When TrumpRx launched in February, it joined the chorus of websites claiming to offer deals on prescription drugs.
Despite the publicity, many of the drugs on TrumpRx include brand-name drugs that patients can get cheaper elsewhere — as generics.
For example, there is Protonix for heartburn and gastroesophageal reflux disease. Available for $200 On TrumpRx. But the generic version, called pantoprazole, costs less. $30 with coupon from GoodRxAnother drug discount website. And depending on the health plan, using insurance could mean a $5 or $0 copayment.
So with sites like TrumpRx, GoodRx, Mark Cuban’s Cost Plus Drugs And with a dizzying list of patient assistance, copay cards and even cash options from drug companies, what can you do to make sure you’re getting the best deal on your prescriptions?
Well, there is no shortcut, and it will take a little work to understand.
“I’m not sure all the options make things better,” says ben romeAn intern and drug policy researcher at Brigham and Women’s Hospital in Boston. “In some cases they do, and in some cases they can make things more confusing if you’re a patient or a doctor trying to figure out where you should go to buy your medications.”
“There’s no one-stop shop,” he says.
Start by talking to your doctor and asking about the lowest-cost options. But because insurance plans vary and the rebate landscape is constantly changing, it’s possible that neither of you will know your share of the drug’s cost until you go to the pharmacy counter to pay, Rome says.
Here are some steps you can take to deal with the growing world of drug discounts.
ask about a generic
When your doctor is writing a prescription, it’s not a bad idea to ask if the drug is available as a generic. But don’t worry if you forget. You can also ask your pharmacist about generic medications.
Generic drugs are copies of brand-name versions that are often cheaper than being available at your regular pharmacy. For example, the generic name for the blockbuster cholesterol drug Lipitor is atorvastatin.
According to the generic trade group Association for Accessible Medicines, 90% of prescriptions filled in 2024 were genericBut they accounted for only 12% of all drug spending. Translation: They’re much less expensive.
“Most generics – not 100%, but most generics – are relatively affordable, relatively low cost,” says douglas hoey National Community Pharmacists Association. “Low cost and affordability can vary from person to person, but generally, they will be under $30, $40, and sometimes even less than $10.”
However, not all brands have generic versions. This is because a brand-name drug is allowed to be put on the market only after its patent and other government-provided protection expires. Generic versions of the drugs then go through the Food and Drug Administration approval process and eventually go on pharmacy shelves.
You can find out about a drug’s generic status by asking your pharmacist, asking your doctor, or checking your insurance company’s app to see if they carry a drug. lu zoloA former pharmacist who is now vice president and national pharmacy practice leader at consulting firm Segal. You can also search online – try a pharmacy or chain drugstore website.
What if there is no generic?
There may be some other medicine in the same category. For example, take Eliquis and Xarelto, two brand-name blood thinners that are similar. They are not the same, but sometimes your doctor will be comfortable with you taking one of these. And one may be cheaper than the other depending on your insurance.
“You, the average consumer, I don’t think you would have the information to know if it has a less expensive therapeutic equivalent,” Zollo says, explaining that you can ask your pharmacist about replacements.
And sometimes, the alternative medicine also has a generic. There is no harm in asking this. Again, it’s always good to ask early – because your doctor is writing the prescription. But if you forget, your pharmacist can help.
“Your pharmacist is the medication expert,” says Hoey. “We have at least six years of college education on drugs. So this is your best bet.”
But switching to another drug when you’re at the pharmacy is a little difficult because you’ll need a new prescription, Zollo says: “Now it’s back to the doctor saying, ‘Hey, can I try this instead?’ “
OK, so you definitely need a brand-name drug… now what?
Although there are plenty of ways to go outside your insurance and get a discount, you should check with your doctor and let them know if the price is causing a problem if you haven’t already.
“As a primary care doctor, I want to know if my patient is struggling to afford a medication,” says Rome, adding that patients often mistakenly assume their doctors already know.
Often, they can help you plan. For example, if your insurer requires a doctor-recommended drug, your doctor can appeal the insurance company’s decision or obtain prior authorization.
If it’s not covered or your payment is too high
Now that you’ve exhausted other options, you may want to check out drug manufacturer discounts. You have a few options.
You can start by checking this out drug discovery tool Pharmaceutical Research and Manufacturers of America, a brand-name drug industry trade group. This can pull up a list of brand-name savings options available to you from drug companies.
These include patient assistance programs for those who are uninsured or underinsured, as well as copay cards, which help offset the cost of patient copays at the pharmacy counter. Drug companies sometimes offer discounts for customers who do not use their insurance and pay cash.
But Rome offered a note of caution: “They are at the discretion of the manufacturer and manufacturers can discontinue or change those programs at any time. So just because you have access to a coupon program this year, it does not mean the program will continue next year.”
Depending on the company’s program, you may need to provide paperwork to qualify. And people with Medicare or Medicaid are not eligible for some of them.
What about all these discount sites?
Rome says that before paying cash and opting out of your health insurance, you should check coupons or discount sites to see if they have a lower price. Never pay more than the cash price at a discount site unless you know you’re going to hit your deductible and it will save you money at the end of the year.
These include GoodRx, Cost Plus Drugs, Amazon Pharmacy, Costco, and Walmart. But who has done it according to Rome Studies examining these sitesThere is no easy answer to who will have the best price on any given day. You have to search and compare.
“Prices vary a lot and they can vary over time. And so it’s not obvious where to go first,” Rome says. “Where is the cheapest option for you now for this drug? TrumpRx is in the mix. Will that be the least expensive option? Maybe in some cases, yes. Maybe in other cases, no.”
He acknowledges that it takes time, and encourages patients to keep their doctor informed.
For what it’s worth, Hoey of the National Community Pharmacists Association says your local pharmacist probably prefers Cost Plus Drugs coupons. The price includes an administration fee and Cost Plus Drugs does not take the money back from the pharmacy, so it has to dispense the drug at a loss.
“It’s only gotten more complicated because there are more options and more options,” says zoloConsultant at Segal. “And I’m not sure from a consumer standpoint that more is necessarily better.”
want to share your Experience navigating drug rebates with NPR? Send an email to slupkin@npr.org.
