Life Kit

How to get lower prices on prescription drugs

November 3, 2025

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  • When facing unexpected high prescription costs, the first steps are to check for simple errors, look for online coupons (like those on GoodRX), and ask the pharmacist about discounts. 
  • If coupons are insufficient, consult your provider about alternative, potentially cheaper, equivalent medications, or initiate a prior authorization process with insurance if no alternative exists. 
  • For long-term planning or during coverage disputes, review the insurance plan's formulary during open enrollment to understand drug costs in advance and proactively seek manufacturer patient assistance programs if needed. 

Segments

Initial Sticker Shock Reaction
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(00:00:09)
  • Key Takeaway: Unexpected high drug costs require immediate questioning of the price and checking for simple errors.
  • Summary: When a prescription price is unexpectedly high (e.g., $170 instead of $20), the first action is to question the pharmacist, asking them to recalculate or verify insurance details for simple input mistakes. This initial step helped one person discover their cost dropped to $0 under a newly updated insurance plan. Pharmacists can sometimes resolve issues quickly by checking for clerical errors.
Checking for Drug Errors/Dosage
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(00:05:08)
  • Key Takeaway: Pharmacists can suggest dosage adjustments (like splitting pills) that might significantly lower the charged price.
  • Summary: Beyond insurance errors, ask the pharmacist if adjusting the prescribed quantity or dosage strength could result in a lower charge, as pharmacies sometimes price different tablet counts disproportionately. For example, a pharmacist might suggest filling a prescription for a higher milligram count and using a pill cutter to achieve the prescribed dose more cheaply. This requires checking how the specific quantity/dosage combination is billed.
Using Drug Discount Coupons
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(00:05:38)
  • Key Takeaway: Online coupon sites like GoodRX reveal significant cash price differences across pharmacies, and manufacturer coupons are easily found via direct searching.
  • Summary: Search online for the drug name plus ‘discount’ or ‘coupon’ to find immediate savings, often through services like GoodRX, which show price variations between competing pharmacies (e.g., $400 at one vs. $15 at another). Manufacturer coupons are also available online and are intended to be easy to find, though they generally require the user to have insurance to be effective. These coupons may not apply if you are covered by federal programs like Medicare or TRICARE.
Seeking Alternative Medications
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(00:09:48)
  • Key Takeaway: If coupons fail, ask the provider if an essentially equivalent alternative drug exists that is covered by insurance at a lower cost.
  • Summary: If the drug cost remains prohibitive, return to the doctor to ask if an alternative version of the medicine is available that your insurance covers better. Pharmacists may identify a competing, equivalent inhaler that costs $20 instead of $500, but consulting the provider ensures the alternative is medically appropriate given other prescriptions. This step is crucial when the original drug faces high costs due to insurance coverage changes.
Navigating Prior Authorization and Samples
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(00:12:24)
  • Key Takeaway: When insurance requires prior authorization, ask the doctor’s office for free drug samples to cover the gap while the appeal process takes time.
  • Summary: If the insurance company requires a prior authorization letter from the doctor, this process can take up to 14 days, creating an immediate need for medication. Pharmaceutical sales reps often leave free samples with doctors’ offices, which can be requested to bridge the gap while fighting the insurance company. This strategy provides necessary medication while the formal appeal or authorization fight is underway.
Applying for Patient Assistance
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(00:15:08)
  • Key Takeaway: Need-based patient assistance programs, often run by manufacturers or nonprofits like Needy Meds, can offer free or heavily discounted drugs.
  • Summary: Drug manufacturers and nonprofits offer patient assistance programs that require filling out an application, unlike simple coupons. These programs are typically need-based and may exclude those who already have insurance or whose income exceeds certain limits. Searching the drug name plus ‘patient assistance program’ or using a resource like Needy Meds can help locate these financial aid options.
Reviewing Insurance Formularies Annually
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(00:16:18)
  • Key Takeaway: Proactively review the insurance plan’s formulary during open enrollment to see exactly how much each drug will cost next year.
  • Summary: The formulary is the insurance plan’s official list detailing coverage and patient cost-sharing for every drug, which must be requested during open enrollment. Reviewing this document allows individuals to identify potential cost hikes before the new year begins, enabling them to discuss alternatives with their provider proactively. Addressing coverage issues before January 1st allows time for appeals or prior authorizations to be sorted out.