changes in store for HHS.

​​”HHS is one of the most bureaucratic and bloated government agencies,” Johnson wrote. “@SecKennedy is bringing new, much-needed ideas to the department by returning HHS to its core mission while maintaining the critical programs it provides Americans.”

Advocates shared Democrats’ concern about the staff cutbacks.

Stella Dantas, president of the American College of Obstetricians and Gynecologists, released a statement saying the organization was “alarmed by the sudden termination of thousands of dedicated HHS employees, whose absence compounds the loss of thousands of fellow employees who have already been forced to leave U.S. health agencies.”

“Thanks to collaboration with HHS, ACOG has been able to contribute to advances in the provision of maternal health care, broadened coverage of critical preventive care, increased adoption of vaccines, raised awareness of fetal alcohol syndrome, strengthened STI prevention efforts, and more,” Dantas wrote. “This attack on public health—and HHS’ ability to advance it—will hurt people across the United States every single day.”

Originally Published on News From The States

All States Newsroom content is free to republish, as per our policy. 

https://www.newsfromthestates.com/article/us-department-health-and-human-services-slash-10000-jobs-close-5-regional-offices

Is there an “epidemic of chronic disease”?

When I practiced medicine, I and other professionals treated “chronic disease” daily. The number of people who live with a specific chronic disease varies, but the number and percentage of the population who have a chronic disease doesn’t seem to change much.

While we will always work to eliminate chronic disease, that will likely be impossible, at least soon. But improved treatments and lifestyle changes do help people with chronic diseases live longer, and healthier.

Key prevention points from the CDC

  • Most chronic diseases are caused by a short list of risk factors: tobacco use, poor nutrition, physical inactivity, and excessive alcohol use.
    • By avoiding these risks and getting good preventive care, you can improve your chance of staying well, feeling good, and living longer.
examples of ways to reduce the risk of a chronic disease, breast cancer.
Cover Image

The cover image is from the CDC website. It represents hypertension, high blood pressure, one of the most prevalent chronic medical conditions.

Exploring the HEART of Health

I’d love for you to follow this blog. I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha