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If we had all the money we spent on illegal drugs, alcohol and other substances that we drank, sniffed, injected or smoked, we wouldn’t have to worry about the cost of prescription drugs in recovery. Some of us possibly could buy a small pharmacy.

We don’t have that money though. It’s gone and we need to maintain our health while we save dollars. Striking that balance is doable — a challenge, but doable.

There are some ways to ease the painful financial side effect that can come with prescriptions. Spending on prescription medication grew over 12% last year — more than five times compared to the previous year. The Center for Medicare and Medicaid Services reported the sickest among us pack the greatest burden as 44% of people in tolerable or ill-health report it’s moderately or very challenging to buy medications.

Following ten years of takeovers and buyouts, three large companies control 40-percent of the generic market according to Gerard Anderson with the Johns Hopkins Bloomberg School of Public Health. Limited consumer choice means higher prices.

Fortunately, there are multiple ways to save. Work with your physician to make tactical options in the medicines you take, where you purchase them and which health plan you choose.

Here are six steps to take to shave 40-percent, or more, from your complete prescribed drug costs each year.

Generic Substitutions

Be sure to chat with your health care provider about any generic types of prescription medications. Even with price increases, immense savings can be found. Wayne J. Riley, president of the American College of Physicians, says, “The data is clear that generics function as well.”

Consolidate Pills — Or Split Them

If you find you are getting two or more medicines for identical conditions, as your doctor if there may be an individual tablet that could do the work. For instance, you may be spending a consolidated $100 each month to obtain a branded beta blocker and brand-name thiazide diuretic for elevated blood pressure. Substituting a nonproprietary compound which contains both medicines can bring the co-pay cost down to under $15.00.

Jump Through Hoops

In 2016, 70-percent of employers required their workers to try over-the-counter generic versions before insurance would manage higher alternatives. Over half of employers mandated “step therapy” for cholesterol-lowering drugs. The process can make it difficult for employees to get the drugs their doctor prescribed.

Many insurance companies are requiring individuals to try three medicines before they can receive the one originally recommended. If the medication you’re on comes with these restrictions, the bad news will hit you when you go to the pharmacy. Work with your physician to find alternatives. If you just ignore the rules, you may have to pay the full bill for your medicine.

Seek an Exception

Your health insurance may waive restrictions, pay for a medication not on the list or lower the co-pay if your physician says a particular medicine is required. But you have to ask.

For instance, when cholesterol-lowering Lipitor became available as a generic, many plans declined to cover the brand-name version. However, some persons couldn’t take the generic as they were allergic to the binding additive. Plans allowed them to take branded Lipitor and pay the generic co-pay.

What do you do if you ask and are still denied? You have the right to internal and external reviews and your plan’s explanation of benefits page will say whom to contact.

Preferred Pharmacies

About 30% of patients are inside a preferred network. This means medicines are available at a discount at particular drug stores. Another 12% had a limited network. Persons free to choose any pharmacy can use OneRx, an app to see which ones offer the lowest prices. WalMart pharmacy prices are among the lowest in the country according to OneRx. In urban regions, with a lot of competition, you may be able to find lower-cost medications. In a rural area, your choices are more limited.

Mail-Order

Depending on the medication, using mail order can help prevent overpaying. The trade-off: processing can take more than a week

Ask for Help

If none of these suggestions lower the cost of your prescriptions medications by enough, ask your pharmaceutical company. Each company is required to have patient-assistance programs in place to aid individuals who are having a challenging time affording their medicine. There might be income limitations as well as other requirements. Visit RxAssist.org or PPARX.org to find programs customized to your medicines.