How to Manage Medication Costs for Chronic Conditions

Living with a chronic condition takes a heavy toll on the patient. It’s nowhere near easy, having to make peace with a disease that’s planning to stay for the long run. As if having to alter your whole lifestyle to live with the chronic condition isn’t exhausting enough, the costs that come with managing the situation are, to say the least, surrealistic.

managing medication costs

Most of those living with chronic conditions take several medications to manage the symptoms. That’s only until they develop a new condition, either as a result of their existing one or as a side effect of the medications they’re taking.

What do they do when this happens? They get prescribed even more medications. Luckily, there are a few ways through which they can manage the medication costs for their chronic conditions. Here, we discuss some of the available options. 

Healthcare Insurance

Although healthcare insurance saves millions of dollars each year on the healthcare expenses of many individuals, the benefiting segment doesn’t include those suffering from existing chronic conditions. Most healthcare insurance providers have strict policies that exclude the treatment and medications of past chronic conditions from their plans. In the case of developing a new disease, it can often be included in the insurance plan in hopes of curing it. Once it exhausts all the available treatment methods and falls into a maintenance phase, it falls out of the coverage. 

On the bright side, a new federal rule has been enacted to reduce the costs of out-of-pocket expenses. Issued on June 24, 2019, the new law requires insurance companies to cover a range of services for Americans living with chronic diseases and are enrolled in high-deductible health plans. These services include medications for heart diseases, diabetes, asthma, osteoporosis, blood pressure, and depression. 

Moreover, chronic condition patients can be eligible for getting Medicare Part D benefits in case they satisfy specific criteria. According to the Medication Therapy Management (MTM) guidelines for chronic diseases and Medicare Part D coverage, a patient can be eligible if they have two or more chronic diseases, use multiple drugs covered by Medicare Part D, and endure high annual medication costs (which can change yearly).

Prescription Drug Alternatives

The truth is that medications don’t always need to be as expensive as one may initially think after walking into a pharmacy with a prescription. Most physicians prescribe brand medications, which will undoubtedly be the most costly on the market. Just like the pharmaceutical experts at explain, you’ll be able to find other generic medications containing the same active ingredients once the patency of the brand expires. By looking up your options and comparing the prices of different generic medicines offering the same effect, you’ll get a better value for your money. 

Support Programs

Alternatively, many support programs exist solely to help those living with chronic conditions find more affordable medications. You may be able to get your medicines at no or little cost through these programs. Such programs can connect you to companies that offer savings coupons, or they may even connect you with a manufacturer that provides saving programs. Following the same concept, you can investigate pharmaceutical companies and find ones that offer financial patient assistance programs for a particular medication. That’s especially common with diabetes medications, such as insulin.

how to help manage the cost of medicine

Comprehensive Medication Management

Managing the costs of chronic conditions can be very difficult for an individual. Looking at the bigger picture, any healthcare specialist can realize the discrepancies in the management regimens for most chronic disease patients. That’s because one patient may be following the treatment regimens of multiple physicians, each prescribing their medications without taking into account the other regimens the patient is currently following. 

The result is that the patient may have to get the same medication twice or stack up on medicines that aren’t all necessary. To prevent the physical and financial ramifications of this issue, physicians need to follow a centralized, comprehensive management system that takes into account the full health profile of the patient. Out of all physicians, pharmacists are the most suitable for this role. 

Managing the costs of chronic conditions as they arise is necessary, but that doesn’t mean there’s no smarter way around it. While some chronic diseases have causes in genetics, traumatic injuries, or accidents, there is an essential share of chronic conditions that one can prevent from developing in the first place. The costs of chronic diseases account for 90% out of the $3.5 trillion spent on healthcare expenses annually. Meanwhile, preventing some chronic conditions can be done by making and sticking to healthy lifestyle changes. These changes include quitting smoking, eating healthily, getting regular physical activity, avoiding drinking too much alcohol, and maintaining good mental health.

Susan Harris

By Susan Harris

Susan Harris is the owner of Rooted Mama Health. She is the mother to two amazing children and wife of a loving husband. She strives to provide the world with all the information they need to live a happy and health lifestyle.