How to Lower Your Prescription Drug Costs: 10 Strategies That Work With or Without Insurance

Prescription drug costs are the fastest-growing component of healthcare spending, and they hit patients directly at the pharmacy counter. Even with insurance, copays for brand-name drugs can be $50-$100+ per fill, and specialty drugs can cost hundreds. Here are 10 proven strategies to lower your costs.

1. Always Ask for the Generic

Generic drugs contain the same active ingredients as brand-name drugs at 30-80% lower cost. When your doctor prescribes a medication, ask "Is there a generic available?" In many cases, the answer is yes. The average generic copay is $10-$15, while the brand-name equivalent is $40-$60. Over a year of monthly fills, that's a $300-$540 difference per medication.

2. Use GoodRx or Similar Discount Cards

GoodRx, RxSaver, and similar apps show the cash price for your medication at every nearby pharmacy, plus available discount coupons. In many cases, the GoodRx discount price is lower than your insurance copay - especially for generic drugs. There's no cost to use these apps. Simply show the coupon at the pharmacy. This works whether or not you have insurance.

3. Compare Prices Between Pharmacies

Drug prices vary dramatically between pharmacies - even in the same neighborhood. A 90-day supply of a common generic can cost $4 at Costco and $45 at a nearby chain pharmacy. Warehouse clubs (Costco, Sam's Club) and independent pharmacies often have the lowest prices. You don't need a Costco membership to use their pharmacy.

4. Request 90-Day Supplies

Most insurance plans offer a discount for 90-day fills compared to three separate 30-day fills. A medication with a $20/month copay might cost $50 for a 90-day supply - saving $10 every three months ($40/year per medication). Ask your doctor to write prescriptions for 90-day supplies, and check if your plan offers a mail-order pharmacy with even lower 90-day pricing.

5. Use Your Plan's Preferred Pharmacy

Many insurance plans have "preferred" pharmacy networks where copays are lower. CVS might charge a $30 copay for a drug that's $15 at Walgreens under the same plan, or vice versa. Check your plan's pharmacy directory for preferred pharmacies in your area.

6. Ask About Patient Assistance Programs

Most pharmaceutical manufacturers offer patient assistance programs (PAPs) that provide free or discounted medications to qualifying patients. Eligibility is usually based on income and insurance status. NeedyMeds.org and RxAssist.org maintain databases of available programs. For expensive brand-name drugs, manufacturer copay cards can reduce out-of-pocket costs to $0-$10 per fill even with insurance.

7. Request a Formulary Exception

If your medication is on a high copay tier or not on the formulary at all, you can request a formulary exception. Your doctor submits documentation explaining why the specific drug is medically necessary and why lower-tier alternatives aren't appropriate. If approved, the drug moves to a lower copay tier. Success rates vary, but it's always worth trying for expensive medications.

8. Split Higher-Dose Pills

Many medications cost the same regardless of dose - a 40mg tablet costs the same as a 20mg tablet. If your doctor prescribes a 20mg dose, ask if you can get 40mg tablets and split them with a pill splitter ($3-$5 at any pharmacy). This effectively halves your medication cost. Note: not all medications can be safely split (extended-release, coated, or capsule forms should not be split). Always confirm with your pharmacist.

9. Explore Mark Cuban's Cost Plus Drugs

Cost Plus Drugs (costplusdrugs.com) sells generic medications at cost plus a flat 15% markup plus a $5 pharmacist fee plus $5 shipping. For many generics, this is dramatically cheaper than insurance copays or retail pharmacy prices. A drug that costs $60/month at a chain pharmacy might cost $8/month through Cost Plus Drugs. The site is transparent about pricing - you can check costs before committing.

10. Review Your Drug Coverage Annually

Plan formularies change every year. A drug covered at Tier 2 this year might move to Tier 3 next year, doubling your copay. During Open Enrollment, check that your current medications are still covered at the same tier on your plan. If not, compare other plans' formularies - a different plan might cover your specific drugs at a lower tier, saving more than any premium difference costs.