What to do when medications are too expensive
January 28, 2016 0 Comments
Over 8 million teenagers were taking psychiatric drugs as of 2013, about half of whom are being treated with stimulants for attention deficit hyperactivity disorder. Others seemingly require antidepressants, antipsychotics and anti-anxiety agents. Still others suffer from various physical or mental illnesses that require expensive medication.
Why medications are so expensive
Prescription drugs accounted for 9.3 percent of health care spending in the United States as of 2013. Many patients have to pay out-of-pocket or copays they cannot afford. The problem seems to be growing, leaving many wondering why.
Medications for more uncommon diseases usually have higher prices because development is so costly and distribution will be lower. Another reason for high prices is that drug companies need to have a lot of insurance against lawsuits for drugs that appeared safe but were not. Drugs that actually work tend to be more expensive than those with mixed results. But new, patented drugs are by far the most expensive.
The cost of research, development and testing of new medications is one reason for the high price tag, particularly for new medications. When a drug first comes out under patent, generic forms cannot be sold until the patent expires in 20 years. In the meantime, if the patented drug is tested and found to be safe for children, the exclusive rights and patent are extended years longer. Patients must pay whatever the drug company asks until generic competition lowers the price. Furthermore, the government doesn’t regulate prices of pharmaceuticals in the United States, so the sky’s the limit.
What to do when you can’t afford your medications
Most psychiatric medications are covered by most insurance companies. But those who lack the insurance or ability to pay for prescriptions still have options. Some suggestions to try when medications become too expensive include:
- Ask about generic versions: The American College of Physicians suggests providers should use generic medications whenever possible to lower prescription costs and improve adherence. Your provider may or may not know which medications are available in generic form, but should know if there is any special reason why a generic should not be substituted.
- Patient-assistance programs: There are many prescription programs funded mainly by drug companies that offer discounted medication to those who qualify. Each program has its own set of rules and eligibility requirements, such as proof of income, insurance documents and information from your doctor.
- Pharmaceutical companies: Most assistance from pharmaceutical companies comes via the above patient-assistance programs, but you can always request samples by contacting the company directly or asking your provider for them.
- State and local agencies: Apply for Medicaid, as income is only one of many eligibility criteria. Other local community health service offices might have some tips and tricks.
- Social agencies like the Salvation Army might offer assistance in certain circumstances.
- Patient advocate organizations will often help with copays.
Are there natural alternatives to medications?
Seeking alternative therapies simply because pharmaceutical prescriptions are too costly does not make sense because alternative medicine is based on a fundamentally different philosophy. In addition, alternative therapies can also be very costly, and may not be covered by insurance. While alternative treatments may be worth the investment in the long term, they should not be used as a substitute for Western pharmaceuticals because they are two very different things.
Nonpharmacological approaches to wellness have existed since the earliest civilizations. There are many different alternative approaches to medicine, such as ayurveda, homeopathy, naturopathy, osteopathy, traditional Chinese medicine and others. Most alternative approaches seek to cure illness by restoring health using time-honored methods passed down through generations. Western medicine generally aims to eliminate diseases or their symptoms using research-based surgery, devices and drugs.
Some say that the use of “complementary” or “integrated” medicine provides the best of both worlds. Certainly safety regulations and quality standards used with pharmaceutical companies might help protect consumers who use alternative treatments. But surgeries, devices and many drugs alter the body’s natural state, which can render otherwise useful alternative treatments ineffective. Expert opinions for individual cases are always advisable.
Today it is more important than ever for families to learn as much as possible about health and take responsibility for their own health care. Doing so takes time, resources and commitment. Understanding all of the options that are available and seeking outside options can help families decide how they want to live and what form of treatment is right for them. Whatever path they choose, money should not be the deciding factor.
At White River Academy, we integrate multidisciplinary strategies to promote lasting behavioral health in young men ages 12 to 17. When treatment becomes necessary for you or a young man in your life, White River Academy can help you make it happen. Our financial counselors can provide insurance solutions, resources and information about how to access the best care possible. For more information, please call our 24/7 helpline.
Written by Dana Connolly.