Prescription drug costs are a major contributor to the increases in health care costs, and they continue to rise. In 2016, while the rate of increase slowed overall, price inflation was still increasing by double digits for common brand name drugs as well as specialty medications. In addition, the utilization of drug products has increased. These increases were related to many reasons including an aging population, the management of chronic conditions, and the opioid epidemic.

At Health New England, we are constantly looking for ways to keep health care costs down while still providing the highest possible quality of care. As part of this commitment, our Pharmacy Department conducts semi-annual reviews for formulary changes and looks at medications that have effective alternatives. Alternatives are checked for quality, safety, efficacy and affordability, and are usually less expensive and have a smaller impact on a member’s out-of-pocket expenses. They help to decrease overall Pharmacy costs as well.

Tips for members to save on prescriptions:

When prescribed a prescription medication, members can use the following techniques to help keep their costs down.

1. Understand plan benefits
   • Do you have a deductible to meet before coverage kicks in?
   • Do you know the formulary or list of covered drug products?
   • Do you understand the payment tier structure?
   • Are there preferred pharmacies in your network?
   • Can you access pre-tax dollars to help pay for your medications?
2. Talk to your doctor about cost
   • Generic drugs generally are significantly less expensive.
   • Sometimes alternative brand medications can be used to treat your condition. Finding the most cost-effective option is something your doctor can help you with.
3. Trust in your pharmacist
   • Your pharmacist can be a great advocate for cost savings.
     • They can work in collaboration with your doctor to assist in finding the most cost-effective treatment.
     • They can suggest different formulations and even potential higher doses that can be split in half before taken.

Members can learn more about their individual Pharmacy Benefits, look up drugs and pharmacies, sign up for mail order and more on our Member Portal at http://my.healthnewengland.org/.

They can also use our Find a Drug tool on healthnewengland.org by clicking on Find a Drug at the top of the page.

Read more about our Find a Drug tool.