How to save money at the pharmacy counter

"In November, Walgreens launched the Rx Savings Finder, which allows patients to access multiple third-party discount cards including GoodRx," analysts with BofA Securities wrote in a January report. "The most likely winner from these changes could be the consumer through lower pharmacy prices."

After making cash purchases, consumers with insurance should check if they're eligible for health plan reimbursement, said Hess, who previously ran a startup company that helped patients with medical billing problems.

For patients with nongovernmental insurance, Hess said, another option is financial and copay assistance programs run by pharmaceutical companies. The trade group for drug manufacturers has launched a website called Medicine Assistance Tool (MAT) with information on these programs.

Established patients at a subset of clinics known as federally qualified health centers can gain access to prescriptions at lower costs through a special agreement between the manufacturers and the federal government. There are more than a dozen of these health centers in Minnesota.

"I would personally encourage somebody having problems paying for their medications to check out a community health center because we might be the answer that they're looking for," said Ken Nelson, a pharmacist with St. Paul-based Minnesota Community Care.

A final option is ordering medicine from pharmacies in other countries, such as Canada. While these prices are sometimes lower, Nelson questioned whether the savings are worth the hassle for patients. Mitsch of UCare added health plan reimbursement is very uncertain for purchases from Canadian pharmacies.

For Medicare patients, there's good news on the horizon when it comes to drug costs, Mitsch said. Starting next year, Part D benefits will become significantly richer, with a cap on out-of-pocket spending on drugs at $2,000.

Longer term, the federal Medicare program is beginning to negotiate prices for a limited number of medications, including Eliquis. The first negotiated prices are effective in 2026. Democrats promise this will bring big savings for both seniors and the federal Medicare program, while manufacturers have warned it will stifle innovation by cutting funds for research.

Even as the drug cost landscape is changing, pharmacists say some patients will continue to confront big expenses.

For a patient taking prescription drugs on a chronic basis, the average annual cost of therapy in 2020 for one widely used drug reached more than $26,000, according to research AARP published in January. The annual cost of therapy would have been more than $14,000 lower in 2020, AARP said, if price changes since 2006 had only kept pace with the rate of general inflation.

Drug companies argued this study paints a misleading picture of drug costs trends by not factoring in how pharmacy benefit managers (PBMs) and other middlemen have been ballooning what patients pay. The Pharmaceutical Research and Manufacturers of America (PhRMA), a trade group, pointed to a different study showing net prices for brand medicines remained flat in 2022 after accounting for rebates and discounts PBMs and insurers collected.

"Policymakers need to address the PBM and insurer abuses that lead to higher