These tips from pharmacy experts can save you money, even if it means bypassing your insurance.

By Kristine Gill
October 08, 2018

Got the sniffles? Avoid compounding your misery by spending more than you need to on prescription drugs that will spare you the worst of those cold and flu symptoms.

One way you might be paying more? Clawbacks. This happens when a patient overpays for a prescription medication through their insurance provider. “If you go to your pharmacy with a prescription to fill for acetaminophen-codeine and you get 30 pills and pay your $10 copay, you walk out thinking that wasn’t too bad,” says Karen Van Nuys, a health economist and assistant professor at the University of Southern California Schaeffer Center. “It turns out that drug only cost your insurance company $4, and so you just paid $4 to the pharmacy and $6 to your insurance company for your drug.”

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Van Nuys and her colleagues conducted a study this year, looking at clawbacks using data from 2013 (the only year when the federal government tracked average retail prices) and found that 23 percent of the time, Americans are overpaying for prescription drugs and giving their insurance providers the extra cash. Take cough syrup for example. In a list of the top 20 drugs most commonly overpaid for, four are prescription cough syrups.

The good news is, Van Nuys says it doesn’t have to be that way. Read on for money-saving tips that apply to prescriptions across the board whether you’re buying flu medicine or your monthly birth control.

Watch for Clawbacks

Clawbacks happen unbeknownst to the consumer and gag clauses prohibit your pharmacist from telling you about the discrepancy. The good news is, many states have laws in place against the gag clauses and federal legislation is in the works to remove them entirely. Some pharmacists may not be allowed to volunteer information about the discrepancy so when filling your prescription, specifically ask whether it’s cheaper to pay with your insurance or out of pocket. “They can also suggest other drugs that might be suitable and less expensive,” Van Nuys adds. Check to see if your medicine is on this list of frequently overpaid prescriptions.

Use Coupons

Through partnerships with insurance companies and pharmacies, GoodRx and RxSaver offer coupons for many of the drugs listed on their sites. Manufacturer coupons are also included in the searches. The coupons are available to the consumer instantly and can either be printed or displayed through the smartphone app. And they help level the playing field when it comes to vast differences in insurance plans and Medicare coverage. Just plug your medication name in the search, and it will show you what it’s going for at pharmacies close to you.

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Switch Pharmacies

If you’ve been going to the Walmart at the top of the street for the past few years simply out of convenience, you might want to switch. “Prices just vary between pharmacies,” says Doug Hirsch, co-CEO of GoodRx, an online price comparison tool for prescription meds. “People assume there’s a sort of set government price list but that does not exist, there’s no benchmark, and because consumers don’t know the prices, pharmacies can charge whatever they want.” In other words, it pays to look elsewhere.