Medically reviewed by, Russell Braun RPH
Do you and other family members take numerous medications? Feel like there is no way to lower your monthly medication costs? Many people are in this situation and feel the only choice is to follow doctors orders and pay up. People often ask how do pharmacy discount cards work? Could they help with this dilemma so many face?
According to the Kaiser Family Foundation, 59% of adults say prescription drugs have made their lives better, but 80% think the cost is unreasonable. In fact 30% of patients don’t take medication as prescribed due to the cost! What can be done to try and control this spending? Pharmacy prescription drug discount cards can be a tool to help slow the spending spree if used correctly.
Can pharmacy discount cards be the answer?
You have probably seen the ads on television, at the pharmacy counter or even received an offer in the mail for a pharmacy prescription drug discount card.
They claim to be free, and save huge amounts off of retail prescription prices… doesn’t it seem too good to be true?
That feeling you had kicking in was your intuition, and it was correct to be skeptical.
The truth is free pharmacy discount cards DO save you money BUT it may not be as much as they claim and it’s not completely “free”.
Made for cash pay customers
Do you find yourself in one of the following groups?
- Underinsured (you have insurance but the deductible is so high you feel like you don’t have insurance?
- Part of a cost sharing group such as Christian Healthcare Ministries or Medishare?
If the answer is yes, then pharmacy prescription drug discount cards are perfect for you. They allow you to see prices as low as possible because you have no insurance that is giving you a contracted rate at the pharmacy.
Comparison shop, go ahead be a consumer!
Most people compare prices on almost every product they buy. However, many do not realize they can comparison shop when it comes to medication. Lack of consumerism like this is a key reason healthcare spending continues to rise year after year.
Do you feel like you can’t question your doctor when they prescribe a drug because they are expert? That is true they are the expert, but keep in mind there are almost always many medication options to treat a disease state. That is where pharmacy drug discount cards come in.
Pharmacy discount cards give you the power to comparison shop!
These comparison tools let you specify generic vs brand, strength, form of the drug and quantity. Then most of them will give you a price lookup at pharmacies that are in your area. Some may even show you options for mail delivery of medications right to your door.
Does that sound like Amazon.com? Well they are not quite that good at customer service but much better than the alternative of calling many pharmacies yourself.
Pharmacy drug discount card types
There are many tools for patients looking to save money on medications. One of the tools in the tool belt goes by they name pharmacy prescription drug discount cards. In a nutshell they help lower the price of medications. There are also other names you may see these referred to, such as:
- Prescription discount card
- Pharmacy savings card
- Prescription savings offer
More and more companies are jumping on the bandwagon and coming up with their own discount option. They are advertised in the mail, on television and social media. Some of the companies and organizations that offer pharmacy drug discount cards include:
- Pharmacy benefit managers (PBMs)
- Insurance companies
- Privately held for profit companies
- Non profit organizations
- State governments
- Patient advocacy groups
What they do:
At the most basic level, these pharmacy drug discount cards offer a price that you can buy that medication for at a particular pharmacy that is a discount to the normal retail price. The cards can be used for a variety of medications that require a prescription, both generic and brand. These offers can only be used without insurance.
How do pharmacy prescription drug discount cards actually work?
These pharmacy discount cards negotiate a lower price with either a pharmacy directly, or a pharmacy benefit manager. Three different types of businesses create the pharmacy prescription discount card programs for the various organizations that market them listed above.
1. Pharmacy benefit managers (PBMs)
These are middlemen between your insurance company and you. They instruct the pharmacy how much your drug will cost you and pays the pharmacy on the behalf of your insurance company. In fact, some PBM’s offer their own pharmacy discount cards that can be used as an alternative to insurance or for the uninsured.
Examples of PBMs include CVS Health, Express Scripts and Optum the three largest players. These companies are all now vertically integrated. What the heck does that mean?
They own the insurance company, PBM and large mail order pharmacy or many retail pharmacies. As you can see there are many ways for their businesses to have conflicts of interest. They essentially can control and profit off of all aspects of drug coverage and pricing.
|CVS Health||Aetna||Caremark||CVS retail & CVS specialty|
|Cigna||Cigna||Express Scripts||Express Scripts mail order & Accredo|
|United Healthgroup||United Health||Optum||Optum mail order & Briova specialty pharmacy|
2. Privately owned companies
They collect data and offer marketing opportunities in exchange for the drug discount program. They offer the advantage of working directly with a pharmacy to get a discounted price. Therefore, the middleman PBM who was taking a part of the discount is cut out of the process. The downside is that the data they collect from you is sold to Pharma manufacturers, insurance companies and for general marketing purposes.
