Latest / The YMyHealth Podcast | Wellness and Healthcare Insights for Millennials / Affordable Prescription Medications: Navigating Healthcare Costs in the US

Transcript

Affordable Prescription Medications: Navigating Healthcare Costs in the US · The YMyHealth Podcast | Wellness and Healthcare Insights for Millennials

• 00:02 Melissa Schenkman Welcome to the why My Health podcast, a healthcare podcast created by Millennials for millennials. I'm Melissa Shankman. 00:08 Julie Woon And I'm Julie Woon. We're two members of Gen Y on a mission to tackle the health challenges unique to people in their 20s, 30s, and 40s. 00:16 Melissa Schenkman With inspiring Survivor stories, plus insights and practical advice from experts across the country. We've got you covered. 00:22 Julie Woon Whether you're navigating a chronic condition, cancer, or challenges to your mental health, or. 00:27 Melissa Schenkman You're trying to manage our complicated healthcare system and your preventive or just want to make smarter healthcare choices, this is the podcast for you. 00:37 Julie Woon Let's get started. 00:40 Melissa Schenkman Hey, everyone. Welcome back to the why My Health Podcast. I'm your host, Melissa Shankman for this episode and we're going to be diving into, I think, one of the most challenging parts of navigating our healthcare system, which is purchasing your medications and trying to understand how to get them at a cost that is affordable and why some of them are really expensive and others are not, and what's covered and what's not. So there are just a lot of little nuances that are hard for us to figure out as the public. We are just so very fortunate to have our why My Health contributor and community pharmacist here with us, Dr. Alexandria Yarbrough. 01:18 Melissa Schenkman And we are so very fortunate to help guide us through all of this, to have someone with more than 10 years of experience as a pharmacist with us, which is our Wyman Health contributor, Dr. Alexandria Yarbrough. She is a community pharmacist at Sam's Club and in South Carolina, and she has joined us before on the podcast. We're always learning so much from your expertise and especially in this area. Really excited to talk to you about this, so welcome. 01:44 Dr. Alexandria Yarborough Thank you. I'm so excited to talk about this, too. I have a lot of tips. 01:47 Melissa Schenkman Well, we need those very much. And as we dive into this, one of the reasons for that, not only is this something that we are hearing from our YMA health community on a regular basis from fellow millennials who are being prescribed medications that they can't afford and trying to figure out different options for that, but also there's some really interesting research out from a Kaiser Family foundation poll that was done just in March of this year, in March of 2026. And one of the findings was that 59% of U.S. adults said that they were worried about affording prescription drugs, and 43% said that they did something in the past year, such as not filling A prescription they were given that they needed, or skipping doses, and all because of cost. 02:32 Melissa Schenkman And I think that just really speaks to what a large problem this is for so many people. 02:39 Dr. Alexandria Yarborough Oh, absolutely. Those numbers and those statistics do not surprise me at all. And unfortunately, there's no way for you to know when you're prescribed a medication, how much it's going to cost. You can't hear the name of something and just assume it's going to be inexpensive or super expensive or even look at what it's for. There's just a lot of times no way to even know, especially on the patient side of things. 03:01 Melissa Schenkman Oh, absolutely. And I think it's such a barrier to preventive healthcare as well, which is so much of what we talk about too. It's one more hurdle to cross. You have been a pharmacist, as I was mentioning, for a decade now, which is incredible. And because of that, you have filled thousands upon thousands of prescriptions and consulted with thousands of patients. From your point of view, what does the landscape with patients having to access prescription medications look like in the United States broadly, and what are some of the biggest pain points in general that you see? 03:36 Dr. Alexandria Yarborough So in general, it's just hard to with the cost of living and the affordability gauge, where that fits into your lifestyle. And so the biggest thing is you just need to sit down and look at your medications and understand what each one of them is for. So. So that's the most important thing is to realize that these medications are so important and you need to find a way to afford them if possible. But the good thing is you have people that can help you, like your pharmacist and your doctors. And then we also have other options as well. We have different ways to pay for that. So even though the landscape is changing, there are options out there for you. Some medications are more expensive. Healthcare plans are not covering things. They. They're very complicated. So that's kind of the negative aspect of it. 04:22 Dr. Alexandria Yarborough But the good thing is there are medications that have been around for so long and you might not have even on them yet, by the time you get on them, they are going to be more affordable. Or there are other options like discount cards, manufacturer coupons, and things like that I can get into. 04:37 Melissa Schenkman That's wonderful to hear. Before we dive in to our conversation and how to more easily navigate the process of getting our prescription medications filled with, can you define for us some of the common terms that are used that we should all know about? 