The modern pharmaceutical industry has revolutionized treatment of psychiatric illness- but all that progress comes at a cost. Medication prices continue their march upwards, insurance gets less generous rather than more generous over time, and people often struggle to pay their bills, for meds and otherwise. What to do?

Tell me about the problem. Don’t be embarrassed- as with any other problem, I can’t help you unless I know about it. This is something I deal with literally every day of my working life- we’ll work together to find a solution.

Shop around.  CVS and Walgreens are great pharmacies- if you have good insurance. They basically never have the best prices for meds. As with any other consumer good, shopping can bring big savings. Kroger, Meijer, Wal-Mart, and Costco are good alternatives.

Look into mail order. Mail order is often an option under insurance, and offers 3 months’ worth of meds, often at a substantial discount to the monthly local pharmacy price.

Try out http://www.goodrx.com. Goodrx offers discount coupons for a variety of meds, and for expensive generics the savings can be dramatic. This is a free coupon and product. Many of my patients tell me with goodrx the cash price with coupon is often less than their copay using insurance! Using goodrx can be a little tricky for Medicare patients. By law Medicare patients are not supposed to use discount coupons (why not is an interesting question, and I can offer my thoughts on that if you’re interested). Many times your usual pharmacy will not honor goodrx coupons if you’re a Medicare patient. You can go to another pharmacy and tell them you’re paying cash and not going through insurance and make it work. Not ideal, but. . .

Cut tablets in half .  Medication pricing is interesting- often different strengths of the same medicine cost about the same per pill. Cut the pill in half and it lasts twice as long! Doesn’t work with capsules, obviously.

Look into low-income programs from the drug manufacturer. Only works for brand-name drugs. Go to the drug’s website and you can often find information on this. Only works if you’re truly low-income- but limits vary from company to company. Worth looking into.

Ask about samples. Companies vary on how generous they are with samples, and their generosity can vary over time as well. For branded meds where no other solution works, I can do my best to keep you in samples. Not an ideal long-term fix, but one of my mottoes is, “to get to the long term you have to get through the short term first!”

Look at alternative meds.  I’m always reluctant to change a medicine that’s working because of economic reasons- the reality is that has to happen sometimes. Almost always there’s a cousin (close or distant) of an expensive med that’s significantly cheaper- it would be worth trying this vs. not taking anything at all.

Hope the above helps! I would encourage everyone to be a good citizen- educate yourselves on the issue of medication prices and write to your Congressman and Senators and ask them to work to help with this important national problem.