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Experts develop guide on online tools to reduce costs of urologic drugs

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Article

"At a time when patients are increasingly concerned about prescription drugs, this information will provide a useful starting point for making essential medications as affordable as possible," says Ruchika Talwar, MD.

A group of experts have developed a practical guide for urologists outlining resources that they can share with patients to help lower out-of-pocket costs associated with prescription medications for urologic conditions.1

Overall, the authors noted that each option offers tradeoffs in the features and savings for each tool, and the best option will depend on each patient’s individual situation.

Overall, the authors noted that each option offers tradeoffs in the features and savings for each tool, and the best option will depend on each patient’s individual situation.

"As clinicians, we find that many patients need help in understanding that prescriptions can often be purchased outside of insurance for significantly lower cost and in navigating the complex options for purchasing prescription drugs," explained senior author Ruchika Talwar, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, in a news release on the findings.2 "Urologists are not trained on how to counsel patients on this important aspect of care. Our analysis provides practical information on online tools to lower prescription costs, including finding the best option for each patient's situation."

The investigators identified 4 online tools to help find more affordable medication options for different patient scenarios, which included the Medicare Part D Plan Finder, GoodRx, the Mark Cuban Cost Plus Drug Company (MCCPDC), and Amazon Pharmacy.

The first option that the authors highlighted was the Medicare Part D Plan Finder, which can be used by patients who are insured by Medicare to compare out-of-pocket costs between insurance plans. This tool provides an estimated total annual out-of-pocket cost for patients based on their zip code and list of prescription medications. These costs include premiums, deductibles, copays, coinsurance, and catastrophic coverage, if necessary. The tool can also identify if certain medications are out of network for a specific plan.

The authors note that patients who wish to use the Medicare Part D Plan Finder should be aware that the cost-sharing requirements vary between Medicare Part D plans and should be compared yearly during the Open Enrollment period, which extends from October 15 to December 7 each year.

Second, the investigators recommend that patients who urgently need to refill a prescription at a local pharmacy use GoodRx, which is a free online service that allows patients to compare out-of-pocket costs for medications between local pharmacies. A recent study showed that GoodRx drug prices for common medications were less costly than those offered by insurance up to 40% of the time.3

The authors also recommended that patients use the MCCPDC or Amazon RxPass to compare prices for recurrent prescriptions for chronic conditions or expensive medications that are now generically available, such as abiraterone or vaginal estrogen inserts.

Specifically, the MCCPDC can be used for patients with chronic conditions who are prescribed recurrent general prescriptions. The pharmacy operates by pricing medications at 15% markup from their cost to purchase, plus a pharmacy fee and shipping fee of $5 or less each. A recent study published in the Journal of Urology indicated that the MCCPDC may reduce costs for commonly prescribed urologic medications, especially for those on 90-tablet prescriptions.4

Lastly, they recommended Amazon Pharmacy for those patients who are prescribed 3 or more chronic medications. As of their partnership in 2018, Amazon now directs patients with multiple chronic medications to PillPack, which offers personalized packets labeled with dates and times, which may help patients stay organized between their difference medications.

Further, although Amazon Pharmacy is free to use, anyone who purchases a Prime membership can get access to Amazon RxPass for an additional $5 per month, which can offer more significant cost savings. According to the authors, this may be most impactful for patients who take medications such as finasteride, oxybutynin extended-release, sildenafil, and tamsulosin. However, RxPass is not yet available for those who receive Medicare or Medicaid, and is currently unavailable in certain states, including California, Pennsylvania, and Texas.

Overall, the authors noted that each option offers tradeoffs in the features and savings for each tool, and the best option will depend on each patient’s individual situation.

Talwar concluded in the news release,2 "At a time when patients are increasingly concerned about prescription drugs, this information will provide a useful starting point for making essential medications as affordable as possible.”

References

1. Pockros B, Cortese BD, Michel K, Ellis TA, Talwar R. Online tools to decrease out-of-pocket prescription costs for patients: A practical guide for urologists. Urol Pract. 2024;11(3):454-460. doi:10.1097/UPJ.0000000000000544

2. Online tools can help to lower costs for urologic medications. News release. Wolters Kluwer Health: Lippincott. Published online and accessed April 22, 2024. https://www.newswise.com/articles/online-tools-can-help-to-lower-costs-for-urologic-medications

3. Patel PM, Len J, Shah S, Vaidya V. Cross-sectional analysis of out-of-pocket payments for commonly prescribed generic medications versus discount card pricing. Ann Intern Med. 2023;176(9):1282-1285. doi:10.7326/M23-0644

4. Schloegel V, Harris L, Harris A, Dropkin B. Evaluation of potential urologic prescription drug savings with Mark Cuban Cost Plus Drug Company. Urol Pract. 2024;11(2):276-282. doi:10.1097/UPJ.0000000000000510

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