04:52 Dr. Alexandria Yarborough Absolutely. So when it comes to medications, you have brand and Generic. So that's very important to distinguish that. So the brand name of the medication is like a designer label. So the easiest way for me to kind of understand that is with cooking. So if you're going to bake a cake and you want to get a cake mix, Betty Crocker would be the brand. But if you want to have a cake mix that's a little bit more affordable, you can just buy the Target Publix Food lion brand of just yellow box cake mix. So those are really important terms. And just looking at the name of medication, you're not really going to know if it's a brand or a generic unless you study it in pharmacy school. But you can always Google it. So those are two important things to understand. 05:37 Dr. Alexandria Yarborough Brand name drugs tend to be a little bit more expensive, and generic is a little bit cheaper. And I can't explain why. And then there's a couple different ways to pay for medications. And some of the words that are going to come up are like premium. So if you have health insurance, most people have commercial health insurance through their job, or they'll have health insurance through a government entity, and that could be through Marketplace or that could be Medicaid, or it could be some other kind of supplement. So in most cases, insurances require you to pay a premium. If it's through your employer, it's automatically taken out of your paycheck. And that's just the amount that you pay to have health insurance every month. Another one is going to be a deductible. Doesn't always apply. 06:18 Dr. Alexandria Yarborough But there are some high deductible health plans now that are available since healthcare has gotten so expensive. So it's basically the threshold of when your insurance coverage will kick in. And then when that does happen, that could be a percentage you have to pay every month, or it could be completely covered. Now, one thing I will say, it's not necessarily a definition, but it's kind of sneaky insurance language. When insurances say that something is covered, they mean that, yes, they will pay some of it, but you're led to believe that means it's going to be $0. And so you need to know the coverage amount. So when you're talking to insurances or you're trying to get things paid for, the pharmacy's talking, you need to actually ask, what is the amount I am required to pay? 07:04 Dr. Alexandria Yarborough And that leads me into another one, which is your copay. So usually that is the set amount that you pay for certain brand or generic or specialty drugs set by your insurance. Plan. Some of the other things that you'll have to deal with are different types of rejections. So if you are using insurance to pay for your medicine, you might run into a prior authorization or a PA is what most people call them. It's basically insurance needs more information in order to cover your medication and they need the doctor to tell them why that particular one is necessary. They need prior authorization before they will pay. Then there's also other ones that go along with that, like step therapy. 07:43 Dr. Alexandria Yarborough So if you're on a certain stomach acid medication, they want you to try Pepcid and then if that didn't work, then they want you to try Nexium. And so it's like they want to see all these other failed therapies that are usually less expensive for them to cover before they pay for the expensive ones. So those are some of the common terms and I'm sure many more will come up. But those are the kind of ones that are thrown around the pharmacy when you go to pick up your medicine that's not ready and you're like, oh, you need a pa and you're like, I don't even know what that is. 08:13 Melissa Schenkman Absolutely. Well, thank you for defining all those. And also about that is a very tricky part where something looks like it's covered. And the word covered to all of us means 100%, as in completely covered. So appreciate you highlighting that too. Definitely something for each of us to take into consideration and ask each time when we're going to fill a prescription. Now we have a much better sense, thanks to you, of what these words mean and their significance. What are the three main ways that patients can pay for prescriptions in today's system and what are the benefits of each of those and what are some common pain points that people might encounter in the process? 08:54 Dr. Alexandria Yarborough Okay, for sure. So there's three main ways you can always pay cash for your medication. And that doesn't mean actual like cold hard cash. You can pay with your debit card, credit card, but you can put any medication on cash. The cash price is usually very expensive. Don't ever do that. At least put it on some type of discount card unless there is some type of restriction, which sometimes there are with certain controlled substances and things like that. Try not to pay cash. There is usually something that can help you, so just even a little bit. The second way to pay is through a manufacturer coupon card. So this is something that is offered by brand name medications. So I'm sure most people have heard of GLP1s, right? 09:35 Dr. Alexandria Yarborough Now, so all of the GLP1s, the injectable medications that are approved for diabetes and weight loss, they all have manufacturer coupon cards because most of them are brand name. Now if you went to a compounding pharmacy and got a GLP one that was injected and you had to draw it up yourself and not get one of the ones that come prepackaged, they're not going to have a manufacturer coupon. But if there's something like Wegovy or Mounjaro that we've all seen the commercials for, they will most likely manufacture a coupon. So there's those two ways and then the final way was insurance. So insurance is the gold standard. Usually in most cases it is the best price, but not always. 