{"id":249,"date":"2015-09-03T10:30:20","date_gmt":"2015-09-03T14:30:20","guid":{"rendered":"https:\/\/singlecare.com\/blog\/?p=249"},"modified":"2025-08-20T14:04:32","modified_gmt":"2025-08-20T18:04:32","slug":"how-to-get-cheaper-prescriptions","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/how-to-get-cheaper-prescriptions\/","title":{"rendered":"What makes prescriptions cost so much?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Prescription drugs are an integral part of healthcare; they help manage symptoms, treat illnesses, and save lives. However, the high cost of prescription drugs can take a big chunk out of the monthly budget for most people in the U.S. It can even hurt those who are able to afford good health insurance plans\u2014not to mention people who opt for Medicare. Those $30 copays add up. When you factor in can\u2019t-miss treatments that are only available as brand-name drugs, it\u2019s no wonder that <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medical-debt-statistics\/\"><span style=\"font-weight: 400;\">customers are going into debt<\/span><\/a><span style=\"font-weight: 400;\"> to get their meds.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The bad news is that it doesn\u2019t look like healthcare spending will drop any time soon. The price of more than <\/span><a href=\"https:\/\/www.statnews.com\/pharmalot\/2022\/01\/03\/drug-makers-ring-in-the-new-year-with-5-price-hikes-on-hundreds-of-medicines\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">450 prescription drugs<\/span><\/a><span style=\"font-weight: 400;\"> jumped up 5% in 2022, with a median increase of 5%. That includes big hikes on major medications like a <\/span><a href=\"https:\/\/www.axios.com\/drug-prices-increase-2022-pfizer-gilead-756945d8-3aaa-463e-b93e-9ba3ab47159f.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">5.6%<\/span><\/a><span style=\"font-weight: 400;\"> price increase on HIV drugs Biktarvy and Descovy, 6.9% increase on the Prevnar pneumonia vaccine and the breast cancer drug Ibrance. Unfortunately, this means some patients are struggling to pay for much-needed prescriptions or, in worse cases, <\/span><a href=\"https:\/\/www.westhealth.org\/press-release\/press-release-the-great-disconnect-between-perceptions-and-realities-of-the-u-s-healthcare-system\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">skipping them altogether<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">And even without the yearly price hikes, some prescription drugs are jaw-droppingly expensive. Take, for example, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/humira-pen\"><span style=\"font-weight: 400;\">Humira<\/span><\/a><span style=\"font-weight: 400;\">, which is used to treat a bevy of autoimmune conditions such as arthritis, Crohn\u2019s Disease, and ulcerative colitis. It costs nearly $7,000 for a 28-day supply, making it <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/most-expensive-drugs-2019\/\"><span style=\"font-weight: 400;\">one of the most expensive drugs available in the United States in 2019<\/span><\/a><span style=\"font-weight: 400;\">. However, the most stunning is <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/afinitor\"><span style=\"font-weight: 400;\">Afinitor<\/span><\/a><span style=\"font-weight: 400;\">, a cancer drug that costs around $19,000 for a 28-day supply if your insurance won\u2019t cover it. And those are just a few of the brand-name drugs with no generics available. The generic version of <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/copaxone\"><span style=\"font-weight: 400;\">Copaxone<\/span><\/a><span style=\"font-weight: 400;\"> (glatiramer), which is used to treat multiple sclerosis, is nearly $6,300 for a 30-day supply.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Despite how drug costs affect our health on a day-to-day basis, few of us are aware of exactly how the pharmaceutical market works, what drives up already high prices of drugs, and how to save money on prescription costs. Let\u2019s take a look at why drugs cost so much, how your choices matter, and how SingleCare can help with prescription costs.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Why are prescription drugs so expensive?\u00a0<\/span><\/h2>\n<h3><span style=\"font-weight: 400;\">1. Lack of price regulation<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">At a basic level, drugmakers call the shots when it comes to how much American patients pay for their prescriptions. While the <\/span><a href=\"https:\/\/www.fda.gov\/about-fda\/center-drug-evaluation-and-research-cder\/frequently-asked-questions-about-cder\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">U.S. Food and Drug Administration<\/span><\/a><span style=\"font-weight: 400;\"> (FDA) regulates how new drugs are tested, marketed, and released on the market, they don\u2019t have any price control over medications. Meaning, customers are subject to the whims of what many call \u201cBig Pharma.\u201d One <\/span><a href=\"https:\/\/healthpolicy.usc.edu\/research\/overpaying-for-prescription-drugs\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">2013 study<\/span><\/a><span style=\"font-weight: 400;\"> found that out-of-pocket costs <\/span><i><span style=\"font-weight: 400;\">with<\/span><\/i><span style=\"font-weight: 400;\"> insurance exceeded the cash price of the drug <\/span><i><span style=\"font-weight: 400;\">without <\/span><\/i><span style=\"font-weight: 400;\">insurance 23% of the time.