When patients indicate they cannot afford the medications you have prescribed for them, do you know what options are available to explore? Often prescribers may be quick to ask about compassionate programs or free supplies that are available to explore, but they are rarely the solution to a permanent problem.

One simple thing to do is to modify how the prescription is written. Below is an example of how changing the way the prescription is written can impact on total cost for the patient.

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Here are five simple things to consider for your patients who may have challenges affording their medications:

  1. Consider cheaper generic alternatives
  2. Consider writing a prescription for a larger quantity
  3. Consider shopping for lower dispensing fees
  4. Consider writing a higher strength (for some medications) if different strength costs the same price and the tablet can be halved for administration (e.g. citalopram)
  5. Consider deprescribing if not indicated or necessary anymore

Recently, the drug prices of many generic medications in Ontario have been reduced. Here’s a document listing all the new prices.

If your patient is struggling financially and you would like to prescribe the cheapest option, here’s my quick list for some common medication categories:

  • ACE-Inhibitor: Ramipril
  • Angiotension II Receptor Blocker: Telmisartan or Candesartan
  • Statin: Rosuvastatin
  • Beta Blocker: Bisoprolol
  • Proton Pump Inhibitor: Rabeprazole
  • Diabetes: Metformin, Gliclazide MR, NPH (insulin)
  • Bisphosphonate: Alendronate 70mg
  • SSRI (Selective Serotonin Reuptake Inhibitor): Citalopram
  • LAMA (Long Acting Muscarinic Antagonist): all very similar but Spiriva Respimat utilizes the most advanced technology for optimal drug delivery
  • ICS (Inhaled Corticosteroid): QVAR, Pulmicort

If the patient requires assistance with their medication costs, here are some options to consider based on age:

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I hope you find this post helpful. Do you have other suggestions to help patients who are struggling with medication costs?

 

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