Examples of privately owned companies include GoodRx, BlinkHealth and SingleCare. Each of these companies have seen rapid growth and now offer other services in addition to the discounted drug prices. These include things such as Telehealth doctor visit services, premium programs and bonus savings options.
3. Non profit organizations
Non profits offer the service as charity in order to gain more recognition for their company. They may also collect a transaction fee from the processing of the claims that use the pharmacy prescription drug discount card.
Examples of non profit organizations with pharmacy prescription drug discount programs include Needymeds and Familywize. Both offer a full range of charity services that are more their core business and the drug discount program helps drive traffic to them.
How do pharmacy discount cards make money?
Given that so many different companies offer a pharmacy drug discount card option, it is important to read the fine print. The one you are considering may have slightly different rules based on what type of company is offering it. They will make there money in one or more of the following ways.
- Negotiating a low price with the pharmacy. The drug prices pharmacies pay their wholesaler can vary greatly due to many factors.
- Reselling your information, for instance your name, drug you inquire about and email address or physical address.
- Small fee for the transaction at the pharmacy. More claims at the pharmacy means more money for the pharmacy and they will pay for anything that brings more customers in store to them.
- Obtaining a kickback from drug manufacturers for each of the claims for their drug that were billed under their prescription discount card.
Who pays all these fees and any marketing fees? You do in the form of a smaller discounted price. See how there are plenty of ways for money to be made here?
Why do pharmacies participate in these pharmacy drug discount card programs?
The pharmacy wants to be in the discount drug card network to drive patients to their store. They hope you will end up buying other items while you are there to increase their revenue. The pharmacy business is very competitive and anything they can do to drive customers into their stores will be done.
Can you use a pharmacy discount card with insurance?
The short answer is no!
However, keep in mind you should always check pharmacy discount card options even if you have insurance. Reason being it may well be cheaper than your insurance price. Especially if you have a high copay, coinsurance or deductible.
|Simvastatin (Zocor) 20mg #30 tablets|
|Insurance copay for generic drug||$15|
|Pharmacy drug discount card price||$4|
As you can see in the example the drug costs $9 less when you DO NOT use your insurance. That may not seem like much difference, but if you refill the medication 12 times that is $108 per year. Do that for more than one prescription and you are talking real savings.
High deductible health plans (HDHPs)
If you have a HDHP then pharmacy drug discount cards are a must for you to check into. There are a few questions you need to ask yourself.
1. Does your deductible cover medical and pharmacy expenses or is there a separate pharmacy deductible you must meet?
Knowing what counts toward your deductible is important so you can estimate if you will hit that limit through the year. Some insurance plans now have a deductible just for medications AND one for things like doctor office visits or medical procedures.
2. Based on your normal spending on healthcare, will you meet your deductible?
Yes: Remember anytime you use a pharmacy drug discount card, it will not count toward your deductible. Therefore, if you were counting on that money to help you meet your deductible it will not and you may not want to use the pharmacy drug discount option. Especially if you have no further costs after the deductible is met.
No: Go ahead and use the pharmacy discount drug card right away. Compare the cost to what you will have to pay out of your pocket. It is likely you will receive a large discount off of the normal retail price.
For more information on HDHPs click here.
Therapeutic alternative shopping
An important reason that pharmacy drug discount cards are an important tool for patients to use is therapeutic alternatives. Most people realize that generic drugs are cheaper than brand ones. However, many times people give up hope on getting a better deal if no generic is available.
Don’t give up!
Many drugs on the market today have competitor drugs that work the same way but are just a slightly different compound. These are known as me too drugs. Pharmacy drug discount cards allow you to easily search for me too drugs and guess what?
Many of the me too’s WILL HAVE A GENERIC option! Your pharmacist can’t just switch to this lower cost option like they can do with a generic. Once you see the tremendous difference in price, you can have a conversation with your doctor about trying the cheaper therapeutic alternative.