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2. Drug exclusivity protection<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">When a new drug hits the market, it\u2019s immediately placed under <\/span><a href=\"https:\/\/www.fda.gov\/drugs\/development-approval-process-drugs\/frequently-asked-questions-patents-and-exclusivity\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">patent<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.fda.gov\/files\/drugs\/published\/Exclusivity-and-Generic-Drugs--What-Does-It-Mean-.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">drug exclusivity<\/span><\/a><span style=\"font-weight: 400;\"> protection, with patents currently lasting 20 years from when the application is filed. Drug exclusivity means that other pharmaceutical companies can\u2019t compete by developing generic drugs with similar effects.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In theory, patenting and drug exclusivity <\/span><a href=\"https:\/\/www.theatlantic.com\/health\/archive\/2019\/03\/drug-prices-high-cost-research-and-development\/585253\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">inspire further research and development<\/span><\/a><span style=\"font-weight: 400;\"> of better and more effective treatments for debilitating diseases like cancer and even aided the race toward a COVID-19 vaccine and coronavirus treatment. They ostensibly protect hard-earned research from being stolen by a competitor. However, this often leaves payers stuck with staggeringly high drug prices. One of the biggest problems, according to <\/span><a href=\"https:\/\/www.nytimes.com\/2015\/01\/15\/opinion\/why-drugs-cost-so-much.html?_r=2\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Peter B. Bach<\/span><\/a><span style=\"font-weight: 400;\">, physician and director of the Center for Health Policy and Outcomes at the Memorial Sloan Kettering Cancer Center, is that the law essentially forces insurers to include each and every expensive drug in their policies, regardless of their efficacy or price.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">3. Price hikes in the supply chain<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Meanwhile, insurance companies are putting the squeeze on consumers with increasing monthly premiums and <\/span><a href=\"https:\/\/www.npr.org\/sections\/health-shots\/2020\/01\/27\/799019013\/when-insurance-wont-cover-drugs-americans-make-tough-choices-about-their-health\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">health plans that don\u2019t always cover brand-name drugs<\/span><\/a><span style=\"font-weight: 400;\">. And then there are the <\/span><a href=\"https:\/\/www.consumerreports.org\/drug-prices\/the-shocking-rise-of-prescription-drug-prices\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">pharmacy benefit managers<\/span><\/a><span style=\"font-weight: 400;\"> (PBMs) who manage price negotiations with pharmacies, insurance companies, drug companies, and even your employers, to come up with a list of approved drugs that will be <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-a-formulary\/\"><span style=\"font-weight: 400;\">covered under your plan<\/span><\/a><span style=\"font-weight: 400;\">. It\u2019s a twisty-turny supply chain that, in the end, affects your bottom line.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">4. High administrative costs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The United States has the unfortunate bragging rights that <\/span><a href=\"https:\/\/data.oecd.org\/healthres\/pharmaceutical-spending.htm#indicator-chart\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">its citizens pay several times more for healthcare than people in other high-income countries<\/span><\/a><span style=\"font-weight: 400;\">, like Sweden, France, the U.K., and Canada, among others. So <\/span><span style=\"font-weight: 400;\">why are drug prices so high in the U.S.? <\/span><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/article-abstract\/2674671\" target=\"_blank\" rel=\"noopener\"><i><span style=\"font-weight: 400;\">Journal of the American Medical Association<\/span><\/i><\/a><span style=\"font-weight: 400;\"> reported, \u201cContrary to some explanations for high spending, social spending and health care utilization in the United States did not differ substantially from other high-income nations. Prices of labor and goods, including pharmaceuticals and devices, and administrative costs appeared to be the main drivers of the differences in spending.\u201d<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">5. Limited market competition<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">By contrast, there are fewer insurance companies in Europe and Canada, which gives them leverage over the pharmaceutical industry. They\u2019re free to reject high-priced drugs, so pharmaceutical companies must actually compete in a free market. As a result, prescription drug prices are more reasonable overall, and despite what the pharmaceutical industry claims, lower prices don\u2019t seem to affect research and drug development.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Generic prescription drug alternatives<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Despite all that bad news, don\u2019t despair\u2014you have more options than it seems to get the prescriptions you need at a price point that won\u2019t make you (more) sick. You can choose <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/are-generic-drugs-as-good-as-brand-name-medicines\/\"><span style=\"font-weight: 400;\">generic drugs<\/span><\/a><span style=\"font-weight: 400;\"> when they\u2019re available; they can cost up to 85% less on average, and they offer the same benefits of a brand-name drug. You might be skeptical of such a drastic price drop, but there\u2019s a simple explanation, and it has to do with FDA regulations (or the lack thereof).