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Meeting Unfilled Needs: For uninsured, an array of options for low-cost prescriptions

In a Consumer Reports study released last fall, over half of American prescription drug users surveyed said they had to cut other household expenses to pay for medications.
The majority of those affected said the struggle to pay for medical services and prescriptions “eclipses other personal economic crises, like losing a job, or facing foreclosure on a home.”
“We get quite a few people without insurance,” said Kyle Yoder, of Moose Pharmacy in Salisbury.
Staff at independent pharmacies in Rowan and Cabarrus Counties estimate that between 10 and 25 percent of their patients don’t have insurance.
That number may seem small, said Teresa Casmus, pharmacist at The Medicine Shoppe on West Innes Street, Salisbury.
But, she noted that 10 percent of a population the size of Rowan County’s is “a pretty large number” of uninsured patients.
“There are still a good number of patients who don’t have any insurance, but don’t qualify for Medicaid and aren’t old enough for Medicare yet,” said Michael Rea, pharmacy manager for Cannon Pharmacy.
The Kannapolis-based chain operates six locations in Cabarrus, Iredell and Mecklenburg counties.
Contrary to what you might think, Yoder said patients with chronic or ongoing medical needs might have an easier time getting help with their prescription drugs.
“It’s more of a problem in the acute case, where they need an antibiotic right now,” Yoder said. “For one thing, you’re fighting time.”
The good news for the uninsured is that most pharmacies will talk to doctors and try to determine a course of action – from switching to another drug at a lower cost, or enrolling the patient in a discount program.
Both large and small pharmacies now offer some way of saving money off the “regular price” of prescriptions.
Rea said Cannon Pharmacy has a list of lower-cost and generic medications available at a discount.
Moose Pharmacy and the Medicine Shoppe in Salisbury advertise similar lists.

At the same time, national chain stores say their customers can get substantial discounts for prescriptions through in-house discount programs.
Each company is quick to say that these are not insurance, nor a substitute for prescription drug coverage, all promise substantial savings.
Walmart store pharmacies advertise $4 and $10 generic medications, with no annual fee mentioned.
According to official details on the website, the program covers “certain generic drugs at commonly prescribed dosages. Higher dosages cost more.”
Walmart advertises $4 for a 30-day supply of those select medications, and $10 for a 90-day supply.
However, “Not all drugs covered by the $4 Retail Program are covered by the $10 Program,” according to the program guidelines.
Among major pharmacy chains in the area, all three offer a prescription drug savings program.
Each requires patients to enroll in order to get savings.
The Walgreens Prescription Savings Club offers discounts for an annual fee of $35 per family, per year.
The program covers family members, including dependents up to age 23.
CVS also offers a discount card program, called Health Savings Pass, for $15 per person, per year.
Rite Aid pharmacies offer the Rx Savings program, free of charge, advertising savings of 15 percent or more on “thousands of generics and brand name prescriptions,” according to the company website.
Not everyone can benefit from these programs.
For instance, federal law prohibits those receiving public funds for health care from taking part in these discount programs, according to disclaimers on each company’s website.
And those who have any kind of prescription drug coverage may have to request the discount program specifically, or may not be able to benefit from it at all.

James Bowman, pharmacist at Moose Pharmacy in Kannapolis, said the company has a staff member dedicated to helping patients get access to medications.
“At our store level, we try to help them with charge accounts,” Bowman said.
Casmus said independent pharmacies can “think out of the box,” unlike a corporation that may have to hold to strict standards.
“I can go online and see if there’s a manufacturer coupon,” Casmus said.
That’s what Casmus said she did recently, when a patient came to her with a new prescription for insulin.
“I was able to go online and get his first month for free,” Casmus said.
And, just like larger companies, her pharmacy offers long-term supplies of generic medications at a discount, as do Cannon Pharmacy and Moose Pharmacy.
“We basically help the customer try to do it the most economical way,” Casmus said.
Something else local pharmacists say they can do is offer help accessing patient assistance programs.
A number of drug companies will “sponsor” patients, Yoder said, through in-house programs for uninsured or low-income patients.
That requires proof of income, and perhaps other requirements that must be met.
Other patients can find help through local agencies, such as Rowan Helping Ministries, Yoder said.
“If we can’t do it for them, we can usually get them to where they can get the care they need,” he said.
Whatever the situation, pharmacists agree that the best course of action for anyone on medication is to choose one pharmacy and stick with it.
Both Yoder and Casmus warn that shopping around from one drug store to another, trying to get a bargain on every drug, leads to fragmented care.
“If you have one pharmacy, and you see 10 doctors, I get to see the whole picture,” Casmus said.
A patient who goes to multiple pharmacists is at higher risk for drug interactions that could lead to serious health problems, Yoder said.
Rea said that the biggest problem his store deals with is the notion that bigger chains, like Walmart, are always cheaper. It’s not true, Rea said.
“When we set our prices, we set them very aggressively to make sure we’re less than the competition,” Rea said.
With so many options to choose from, and no single path, the best thing patients can do is talk to their doctors, build a relationship with a pharmacy and stay informed.

Contact Hugh Fisher via the editor’s desk at 704-797-4244.

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