How to find alternatives
While Dr. Google can be a great resource, it can give you bad health information sometimes. However, if you are simply looking for therapeutic alternatives it is great for that. Simply search in Google “therapeutic alternatives for drug x”, where drug x is your medication. Results from sites such as drugs.com will provide lists of the therapeutic alternatives by brand and generic names.
Take those generic drug names and plug them into the pharmacy prescription discount drug card website or mobile app. A whole bunch of options that can save you a lot of money will magically appear.
Pharmacy drug discount card key points
1. Don’t pay a fee!
- With all the free programs out there, it does not make sense to pay for a service that charges a fee. These programs might be legitimate but could end up costing more than you save.
2. Compare the discount price to your insurance cost.
- These programs can’t be used with insurance. Ask the pharmacist to give the price with your insurance and then with the pharmacy drug discount card. Take the lower price option.
3. Brand medications offer copay coupon cards, which are different than pharmacy drug discount cards.
- Copay coupon cards have to be used WITH insurance. Take this cost difference in consideration before making your decision.
4. Medication costs will be affected by strength, quantity and the pharmacy you want to use.
- Make sure you plug in these variables to get a price. Get creative, often higher strengths that can be split in half cost the exact same amount. Similarly, buying in higher quantities may be cheaper.
5. Different programs work with different pharmacies.
- Pharmacies agree to get in the network of the discount provider to drive more traffic. Therefore, discount cards like SingleCare for example may or may not work at your pharmacy. If your pharmacy is not part of the program, call them to see if they will price match.
6. Over The Counter (OTC) medications are not covered by pharmacy prescription drug discount cards.
- If the OTC drug you take has a prescription strength in addition to the OTC strength then it will be searchable with the discount programs.
7. Your claim won’t be denied.
- Most people who have had a prescription or two filled using insurance know that there can be some road blocks. However, with a pharmacy prescription discount card there are no formularies, prior authorizations or drug coverages that are denied. There is also no restrictions based on income.
8. Poly pharmacy… what the heck is that?
- Simply put it means getting prescriptions from more than one pharmacy. If you have four prescriptions and they are all lowest price at different pharmacies what do you do? The best practice would be go to your preferred pharmacy and ask them to price match the other lower prices for you. More often than not they will to get and keep your business. Customer loyalty is huge for retail pharmacies.
9. Drug interactions may not be checked when you use a pharmacy prescription drug discount card.
- One good thing that PBMs do for consumers is run a program called Drug Utilization Review (DUR). This scans your prescriptions for dangerous drug interactions and alerts the pharmacist. The pharmacist can talk to your doctor about this or provide you counseling on the potential problem.
- Keep in mind when you use a pharmacy prescription discount card DUR doesn’t know about those medications because they are not going through the PBM system. This is why keeping a medication list you can show your pharmacist is so important.
What is the best prescription drug discount card?
There are many different types of pharmacy discount cards available. They range from physical cards you put in your wallet to websites and mobile phone apps. It is important to remember that no two programs are exactly alike and it is wise to read the fine print.
Remember, each pharmacy prescription discount card program may have a different price for every drug at any given pharmacy! That means you need to check on them all and not just assume one is the best for you. Trust me, this will be worth your time to go to the sites below, plug in your specific medications and see who has best pricing.
1. InsideRx, owned by Express Scripts.
2. CVS partners with privately owned drug search tools such as SingleCare to offer increased savings opportunities at CVS pharmacies.
3. Optum Perks utilizes a discount card program known as Script Relief that had been privately owned until Optum purchased them.
1. GoodRx, great website and app, with large pharmacy network.
2. Blink Health, large network of pharmacies and offers a free home delivery option.
3. SingleCare, higher savings programs with Walmart and CVS, bonus savings program can offer accumulated savings over time.
4. RxSaver from the same company that provides Retailmenot.
5. WellRx Script Save, has an easy to use mobile application.
1. Needymeds not the best discounts of any discount card, but a great resource overall for patients.
2. Familywize more focused on the discount card and partners with other major organizations.
Remember to also check with your state for discount options.
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
Share your story
Have you used a pharmacy drug discount card? Also, please share how it worked for you. Chime in below with your comments and thoughts.