Part two in the series will focus on discount cards, manufacturer coupons, and online sites for patient assistance.
Discount cards can be amazing things! However, please understand that by providing the pharmacy with those discount cards you are allowing this company (the discount card processor) to *possibly* have access to your personal information. Research your cards carefully especially unsolicited cards delivered via USPS or email. Using a card affiliated with a national chain or a known non-profit organization is a safer option.
There seems to be a massive grey area with regards to discount card use. Pharmacists at various chains have been told conflicting information about 1. whether pharmacies MUST accept the cards and 2. whether it is legal in certain circumstances to process the cards. And here is why…
1. Unless there is a contract in place, pharmacies have no obligation to accept random discount cards especially if these cards cause the pharmacy to lose money. And yes, sometimes they do. Each transaction comes with a processing fee (which is often how these companies make money) and sometimes the prices they set are below the actual cost for the pharmacy to purchase the medication from the wholesaler. How can this happen? I have no idea; but it does. I have personally seen a discount card give a price less than the pharmacy’s purchase price.
(Side note: I wonder how much personal data the discount card processor obtains via these transactions; as a chain retail pharmacist I am not privy to any of that information. I have tried researching it but ultimately came up empty handed. My advice is to use these cards with caution.)
2. Some pharmacists/lawyers contend that discount cards legally cannot be used if you are enrolled in any plan that is supplemented by the federal or state government (Medicare, Medicaid, Tricare) due to the federal anti-kickback statute. This means that even if you are paying the cash price because the insurance will not pay for the medication (or you are just choosing to not run the medication through the insurance) the discount card still cannot be used. Simply being enrolled in the program means that you are not allowed to use these offers. Other entities interpret the law differently, stating that the discount cards may be used if the medication is 100% not covered by the state/federal program.
The bottom line is that each chain will determine its own policy based on the recommendations of that chain’s corporate attorney. The answer to this question is something I have been struggling to track down for months; I hesitated to even post about it because the answers seem to be so variable but in the end, a discount card may be the best option in certain circumstances for people without insurance.
Keep in mind that pharmacies cannot legally bill your insurance then use a discount card on the copay.
Patients may obtain manufacturer coupons
1. Online. Sometimes you can apply for patient assistance online via a short questionairre on the medication or manufacturer’s official website. Use a search engine to inquire about the specific medication you need. Brand name medications will have their own website. Older medications may still have options for assistance through the manufacturer’s website. Simply do a search for the name of the medication and patient assistance or coupon.
2. By contacting the manufacturer directly (pharmacists can provide manufacturer phone numbers; I have also provided the contact information for epinephrine auto-injectors in my post)
3. From the pharmacist
4. From the prescriber
Again, just like the discount cards, patient’s enrolled in Medicare, Medicaid, or Tricare are typically not eligible but manufacturer coupons are a safe and legitimate way to obtain discounts. Some manufacturers may even have patient assistance programs that surpass the individual discount card; it never hurts to call and ask.
Sites such as www.needymeds.org and www.goodrx.com have been mentioned in pharmacy publications and would be a good place to start. Goodrx.com is also an approved e-advertiser for the NABP (National Association of Boards of Pharmacy) and has been featured in Forbes, Wall Street Journal, and the New York Times.