The GoodRx Prescription Savings Blog

The latest updates on prescription drugs and ways to save from the GoodRx medical team

Eliquis Generic Alternative Coming in 2018?

by Tori Marsh on November 17, 2017 at 11:31 am

Eliquis is a common anticoagulant medication that helps prevent blood clots, stroke, and pulmonary embolism. Common, but not cheap: cash prices average around $488 for a 30-day supply. Currently, there is no Eliquis generic alternative available, but one could be available as early as 2018. Since Eliquis tends to be a maintenance drug, taken for a longer period of time, it can break the bank.  

If your doctor thinks Eliquis is right for you, how can you make it more affordable? Here’s some information on Eliquis and how you can save.

How popular is Eliquis?

Eliquis (apixaban) is the second most popular anticoagulant, a class of medications that also includes Coumadin (jantoven, warfarin), Xarelto, and Pradaxa. Commonly referred to as blood thinners, drugs in this class help to prevent blood clots that can cause deep vein thrombosis, pulmonary embolism, angina, stroke and heart attack.

When will generic Eliquis be available?

There are two things keeping generic Eliquis off the market for now. First, the FDA has granted Eliquis market exclusivity, which expires on December 24, 2017 (Market exclusivity prevents competitors from submitting new drug applications). There is also a patent on Eliquis which expires in February 2023. The patent prevents competitors from manufacturing and distributing alternatives.

This double-barreled protection means that we can’t be sure when generic Eliquis will be available. A generic alternative could be approved by the FDA as early as 2018, but the new generic might not hit pharmacies until 2022.

Another caveat: While generic manufacturers like Mylan are currently developing generic versions of Eliquis, multiple lawsuits from brand manufacturer Bristol-Myers Squibb are preventing these cheaper alternatives from making it to the market. With no end in sight for these lawsuits, it’s hard to say when we could see a generic alternative.

We will be sure to update with any information regarding a cheaper alternative for Eliquis.

Are there any cheaper alternative medications?

  • Coumadin (warfarin, jantoven). Coumadin is a popular coagulant that has two affordable generic alternatives, warfarin and jantoven, that can cost less than $10, and often as little as $4. $4 a month vs $488 a month? What’s the downside? Well, Coumadin can raise your risk of bleeding and bruising and requires regular blood work to ensure its effectiveness.
  • Other anticoagulants. Pradaxa or Xarelto are both still only available in brand form – so no cheaper generic versions. Still, these alternatives may be cheaper, especially considering your prescription insurance coverage.
  • For more information on how Eliquis compares to other anticoagulants, check out Iodine’s page on Eliquis alternatives. As always, you’ll want to speak with your doctor if you think another medication might work better for you.

Eliquis works best for me—can I still save?

Once you find a medication that works for you, it can be difficult to switch. But don’t worry, there are still other ways to save.

  • Fill a 90-day supply. This can help shave a little more off of your out-of-pocket costs. Be aware that you will need a new prescription from your doctor, and approval from your insurance to fill for a higher quantity. Check in with your doctor, insurance, and/or pharmacist.
  • Use an Eliquis coupon from GoodRx. GoodRx offers discounts for Eliquis online which can usually save at least 15% off the full retail price.
  • Save with a manufacturer coupon or the Eliquis patient assistance program. Eliquis’s two manufacturers, Pfizer and Bristol-Myers Squibb offer multiple ways to save. Manufacturer coupons can reduce your co-pay to as little as $10 per fill, while patient assistance programs can help you receive your medication at no cost. For more information on these programs, eligibility, and how to apply, be sure to read through our Eliquis Savings Tips or visit the Pfizer website.  
  • Split a higher dosage pill. This can help reduce costs, especially if two strengths are priced similarly. You’ll want to check in with your doctor to see if this is a safe option for you.

Try to appeal your coverage. If you have insurance and your plan doesn’t cover Eliquis, ask your doctor about submitting an appeal. Some plans require prior authorizations—meaning you need permission from your insurance plan and a special request from your doctor before you can fill your prescription. If you have insurance, call your provider and ask how to get this process started.


10 Most Common Drug Combinations

by Tori Marsh on November 7, 2017 at 3:26 pm

Did you know that nearly 7 in 10 Americans take a prescription drug, and about 50% of Americans take at least two? In many cases, taking more than one drug is necessary to cure an ailment, treat symptoms, or control a chronic disease. But in others, multiple drugs may not mix well in your body, and in your pocketbook.

We’ve compiled a list of drugs commonly taken together. We’ll tell you more about why these drugs are taken together, and which ones work. But are all of these combinations safe?

