Prescription Drug Pricing Is Totally Broken

 

Some new applications like GoodRx can help the patients to compare prices of drugs from various pharmacies and programs in different locations before committing to buying them, and this way they can get up to 75% off on the market price of the medication they need.

Solutions to the pricing problem that is affecting generic drugs-drugs that are supposed to be a safe and cheap alternative for the masses-are direly needed. More than 50% of Americans are struggling with a chronic illness, and the majority of them cannot afford the exorbitant prices of drugs. It is not only essential, it is necessary that healthcare reforms target this area of drug pricing so that drugs can be accessible to the average American who needs them. The high cost of drugs in America is a problem that needs swift and decisive solutions now, rather than later.

https://www.buzzfeed.com/maximmaider/prescription-drug-pricing-is-totally-broken-even-3be9o

Appeals if you have Medicare prescription drug coverage

You have the right to do all of these (even before you buy a certain drug):

• Talk to your prescriber - your doctor or other health care provider who's legally allowed to write prescriptions. You can ask:
  • Whether the plan has special coverage rules
  • Whether there are generic, over-the-counter, or less expensive brand-name drugs that could work as well as the ones you're taking now.
• Get a written explanation (called a coverage determination) from your Medicare drug plan. A coverage determination is the first decision made by your Medicare drug plan (not the pharmacy) about your benefits, including these:
  • Whether a certain drug is covered
  • Whether you have met the requirements to get a requested drug
  • How much you pay for a drug
  • Whether to make an exception to a plan rule when you request it
• Ask for an exception if:
  • You or your prescriber believes you need a drug that isn't on your plan's formulary.
  • You or your prescriber believes that a coverage rule (like prior authorization) should be waived.
  • You think you should pay less for a higher tier (more expensive) drug because you or your prescriber believes you can't take any of the lower tier (less expensive) drugs for the same condition.
   

https://www.medicare.gov/claims-and-appeals/file-an-appeal/prescription-plan/prescription-drug-coverage-appeals.html