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Beyond 7 minutes

I trained as a Family Doctor so that I would be ready to help patients with any challenge. The old school family doc used to take that skill set out into the community on house calls, sports sidelines, and town hall meetings. At some point the job description was boiled down into a job that started and ended with a 7 minute office visit. That setup is not good for patients, and it's not good for doctors. In this column I hope to start to push the boundary of where the doctor patient interaction takes place - onto the page, into the community, and beyond 7 minutes.

5 tips to get the most out of your prescription medications

Americans spend more on health care than any other nation. Consumers often feel powerless to control the costs associated with health care. Many doctors are not much help, as they are disconnected from the actual costs of the care they provide. An area where I would encourage patients to exercise some “smart shopping” is in buying prescription medications.

Deprescribing is a concept that a doctor can recommend stopping a certain medication, rather than starting new ones. In some cases being on fewer medications will help a person feel better. Especially in elderly populations medication lists can grow to be ten or more medications. It is not uncommon to have a medication prescribed just to combat the side effects from another medication.

An experienced doctor can come up with a plan to whittle down the medication list to only the essential medications, saving patients money and harm from adverse side effects. Sometimes a change in diet or weight loss may be just as effective as medication. Medication lists should be reviewed with your doctor on a periodic basis.

The vast majority of pharmaceuticals on the market have generic equivalents that are just as effective as the brand name. For example, a common blood pressure medication called metoprolol has a cost of $44 per month for brand name and $13 per month for generic. Buying a 90-day supply of the generic would bring the per month cost down to $8 (prices obtained using GoodRx.com).

There are some medications such as infusions used to treat auto-immune diseases, which are only available as brand name meds. Add to this that these infusions require medical supervision while being administered and the cost of these medications quickly adds up. Although a generic alternative is usually not available, patients have choices in where to receive the infusion. In general hospital-based infusion centers charge more than other outpatient sites like urgent cares, which offer comparable medical supervision for a better price.

As always having a good primary care doctor to guide you through this process is essential in making sound decisions.

5 tips to get the most out of your prescription medications:

  1. Make sure you know what your medications are for and why you are on them. The cheapest medication is the one you don’t have to take.

  2. Using insurance is not always the cheapest way to buy a medication. Use the GoodRx app or ask your local pharmacist or primary care doctor about cash pay pricing.

  3. For long term medications, asking for a 90-day supply may be more cost effective.

  4. Infusion centers, such as those at urgent care centers, are often cheaper than hospitals for medication infusions.

  5. In almost all cases generic meds work just as well as brand name.

A version of this article was published in the West End News 7/17/19

Oren Gersten, MD