Press Release (ePRNews.com) - NEW YORK - Jan 02, 2019 - In preparation for the 2019 insurance plan year, the ScriptSave WellRx prescription discount program has just completed its annual update for members which highlights big Changes to Prescription Formulary Lists for the year ahead. The analysis reveals the prescription drugs being dropped by the largest pharmacy benefit managers and which are thereby destined to be dropped by many leading insurance companies next year.
The analysis showed how two of the largest PBMs in the U.S. – Express Scripts and CVS Caremark – are dropping dozens of medications from their insurance plans, impacting patients suffering from a wide range of health conditions.
Patients with lung disease, heart disease, reproductive health issues, hormonal conditions, allergies and severe acne, chronic bowel disease, Lyme disease, high cholesterol and insomnia will be just some of those who might be well advised by this analysis to do a little fact-finding now, before the time comes to fill their first prescription of the new year.
An article in today’s The Wall Street Journal reported that more than 36 drug-makers are raising their prices on hundreds of medicines in 2019. The article, Drugmakers Raise Prices on Hundreds of Medicines, reported prices will rise an average 6.3 percent, including pricing hikes on different doses for the same drug.
The Prescription Drug Formulary is a list of approved medications that an insurance company agrees to subsidize. Under the annual prescription formulary changes, PBMs and insurance companies review their cost structures and identify medication options across different therapeutic classes to find alternative ways to treat the same conditions with less expensive meds that are designed to achieve the same health outcomes for the patient.
Andrew Potter, pricing analyst with WellRx, says the formulary changes mean that patients and consumers need to be aware that their out-of-pocket costs could be set to change drastically if they’re not paying attention. Perhaps more importantly, Potter highlighted the potential impact on patient care if patients end up having to reassess whether to refill their prescription at the turn of the year due to sticker-shock from their insurance plan.
“Conceivably, patients could show up at their pharmacy ready to collect their refill, only to find that the drug they had been taking in 2018 is no longer covered and no longer affordable for them,” said Potter. “Nobody enjoys sticker-shock, especially when dealing with prescription medications which genuinely could be live-saving. Patients shouldn’t simply assume that their prescription is covered in 2019 – just because it was covered by insurance in 2018.”
Potter says ScriptSave WellRx puts together the annual analysis to educate consumers on how their prescriptions are priced.
“We hope the free price-check tools on the WellRx website can provide a helpful ‘second opinion’ (and possibly even a discount) on prescription costs relative to the copays under a given health plan,” he said.
What Patients Can Do If Their Medications Are Excluded
Potter says consumers have options if they ever learn their prescription is dropped from their insurance plan. He encourages consumers to speak with their doctor or pharmacist about alternative medications designed to treat the same health condition. He also says if patients learn at the pharmacy that their prescription is no longer covered by insurance, they should always ask for the cash price.
“For many prescriptions, the cash price can be cheaper than the co-pay with insurance,” said Potter. “Asking for the cash price can quickly help the pharmacist save you money. It’s an easy price comparison.”
WellRx Mobile App Helps Patients Find Lowest Prices at the Pharmacy
Scriptsave WellRx negotiates drug prices in bulk with pharmacies across the nation, giving it access to prices for most prescription drugs being sold at independent and chain pharmacies. It makes these pricing data available at no cost via the free ScriptSave WellRx mobile app.
The free mobile app and related website provide a fast, easy, free way for patients (and physicians) to get a second opinion on what an out-of-pocket cost might be. Patients can price-check all their family’s medications at most pharmacies in any zip code with just one click.
WellRx’s price-check tool is available for free – no sign-up necessary – and features savings on medications at over 65,000 retail pharmacies across the U.S. Patients can save up to 80 percent (relative to the cash price of their prescription).
Patients can download the free ScriptSave WellRx mobile app (for iPhone and Android) and visit their website for more information.