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">After a patent and\/or drug exclusivity for a particular drug expires, other pharmaceutical companies are free to develop their own identical version of the treatment, which means drug pricing must be more competitive. Additionally, <\/span><a href=\"https:\/\/www.fda.gov\/drugs\/questions-answers\/generic-drugs-questions-answers\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">the FDA <\/span><i><span style=\"font-weight: 400;\">does<\/span><\/i><span style=\"font-weight: 400;\"> regulate<\/span><\/a><span style=\"font-weight: 400;\"> how generic drugs are manufactured, packaged, and tested, so even though your medication might look slightly different, it will work the same way.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For example, the ADHD medication <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ritalin\"><span style=\"font-weight: 400;\">Ritalin<\/span><\/a><span style=\"font-weight: 400;\"> can also be purchased under the generic name methylphenidate, and often at a cheaper price. <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin\"><span style=\"font-weight: 400;\">Metformin<\/span><\/a><span style=\"font-weight: 400;\">, which is used for Type 2 diabetes, is available under the brand name <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/riomet\"><span style=\"font-weight: 400;\">Riomet<\/span><\/a><span style=\"font-weight: 400;\">; you can get generic Riomet for about $167 with a SingleCare coupon, depending on your pharmacy and location.<\/span><span style=\"font-weight: 400;\">\u00a0In 2019, drug manufacturer Eli Lilly and Company released <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/insulin-lispro\"><span style=\"font-weight: 400;\">insulin lispro<\/span><\/a><span style=\"font-weight: 400;\">, a cheaper, generic version of Humalog.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to the <\/span><a href=\"https:\/\/www.fda.gov\/drugs\/generic-drugs\/what-are-generic-drugs\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Congressional Budget Office<\/span><\/a><span style=\"font-weight: 400;\">, generic drugs save consumers on average $8 to $10 billion a year on drug spending. So the next time your doctor writes you a prescription, make sure to ask whether it\u2019s a new medication, and whether there\u2019s a generic version available.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Prescription savings tools: Rebates, pharmacists, and drug cards<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Going generic can help you save on prescription costs. There are also a variety of other methods to find the best drug prices. All you need is a little know-how and perseverance, and you can at least make a dent in how much you\u2019re spending on prescriptions.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The biggest surprise is that paying for prescriptions using your insurance might not be saving you money at all. A traditional $10 copay on generic drugs sounds reasonable at first, but those same drugs might only cost you around $3 if you pay out-of-pocket without insurance.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">And whether or not you have insurance, you should always check the cost of your prescription against a pharmacy savings card, like SingleCare. You could save up to 80% on your prescription medication\u2014and there\u2019s no hidden fees or catches.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also ask your pharmacist about patient assistance programs, which many pharmaceutical companies offer for prescriptions and even vaccines, depending on various qualifiers.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another great way to save money is to <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/save-on-my-prescriptions-discounts\/\"><span style=\"font-weight: 400;\">compare Rx drug prices at different pharmacies<\/span><\/a><span style=\"font-weight: 400;\">\u2014some will charge less for particular medications. Head to <\/span><a href=\"https:\/\/www.singlecare.com\/\"><span style=\"font-weight: 400;\">singlecare.com<\/span><\/a><span style=\"font-weight: 400;\"> and plug in your medication, then select your zip code to compare the price of drugs at local chains and big-box stores.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">People in the U.S. feel like they don\u2019t have a choice when it comes to filling their prescriptions, but SingleCare provides a more transparent and affordable way to get the medications you need.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Prescription drugs are an integral part of healthcare; they help manage symptoms, treat illnesses, and save lives. However, the high cost of prescription drugs can take a big chunk out of the monthly budget for most people in the U.S. It can even hurt those who are able to afford good health insurance plans\u2014not to [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":11240,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[15103,72,4350],"coauthors":[16175],"class_list":["post-249","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-drug-pricing","tag-fda","tag-prescription-savings","franchise-ask-singlecare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Why are prescription drugs so expensive?<\/title>\n<meta name=\"description\" content=\"There are a number of factors 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