Prescription medicines impose a heavy financial burden on many people with diabetes, and depending on your income and insurance coverage, it may be difficult to reduce this expense substantially. A number of options can, however, generate at least some savings. One is using a mail-order pharmacy; many insurance companies offer reduced co-pays for this service, and the actual cost of the drug is likely to be lower, too. This will benefit you directly if your insurance plan has restrictions on the total cost of covered prescriptions within a time period (as does Medicare Part D), or if you are paying for the drug yourself.
If you do not have insurance coverage for prescription drugs, you may be tempted to use an online Canadian mail-order pharmacy. While this can cut costs, it is technically illegal under federal law, and the US Food and Drug Administration (FDA) plays no role in the oversight of non-US pharmacies. Nevertheless, several states, including Illinois, Kansas, Missouri, Vermont, and Wisconsin, have authorized programs through which their residents can order medicines from select foreign pharmacies. (No insurance companies recognize these programs.)
If you have insurance that covers prescription drugs, check to see if the policy has its own mail-order program. If you decide to look for a mail-order pharmacy online by yourself, look on the site for the VIPPS (Verified Internet Pharmacy Practice Site) seal. (Only US pharmacies are eligible for this certification.) Make sure to check any drugs received by mail, especially insulin, for spoilage before using them. Medicines from all pharmacies should look the same; if you have any doubt that a prescription you receive by mail is the correct one, do not use it until you have checked it out with the pharmacist or your doctor.
When selecting either a traditional or a mail-order pharmacy, look for the lowest total cost of all your prescriptions. Mixing and matching pharmacies may save a little bit of money, but buying all of your drugs from one place allows pharmacists to check for potentially dangerous drug interactions.
If you cannot or would rather not change the source of your prescriptions, or if doing so doesn’t save you enough money, you may want to consider changes in the drugs you take themselves. Ask your doctor whether an older, less expensive medicine might work instead; new drugs are not always more effective. (You can read about good drug values at Consumer Reports Best Buy Drugs, www.crbestbuydrugs.org.) If you are taking a brand-name medicine that has a generic equivalent, ask your doctor if you can switch; with just a handful of exceptions, generic drugs are just as safe and effective as their more expensive brand-name counterparts. You may also be able to cut the cost of certain drugs through pill-splitting, since pills with a higher drug content are often no more, or only slightly more, expensive than pills with a lower drug content. Not all pills can safely be split, however, so it is necessary to discuss this option with your doctor.
If you have a relatively low income and none of these options offer enough savings, consider applying for a patient assistance program, under which drug companies offer substantial discounts. Several Web sites exist for this purpose, including RxAssist (www.rxassist.org), BenefitsCheckUp (www.benefitscheckuprx.org), and the Partnership for Prescription Assistance (www.pparx.org).
No matter what your financial situation is, never alter the dose of a drug without first talking to your doctor. It may be possible over time, however, to lower the doses of some drugs or even eliminate them from your regimen through regular exercise and weight loss, since both of these can reduce insulin resistance.