Top 10 Two Drug Combinations
Rank Drugs What is it for?
1 lisinopril
atorvastatin
Heart disease
2 lisinopril
metformin
Heart disease & diabetes
3 amlodipine
lisinopril
Heart disease
4 alprazolam
amphetamine salt combo
ADHD & anxiety
5 amphetamine salt combo
amphetamine salt combo xr
ADHD
6 hydrocodone/acetaminophen
alprazolam
Pain & anxiety
7 amlodipine
atorvastatin
Heart disease
8 lisinopril
hydrochlorothiazide
Heart disease
9 atorvastatin
clopidogrel
Heart disease
10 atorvastatin
metformin
Heart disease & diabetes

 

Top 10 Three Drug Combinations
Rank Drugs What is it for?
1   metformin
lisinopril
atorvastatin
Heart disease & diabetes
2 clopidogrel
atorvastatin
lisinopril
Heart disease
3 glipizide
metformin
lisinopril
Heart disease & diabetes
4 atorvastatin
amlodipine
lisinopril
Heart disease
5 amlodipine
hydrochlorothiazide
lisinopril
Heart disease
6 carvedilol
atorvastatin
lisinopril
Heart disease
7 atorvastatin
metoprolol
lisinopril
Heart disease
8 clopidogrel
metoprolol
atorvastatin
Heart disease
9 lisinopril
carvedilol
furosemide
Heart disease
10 amlodipine
metformin
lisinopril
Heart disease and diabetes


What’s going on in this table?

We compiled a representative sample of nationwide U.S. prescription drug claims to see common drug combinations. Here are some patterns we found interesting.

  • Heart disease medications dominate the list. In many cases, certain heart medications may be taken together to increase effectiveness, or treat different symptoms. Most people with a heart condition will likely take any combination of an ace inhibitor (lisinopril), a beta blocker (metoprolol) a diuretic (furosemide) or a statin (atorvastatin). Heart disease is currently the leading cause of death for men and women in the US, so it makes sense that these medications overtake the list.
  • Heart medications and diabetes medications are a common combination. Over time, high blood sugar from diabetes can damage the blood vessels and heart, increasing your chances for heart disease. In many cases, people with diabetes will be prescribed metformin along with a heart medication like lisinopril or atorvastatin to reduce the risk for heart complications.

Dangerous combinations.

It’s hard to imagine that people would be prescribed drugs that have dangerous interactions. Unfortunately, it’s more common than you think. Most dangerous combinations happen when two different doctors prescribe two different medications and are unaware of the other prescription. In order to avoid taking drugs that may interact, make sure you discuss any medication you are on with every doctor you see.  

  • Alprazolamamphetamine salt combo. This is a common combination as alprazolam, a common anxiety medication, can help combat the restlessness and insomnia that people typically feel after taking an amphetamine. While the combination isn’t necessarily dangerous, alprazolam should not be taken on a regular basis. One way to combat the restlessness and insomnia? Try taking a long-acting stimulant, like amphetamine salt combo XR, instead. Longer-acting amphetamines tend to have more constant delivery and can have negative side effects.
  • Lisinopril & metformin. Most people with diabetes are treated with metformin, and an ace inhibitor, like lisinopril. In most cases, there are few interactions between the two. However, lisinopril can increase the effects of metformin, and cause blood sugar to dip too low. If you are taking both of these medications and consistently experience signs of low blood sugar, be sure to speak with your doctorthis combo could be the culprit.  

What’s the good news?

Although some drug combinations can be dangerous, there are some combinations that work very well together, with few side effects or interactions.

  • Atorvastatin & lisinopril. The American Association of Clinical Endocrinologists and American Diabetes Association recommend that all diabetics with a blood pressure greater than 140/90 be on a statin (atorvastatin, simvastatin, rosuvastatin, etc) and an ace inhibitor (lisinopril, benazepril, etc).
  • Amphetamine salt combo & amphetamine salt combo XR. It might seem odd that people fill for both the short (amphetamine salt combo) and long (amphetamine salt combo XR) version. However, it’s quite common. Most people who fill for this combination use the short-acting amphetamine like a booster—taken only if they feel the long-acting amphetamine is wearing off. If taken responsibly, there are no interactions between the two.
  • Most heart medications. There are many types of heart medications on this listace inhibitors, statins, diuretics, and beta blockers—all treating some component or symptom of heart disease. But do they work well together, and can you take them long term? If taken appropriately, yes.  

Are there ways to save?

Believe it or not, in some cases, you can save by taking fewer drugs, or switching to a less expensive alternative. These common combinations have less expensive alternatives you might want to discuss with your doctor.  

