Medication cost savings: More than just Rx

Big savings on meds: More than just prescriptions

During a private medication counseling consultation, our other clinical pharmacists and I are often asked how we can suggest changes to a patient’s drug regimen to save money. After all, the older and/or a patient gets, the more things he or she takes to stay in the best-possible health.

A few months ago, I wrote a related blog titled “Are the High Costs of Your Prescription Medications Getting You Down?” that’s worth another look. Since the CDC estimates that 8% of U.S. adults don’t take their prescriptions as ordered — doubling to 14% for those uninsured — it’s an important topic. No one should have to choose between their meds and food, heat, rent or other basic necessities.

Unfortunately, too many still feel forced to choose between their meds and life’s other essentials…and sometimes don’t really have that choice in order to live, let alone live well.

I recently consulted with a patient who was taking over 20 meds. She had admitted to her doctor that she couldn’t manage all of them. She asked if she could take fewer prescriptions. He looked straight in her eye and said, “This is what’s keeping you alive.”

OK, if that’s true, it’s true. Here’s the kicker though — the patient thought that her doctor’s statement applied to all of her over-the-counter supplements as well. She didn’t understand how to “rank” her pills by importance, so they didn’t have that important part of the discussion.

If you take many OTCs — and depending on what you take — they can be very expensive. Vitamins, herbals, probiotics and other supplements can add up quickly. In fact, if a patient has good insurance, supplements can cost more than out-of-pocket costs for covered prescriptions.

The above blog offers what my years as a clinical pharmacist have taught me are good (and often unknown) strategies for ensuring you’re getting the best value from your medication regimen. For instance, you can choose to only use your insurance plan’s preferred pharmacies. You can check out any free meds on the pharmacy’s list (yes, there are some!), ask if they have a savings club, researching the price at different pharmacies often affected by insurance contracts, check the GoodRx or cash price versus your insurance co-pay (you can choose which one to use, on a prescription-by-prescription basis), change from a 30-day supply to 90 days, and more. But here let’s talk OTCs.

Higher cost doesn’t = better quality

Studies have shown that people equate cost to quality/benefit. For example, they think taking a $45 name-brand COQ10 or AREDS 2 supplement offers more value than a lesser-known brand or generic with the similar ingredients and strength.

Here’s a few examples. An aging population that’s typically spent much of its adult life staring at computer and phone screens today see eye-health supplements as a valued supplement to lessen eye strain and slow the progression of possible macular degeneration. Bausch+Lomb’s PreserVision AREDS 2 formula is highly rated, but as of this writing can range from $22 to more than $65 for 120 capsules, depending on source. That’s typically a two-month supply. Another brand is only $14 with the exact same ingredients and strength. (All prices from as merely one source for comparison.)

Two months of Prevagen (apoaequorin) extra strength, touted to improve memory, costs $120. In addition, some have questioned — including through lawsuits — the company’s advertised proof that it enhances people’s memory and cognitive function. There are many other “brain-supplement” choices to consider that are far less expensive, which may or may not help.

As the U.S. population ages, this is a fast-growing field. Newsweek has noted that “often-desperate pursuit of remedies has created a lucrative marketing opportunity, and the supplement industry is cashing in. Products aimed at consumers worried about brain health and memory have contributed to a more than 10-fold increase in the number of supplements marketed in the U.S. over the last two decades.”

There are also many other supplements many patients take together, ranging from CoQ10 (aka coenzyme Q,  ubiquinone or ubidecarenone) to Culturelle (probiotics for digestive health), multi-vitamins and more. Add all of these up and you could easily be spending $100 a monthly or more or your supplements alone…especially if you haven’t researched less-expensive brands and generics with the same active ingredients. And above all, ensure you’ve talked with your clinical pharmacist and your doctor about adverse reactions of any OTCs, the validity of research behind their benefits claims, and potential reactions with each other and your prescriptions, diet and lifestyle.

And remember to read directions and advertising claims carefully. As with patent medicines and the fast-talking salesmen of the 18th, 19th and early 20th centuries, if claims sound too broad or “too good to be true”…well, they probably are. Remember your grandparents talking about a potion that promised to cure or prevent nearly every ailment known to man — venereal diseases, tuberculosis, colic in infants, indigestion or dyspepsia, and even cancer. Most patent medicines had more alcohol and/or opium in them than anything. That’s much less true today, but remember these types of examples when you’re watching late-night infomercials or reading an online ad. Again, talk to your pharmacist or doctor!

Taking the time to focus on your meds

I’m not saying you shouldn’t consider taking some supplements. Many can provide significant value, if evaluated along with your prescriptions. But having these conversations with your healthcare professionals takes time…which busy physicians and retail pharmacists have in short supply. And frankly, because the cost of supplements can vary dramatically, I’m not sure most doctors have a good sense of how much a combination of OTC supplements can cost these days.

These are all reasons why we formed RxLive. It’s our job — and our passion — to take the time to put all of the pieces together. We help our patients find unnecessary meds and supplements, consider less-costly alternatives and provide other recommendations that can save their pocketbook, their hassles and, possibly, even their lives.

The good and bad news today is that there are so many choices and — like the bygone era of traveling snake-oil salesmen — lots of claims regarding the benefits of various supplements. As we say at RxLive, “it’s good to check your meds.” And that includes your supplement regimen. We’re here to help make that a no-brainer.


To learn more about RxLive pharmacogenomic testing and medication counseling services, contact our team at at

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Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.