New Prescription Pricing System Costing Consumers

Bob Bell, Registered Health Underwriter
Bob Bell, Registered Health Underwriter
Dick Storseth, Pharmacist
Dick Storseth, Pharmacist

We want to alert you to some changes that will have many people digging deeper into their pockets to pay for prescription medication. 
More health insurance companies are embracing a new pricing system for costly prescription drugs. The plan does away with traditional co-payments for expensive Tier 4 drugs and charges patients a percentage of the cost of the medication. These costs can add up to hundreds, even thousands of dollars per month. 
"The drugs are divided in four categories, Tier 4 being the most expensive for the patient. Some companies require the patient to pay a percentage some as low as 25%, some as high as 44 to 50 percent." says Registered Health Underwriter, Bob Bell.

For example, instead of paying a  $60 co-pay for a drug like Enbrel to treat Rheumatoid Arthritis, it will now cost $340 with a 25% percent co-insurance. 
Pharmacist say the best way to save is clip coupons from the manufacturer, or participate in one of their discount buying programs. Or on Bell says buy in bulk or shop around.
"If it's about number one and you have to save yourself as much money as you can that's a good way to do it."

A local pharmacist says if you do get your drugs from several places make sure you tell each pharmacist all the medications you are taking. That will help you avoid harmful side effects. 

"The big problem is we have a list of their medications. We can't really do the job we're supposed to do and protect the patient." said Pharmacist, Dick Storseth.

Storseth is also concerned that the new prescription pricing will drive people out of state or even out of the country looking for the best price for their much needed medication, and that can also be dangerous.

"The safety of the patient is our main concerns and if we can't provide that because of an insurance decision that's frustrating to us and to the patient."

Pharmacists say they are adding new drugs to the Tier 4 list constantly.  They recommend if you are on one of these medications, talk with your insurance agent to find out what your percentage is in advance. They also say call the manufacturer and find out how you can participate in their special buying programs.