  • Lisinopril & hydrochlorothiazide. This combination is good for high blood pressure/hypertension, and are both first-line therapies. However, there they come in a combination pill–Zestoretic (lisinopril/hctz)–that is more affordable, and more convenient, than taking two separate medications.
  • Amlodipine & lisinopril. Both of these medications tend to work well together to control blood pressure. However, if you currently take these together, you have another option that can help save you time and money! Lotrel (amlodipine/benazepril) is a combination calcium channel blocker/ace inhibitor that works just like amlodipine and lisinopril, in just one pill!

Information on drug interactions and savings tips come from Dr. Sharon Orrange, MD MPH, a contributor on the GoodRx Medical Team. Data comes from several sources, including pharmacy data and insurer data, and provides a representative sample of nationwide US prescription drug claims.


Everything You Need to Know About 2018 ACA Open Enrollment

by Tori Marsh on November 1, 2017 at 8:28 am

The sign-up period for the Affordable Care Act (ACA, also known as Obamacare) is upon us, and enrolling is going to be a little more challenging than years past. The enrollment period is now only six weeks – until Dec. 15 – and the Healthcare.gov website will periodically go dark throughout this span. What’s more, there’s less funding this year for ACA advertisements and enrollment counselors.

While these changes could make it more difficult for you to sign up, we’re here to help you save. Here are some helpful tips on enrollment, and information on how GoodRx can help cut your costs.

When do I sign up?

This year, the enrollment window is shorter than evercut in half from last year. For states that use the federal marketplace, 2017 enrollment runs from November 1st to December 15th.

But: states that have their own marketplace can set their own enrollment dates. So if you live in California, Colorado, Connecticut, District of Columbia, Idaho, Hawaii, Kentucky, Maryland, Massachusetts, Minnesota, New Mexico, Nevada, New York, Oregon, Rhode Island, Vermont, or Washington, check your state’s marketplace to confirm your exact enrollment dates and sign-up.

Also, know that the Healthcare.gov website will be offline the night of Wednesday, Nov 1, and then every Sunday, except for December 10th, from midnight to noon eastern standard time.

What does this mean for you? With a shorter enrollment period and more blackout dates, it’s more important than ever to enroll early!

What is special enrollment?

The ACA has a program that allows individuals who have undergone a significant life event to enroll in coverage outside of the open enrollment window.

You may qualify for special enrollment if anyone in your household has: married, had a baby, been released from jail, divorced, or died in the past 60 days. If you have experienced any of these events, you will have a 60-day window to enroll in Obamacare, no matter when it happened. Read more to find out if you qualify here.

What’s changing in 2018?

  • Premiums are going up. It’s estimated that premiums could rise by 35% this year. Why? Most attribute this to the administration’s threat to cancel the cost-sharing reduction reimbursements. These payments to insurance companies give them incentives to lower deductibles, copayments, and coinsurance. You can read more about this decision here. Unfortunately, those who are not eligible for subsidies will be hit the hardest by the rising premiums this year.
  • Average subsidies are increasing. Good news, for some. The Department of Health and Human Services reported that the average subsidy in 2018 will increase by 45%. This means that net premiums could be lower for manybut only for those who qualify. In all states, people with gross incomes between 138% and 400% of the federal poverty level may qualify for premiums. To see if you qualify, read here.
  • Deductibles are rising. A deductible is the amount of money you pay for health services out-of-pocket before your insurance kicks in. Unfortunately, these rates are on the rise, too.
  • Fewer low-cost plans available. Last year, 17% of enrollees had access to a plan that cost under $200 per month. This year, only 6% of enrollees will be able to find a plan under $200.
  • Fewer issuer and plan options. There are 132 available insurance providers, or issuers, available this yeardown from 167 last year. Additionally, people in 8 states, or 29% of enrollees, will have only one issuer to choose from. Last year, only 2% of enrollees were limited to one plan.
  • Premiums for silver plans are increasing—37% on average according to The Department of Health and Human Services. Additionally, average costs for silver plans will go up by 49% in Florida and 65% In Wyoming. Silver plans are often the most popular, as they tend to have the best options for coverage and cost. However, with such a large increase in silver premiums other metal plans (bronze, gold and platinum) could be a more viable option.

Tips for enrollees

  • Watch out for auto-enrollment. If you were enrolled in a plan last year, be sure to log in and re-enroll before December 15th. If you don’t, you will be automatically re-enrolled in your current plan. This might not sound bad, but with premiums rising and coverage changing, your current plan might not be the best option for you. Compare, compare, compare.
  • Don’t count on enrollment events or navigators. Navigators and enrollment events educate people on ACA enrollment and help them find the best plan for their family. Unfortunately, funding for these enrollment services has been cut by 92%. These programs have helped many people understand their options in the past, especially non-english speaking families. While it may still be possible to find an event or a navigator, they’ll be hard to find this year. Start early!

