1 in 5 older adults struggle to afford their medications; here’s what you can do and how Regence can help

About one in five adults over age 65 either skipped, delayed, took less medication than was prescribed, or took someone else’s medication last year because of concerns about cost, according to a study recently published in JAMA Network Open. More than 8% of study respondents reported having to go without basic needs like food and gasoline to afford their medications, and 4.8% said they went into debt to get their medication.

The study results show a notable increase from the results of a similar study conducted in 2016 that found one in seven older adults weren’t taking their medication as prescribed because of cost. Study authors attribute the increase to inflation and increasingly high prescription drug costs.

Another study recently released by the Centers for Disease Control and Prevention (CDC) found 8.2% of adults ages 18 to 64 who took prescription drugs in 2021 reported not taking medications as prescribed because of cost. These people used strategies like skipping doses, taking less than the prescribed dose or delaying filling a prescription — all of which may make health conditions worse, lead to more serious illness and require additional expensive treatment.

What’s Regence doing to help control members’ medication costs?

• Regence has been working for years to help members switch from expensive brand name specialty drugs to less expensive generic alternatives called biosimilars. We’ve been able to convert 95% of the therapies that have an available biosimilar, saving more than $37 million annually. We’re continuing this important work as new biosimilars become available.
• We partner with many pharmacies to negotiate preferred rates for our members.
• We’re continually evaluating low-cost generic drugs to make sure they’re included in the lowest tier of our formularies, so members pay less for them.
• Most Regence plans include medication support. Our team of experts work with members to review medications and identify opportunities to save. Learn more about the program and see if you’re eligible.
• We also offer a solution for Medicare members, RxPartners, that helps reduce the cost of prescriptions not covered by Medicare.
• We’re launching a new initiative in 2024 designed to prevent provider upcharges for specialty medications.

What can you do to save on prescriptions?

• Talk to your provider and let them know you’re looking for ways to save. Your provider can review your medications to see if there are any you can stop taking, any that can switch to a generic option, or any combination drugs — drug that can treat more than one health condition — that might work for you.
• You could also ask your provider for a prescription for a 90-day supply of your ongoing medications. A 90-day supply often costs less and is more convenient. If you’re on Medicare, you may be eligible to get a 100-day supply for the price of a 90-day supply.
• Shop around to find the best pharmacy. Be sure you’re using an in-network or preferred pharmacy. Even among pharmacies in your network, the price of a medication can vary, so you might want to shop around to find the best deals. Regence members can sign in and use our Find a Pharmacy tool to search in your network and see how much a medication will cost at various pharmacies. Medicare members should look for the yellow Preferred Pharmacy indicator for the best savings opportunity. You could also consider a home delivery pharmacy, which is more convenient and can sometimes save you money.
• Get help from assistance programs. If you can’t afford to pay for your medications, you can look into assistance programs sponsored by drug companies, nonprofit organizations and the government. For example, you may be able to apply for the Extra Help program through the Social Security Administration (SSA) at www.ssa.gov. These programs often have limits on income and other requirements, so make sure to do your research.

We’re here to help

You can learn more about your prescription drug coverage and get help finding ways to save money on your medications by signing in to your account at regence.com. Once signed in, you can review your health plan benefits, explore covered drug options, as well as live chat or message our Regence Customer Service team. You can also call us using the phone number on your member ID card.