Finding a Path to Affordable Prescription Medications

The Public Health Council, in partnership with Dartmouth Hitchcock and Alice Peck Day Memorial Hospital are excited to announce the availability of “Finding a Path to Affordable Prescription Medications: A Resource Guide.” This tool will help individuals and their trusted health advocates develop a plan for getting the medications they need at a reasonable cost.

The frontiers of science seem to expanding every day, and now more than ever before, our health care system can offer life changing and life saving medications. However, the cost of prescription medications is also on the rise. This spring, a report from IMS Health found that the list price of drugs increased 12 percent in 2015, which is in line with a 5 year trend of increasing cost. Insurers and pharmacy benefit programs still demand deals from drug manufacturers, which decreases a drugs effective cost. In fact, the net price growth – what insurance companies or employers actually pay, has only risen 2.8 percent. However, the burden of increasing drug costs is felt most by those least able to pay. Uninsured people often are asked to pay the full list price, and even insured individuals are required to pay a significant percentage of the list price. Notably, cost exposure (in the form of co-pays and pharmacy deductibles) for patients with commercial insurance has increase over 25 percent since 2010.

If you or someone you know is struggling to pay for your prescription medications, you are not alone. The PHC heard from community members and providers alike that the financial burdens of prescription medications were impacting the health and well-being of the Upper Valley. Additionally, we heard from healthcare providers and social service organizations that, though there are many potential solutions for someone who has unaffordable medications, sorting out the best options for that individual is a challenge in itself. Certain programs may be especially helpful for one class of medications, but not others. Some are only available in one of the states in our region, and others have specific eligibility requirements.

To address these challenges, the PHC set out to sort through the various resources that can help someone pay for their prescription medications. We compiled information on national, state and regional programs to find the best tools available in the Upper Valley. We also spoke with community health care and social service organizations to learn from their expertise – we asked, what programs were they using, who could access them, how does someone decide what is best for their needs and where are the gaps?

The result is “Finding a Path to Affordable Prescription Medications: A Resource Guide.” This tool is intend for case managers, community health workers, community nurses, clinicians, and others to use in partnership with someone who is having difficulty paying for their medications. It begins with a self-assessment to help the health advocate and the individual determine their needs and their options. Then, it offers resources that include local provider programs, community supports, insurance options, medication assistance programs and pharmacy programs. Finally, it outlines a planning tool for the individual and advocate to use to identify short term and long-term strategies for making medications affordable. You’ll find this guide out in the community soon!