How can GoodRx help?

Just because a drug is covered by your insurance, doesn’t mean your plan will make it affordable. But we have some good news, you can use a GoodRx discount instead of your prescription. On average, GoodRx coupon prices beat insurance co-pays 70% of the time in 2017. GoodRx coupons can be especially important if you have a plan with high deductibles or a strict formulary. If you don’t already know your co-pay for your prescription, try calling your insurance or using their web portal to estimate your cost.

When using GoodRx instead of your insurance, the amount you pay will not count towards your deductible. However, you can always contact your insurance company to see if they can apply your purchase to your deductible. Some plans will allow you to submit receipts for potential reimbursement or credit towards your deductible.

Need more than a coupon? GoodRx can also help you find savings tips, suggestions for alternative less-expensive drugs, and information on assistance programs and manufacturer savings.


Everything You Need To Know About Medicare 2018

by Tori Marsh on October 25, 2017 at 1:05 pm

We are in the thick of Medicare open enrollment, meaning that seniors 65 and over now have the chance to enroll in—or switch to—a new healthcare plan that could save hundreds or even thousands of dollars in out-of-pocket costs.

Yet surprisingly, only 1 in 10 seniors voluntarily switch their plan each year, with most members staying put, even if their premiums have increased or their medications are dropped from their formulary. This can leave older patients on the hook for hefty out-of-pocket costs. Needless to say, enrollment can be a confusing process, but GoodRx is here to help.

When is open enrollment?

Medicare plans offer open enrollment from October 15th to December 7th. Keep in mind that this is different from the Affordable Care Act (ACA/Obamacare) open enrollment that lasts from November 1st to December 15th. (More to come on ACA enrollment soon.)

There is one exception. In 2017, seniors who live in hurricane-affected areas have until the end of December to enroll. This includes seniors in Alabama, Florida, Georgia, Mississippi, Louisiana, Texas, South Carolina, Texas, Puerto Rico, and the U.S. Virgin Islands. For more information, read here, or call 1-800-633-4227.

What’s changing in 2018?

  • Most plans will have a preferred pharmacy network99% to be exact, up from 85% last year and 7% in 2011. This means that your plan will offer greater savings on medications at certain pharmacies. In most cases, you will still have the option to go elsewhere, but you’ll pay more.
  • Medicare Part D premiums are rising. According to The Kaiser Family Foundation, prices on standalone Part D drug plans have risen 9% from last year, with monthly premiums now averaging around $43.48. While 9% may not seem like much, keep in mind that premiums have risen a whopping 68% from 2006.
  • But Medicare Advantage premiums are going down. Average monthly Medicare Advantage premiums will be around $30, down $2 from last year. Also, this year, most Medicare Advantage plans include drug coverage. Unfortunately, this drug coverage can be limited – with fewer drugs covered than in standard Medicare – so make sure you read the fine print before you commit!
  • Good news for the donut hole. The coverage gap between the initial coverage limit and the out-of-pocket maximum is commonly known as the “donut hole.” During this coverage gap, you are responsible for a percentage of your drug costs. The good news? This percentage has been slowly declining. For brand name drugs you’ll pay 35% of a prescription price (down from 40% in 2017), and for generics, you’ll pay 44% of the price (down from 51% in 2017).

Traditional Medicare or Medicare Advantage?

Medicare Advantage, also referred to as Medicare Part C, has increased in popularity over the past couple of years. But how does it differ from original Medicare, and is it better?

Medicare Advantage plans are run by private insurance companies that wrap Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) into one plan. Some will even include prescription drug coverage (Medicare Part D). Advantage plans have a lot of benefits like coverage for outpatient services, and the ability to include dental, hearing, and vision coverage into your plan.

The trade off? Most Medicare Advantage plans limit you to certain doctors and hospitals, whereas people on original Medicare can visit any provider who accepts Medicare. If you’re comfortable with the network, though, these plans can be great ways to get great care.

Read here for more information on Medicare Advantage plans.

What plans are available?

Most seniors have around 20 Medicare plans to choose from, depending on where you live. If you live in a rural community, it may be harder to find a plan that suits you.

Overall, eight insurers dominate the marketplace. These include United Healthcare, Humana, Anthem, Blue Cross/Blue Shield, Aetna, Kaiser Permanente, Cigna, and WellCare. The plan finder from Medicare.gov is a great way to find the best insurer.

