Tips for Lowering Medicine Costs

Even for people with health insurance, the out-of-pocket costs for cancer treatment, including medicines, can represent a major expense. If you’re concerned about your cancer medicine costs, a good first step is to find out if your cancer center or hospital has a financial navigator on staff. 

A financial navigator or someone on your healthcare team can help you find ways of lowering medicine costs. There are also steps you can take to reduce these types of out-of-pocket costs after you calculate what your health insurance plan is supposed to cover. 

It’s a good idea to ask your doctor — and a trusted pharmacist as well — about generic medicines and biosimilars.

Generic medicines are chemically identical to but usually less expensive than brand-name medicines. Your doctor can talk to you about generic options for: 

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  certain chemotherapy medicines

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  hormonal therapies, such as tamoxifen and aromatase inhibitors

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  bone-strengthening medicines, such as bisphosphonates

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  certain medicines for side effects, such as pain and nausea

Still, it’s important to work closely with your doctor to make sure a generic option makes sense for you.

You may want to ask your doctor if it’s possible to get samples of certain medicines. Doing so can help you see if you have any side effects before having to pay for a full prescription. It’s important to know that doctors may not have samples for certain medicines. Doctors also aren’t allowed to give out samples of narcotic medicines for pain (also called opioids, such as morphine, codeine, or oxycodone). If getting samples is not possible, you may want to ask your doctor to prescribe a smaller supply of medicine — for example, one month versus three months — so you can see if you have any difficult side effects. It’s also important to know that oral chemotherapy medicines — pills taken by mouth — tend to be more expensive than intravenous (IV) versions. You may want to ask your doctor if it’s possible to pick prescription options that are the most cost-effective for you. 

Different pharmacies may charge different prices for the same medicine. You may want to contact pharmacies near you to see how much each of them charges for your prescription medicines. Your pharmacist may be able to recommend websites that offer discounts and manufacturer coupons or discount cards, all of which could help lower your out-of-pocket costs. You may also want to check non-profit organizations to see if they offer discount drug cards. 

For example, non-profit organizations Triage Cancer and NeedyMeds have teamed up to offer people diagnosed with cancer a drug discount card that is accepted at more than 65,000 pharmacies nationwide.

Some health insurance plans in certain U.S. states have co-payment accumulator or co-payment adjustment programs in place, which prevent you from using any financial assistance that manufacturer copayment coupons or discount cards provide toward a deductible or out-of-pocket maximum. People who have public health insurance plans, such as Medicare, Medicaid, or TRICARE, also aren’t eligible to use drug manufacturer coupons or discount cards, if they are going to use their insurance to pay for their medicines. 

Many pharmaceutical companies offer patient assistance programs to help people with commercial health insurance or no health insurance get the medicine they need at a lower cost or, in some cases, free. People with public health insurance plans such as Medicaid or Medicare are usually not eligible for these programs. 

You may also want to ask the pharmaceutical company that manufactures your medicine whether it can help get you coverage for your medicine through your health insurance company or even if you have a public health plan, such as Medicaid or Medicare.

Some national non-profit organizations offer financial assistance for breast cancer medicines and other treatments. You may have to meet certain income and other requirements to be eligible. Diagnosis-specific funds may open and close at different times throughout the year. In some cases, you can sign up for a waiting list to get notified when a fund has reopened.

Here are some non-profit organizations that offer prescription assistance programs:

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  The PAN Foundation offers financial assistance for prescription drug co-payments to people who have been diagnosed with metastatic breast cancer, have health insurance, and meet income and other eligibility requirements. Call 1-866-316-7263.

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  CancerCare Co-Payment Assistance Foundation offers financial assistance with prescription drug co-payments to people diagnosed with breast cancer who meet eligibility requirements. Call 1-866-552-6729 or email information@cancercopay.org. Funds are limited, but you can also contact their Hopeline at 1-800-813-4673 or info@cancercare.org to see if they can help you find other resources.  

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  Patient Advocate Foundation’s Co-Pay Relief Program provides financial assistance for prescription drug co-payments to people who have health insurance and meet other eligibility requirements. Call 1-866-512-3861.

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  The Assistance Fund offers financial assistance for certain breast cancer prescription drug co-payments to people who have health insurance and meet other eligibility requirements. Call 1-855-845-3663.

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  Komen Financial Assistance Program offers financial assistance for certain oral breast cancer medicines to people who meet eligibility requirements. Call 1-877-465-6636 or email helpline@komen.org.

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  Rx Outreach is a non-profit online pharmacy that offers lower-price medicines to people who meet certain income requirements. Call 1-800-769-3880.

You may want to ask someone on your healthcare team, a social worker, or a financial navigator to recommend local resources that can help you pay for medicine. You can also ask if your hospital or cancer centers has a financial assistance department that might be able to help cover out-of-pocket medical costs.

According to the American Society of Clinical Oncology’s (ASCO) Cancer.Net, your local American Cancer Society or United Way office may have available programs that can help. Service or faith-based organizations such as Catholic Charities, Jewish Social Services, and the Lions Club may offer grants to help with the costs of treatment. Local religious organizations such as churches, synagogues, and mosques may be helpful as well.

It’s important to know that resources and regulations vary by country. If you live outside of the United States, ask your doctor about resources that are available in your country.