5 tips to help you save

  • Watch your mail. If you are already enrolled, be sure to read over any mail you get from your insurer. Most insurers will send out an “annual notice of change” or “evidence of benefits” letter that details the changes you will see on your plan in the next year. If you see that your premiums are increasing, or a maintenance drug you take is being removed from the formulary, it might be time to think about switching.
  • Use the Medicare.govPlan Finder.” This tool can help you find the best plan, and estimate your annual costs on each plan, based on your location and the medications you take.
  • Don’t forget about the penalties. Prescription drug coverage, also known as Medicare Part D, is optional. Keep in mind that lofty penalties may apply if you fail to enroll when you are eligible. For more information on these penalties, and how to avoid them, read here.
  • Check your plan’s network. This is especially important if you are enrolled in a Medicare Advantage plan. Contact your doctors, hospitals and other providers you may frequent to ensure that they are covered under your plan. This step can ensure that you won’t have to find a new provider, or pay out of pocket.
  • Use GoodRx. Whether you’re choosing a plan, or enrolling in a new one, shopping around can still help you save. In fact, for the top 20 Medicare plans in America, 66% of prescriptions can be purchased for less than your typical Medicare co-pay using discounts found on GoodRx. Moral of the story? It pays to use GoodRx!

For any additional questions, be sure to read through this FAQ from The Kaiser Family Foundation.


Taking Vyvanse for ADHD? Here’s How You Can Save

by Tori Marsh on October 23, 2017 at 12:33 pm

Let’s start with the bad news. Vyvanse—a stimulant typically taken to treat attention-deficit hyperactivity disorder (ADHD)—is really expensive. Many similar (but not exactly the same) drugs are available as inexpensive generics, but Vyvanse isn’t expected to be available as a generic for some time. If your doctor thinks Vyvanse is right for you, how can you make it affordable?

Here’s some information about Vyanvse and how you can save.

How popular is Vyvanse?

Vyvanse is the third most popular central nervous system stimulant, a class of medications that also includes Adderall (amphetamine salt combo) and Ritalin (methylphenidate). Drugs in this class are prescribed to help you focus and stay alert but can also be prescribed to treat narcolepsy and aid in weight loss.

For more information on Vyvanse, read our previous blog here.

When will generic Vyvanse be available?

As of October 2017, there is no generic available for Vyvanse. However, it may become available as generic lisdexamfetamine after 2023, when the brand name patent expires. While a generic alternative is still many years out, there are other ways to save on Vyvanse.

Are there any cheaper medications I can try for ADHD?

Finding a stimulant that works best for you and your pocketbook can be tricky. While Vyvanse doesn’t have a generic, there are a couple other options to speak with your doctor about.

  • Other similar stimulants, including Concerta (methylphenidate er), and Adderall (amphetamine salt combo) have cheap generic alternatives. (See this Iodine comparison of Vyvanse vs Adderall for more information.) Keep in mind that switching stimulants may not always be easy, so it is always recommended that you consult your doctor.
  • If you have insurance, check your coverage. While Vyvanse is not usually covered, plans tend to offer coverage for other brands.
  • For more information on how Vyvanse compares to other stimulants, check out Iodine’s Vyvanse alternatives. As always, you’ll want to speak with your doctor if you think another medication might work better for you.

Vyvanse works best for me—can I still save?

  • Filling a 90-day supply can help shave a little more off your out-of-pocket cost. Note that you may need a new prescription from your doctor, or approval from your insurance to fill a higher quantity, so check with your doctor, pharmacist, and/or insurance.
  • Splitting a higher dosage pill can help decrease costs, especially if two strengths are priced similarly. You will want to ask your doctor to make sure this is a safe option for you.
  • Use a Vyvanse coupon from GoodRx. GoodRx offers discounts for Vyvanse online. A GoodRx Vyvanse coupon can usually save at least 15% of the full retail price. Keep in mind that Vyvanse is a controlled substance, which means that some pharmacies may not honor the prices listed.
  • Use a Vyvanse manufacturer coupon or patient assistance. Shire, the manufacturer of Vyvanse, offers both a manufacturer coupon and a patient assistant program. The manufacturer coupon can help reduce your out-of-pocket costs to $30 (for insured patients only), while the patient assistance program can help qualified patients get medication for free. For more detailed information on each program see the Vyvanse manufacturer coupon at GoodRx or visit Shire’s website directly.
  • Try again to get it covered. If you have insurance and your plan doesn’t cover Vyvanse, ask your doctor about submitting an appeal. Some plans require prior authorizations—meaning you need permission from your insurance plan before you can fill your prescription—and then they will provide coverage. If you have insurance, call your provider and ask.

Learn more about Vyvanse at GoodRx’s Vyvanse page.


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