10:18 Dr. Alexandria Yarborough So I know, for example, at my pharmacy, some of the statin medications that are used for cholesterol, they tend to be about $50 for a 90 day supply. On some insurances, some of them completely cover them at $0, but some of them are a little bit higher. But with a discount card, on average they should cost no more than $30 for a 90 day supply. So you think about it, you're getting 90 days and it's $50, you can get it for 30 on a discount card. You're saving 20, 46, almost $100 a year when you think about it. 10:50 Melissa Schenkman Yeah. 10:51 Dr. Alexandria Yarborough And that's just one medication. Now the caveat with that, if we think about those manufacturer cards, again, you can use that with your insurance in most cases. So there are, there's so much fine print, sometimes they'll have a max amount that they'll pay. So for example, let's say Your medication is $1,000 and you want to use your insurance and you have the type of insurance that allows a manufacturer coupon to be applied with it. So your Insurance brings that $1,000 drug down to 500. Now the manufacturer coupon can bring it down even lower, but it has a max monthly amount and the tiny print in the bottom, so it'll bring it down 200 or that's the maximum amount of savings. So even though this drug was once $1,000 a month, it's now $300 because your insurance brought it to 500. 11:43 Dr. Alexandria Yarborough And then we can add a manufacturer coupon on top of that to get it to a little bit more of an affordable option. That's a higher level example of buying expensive drug. They tend to usually end up being about 25 to 50 or under a hundred dollars with the manufacturer coupon. But it all depends on that insurance amount. So there are those three ways, but then there's also a fourth way that's a combo of the two and you can't use a discount card with the manufacturer coupon. So there's all kinds of different rules and policies and things like that. So even though we're trying to get you the best price and trying to do everything we can, there are so many stipulations with using each one of those. 12:19 Melissa Schenkman Oh, I really appreciate you explaining that. That was one of my questions is really, because I think a lot of us don't know or we believe that it's either. Or either you can only use a coupon, that's the rule, or you can only use your insurance. And so I was curious, can you use both? And I didn't realize that there are instances to ask about that you can use both because there are several drugs to your point that are very expensive. You know, you're looking at $500 or more at the original price. And obviously for the majority of people, 500amonth just for that one medication is not sustainable. Right. And it's interesting and sometimes insurance will lower it, but not enough as to your point. So that is very interesting and helpful to hear that there is that possibility. 13:09 Melissa Schenkman And would you just, you know, like you mentioned, there's so much fine print. Would it best to take that. Let's say you're bringing your prescription. Would it best for you and for your staff? Have you found it that somebody bring in that discount card that they have along with obviously their insurance, which is going to go in your system and really ask your staff or ask you, can I use both to even bring it up? 13:32 Dr. Alexandria Yarborough Oh, that would be amazing. Yeah, we don't have a lot of time to do that or a lot of times I'll put notes in with medications once they're ready, like discount card available because we're not legally allowed to get that for you. There used to be a time where drug representatives would come to pharmacies and give us stacks of coupons, but now they want you to sign up for it and you have to use your email address or you have to verify with a text message. So if you have a medication that you want to see if it's a little bit more affordable, I would always have your most up to date insurance card. Make sure the pharmacy has that. I would also have a GoodRx ready to go. You can just Google Goodrx and you can get an instant coupon. 14:12 Dr. Alexandria Yarborough And then if you get prescribed A medication that you've never had before. I would just also search is this a brand or generic? And anytime it's a brand name, always type in the name of that medication and then put coupon card because usually there will be an option out there, especially if it's a newer drug. 14:29 Melissa Schenkman That's incredibly helpful to hear. And yeah, because as you had mentioned before, the brand are usually the more expensive of the two. So to take those steps first would be really helpful and get you the best price. And I was going to say to you, I think you may have already answered question four. So I don't think I have to ask you question four because I think, yeah, because I'm looking, that's how I was looking down was about using the manufacturer coupon with insurance. So you covered that completely. And I love how you're giving the steps because that's what we need, that's what we all need. It just makes it so much easier. So sometimes we'll hear, we'll have something that's coming out more expensive, we'll have a discount card. But maybe the discount card isn't working for whatever reason. 15:11 Melissa Schenkman To your point, I know sometimes with the fine print, it's interesting because I've tried to use them myself many times and sometimes they work and other times they'll say to me, oh, you have insurance so you're now ineligible for even though the price is better with that. But I've had different pharmacists say to me over time at different pharmacies, well, actually if that doesn't work, we have this other option, we have a pharmacy discount program. So tell us a little bit about how that works and how that's different compared to the discount card. And when should we, like when is the time for us to explore that option and bring that up. 15:46 Dr. Alexandria Yarborough Oh, for sure. So the discount cards that are used pretty much anywhere at any pharmacy, the universal ones, those are pretty much GoodRx. But the other discount program that you can use is basically the same thing, but it's pharmacy specific. And so where I work at Sam's Club, we have an awesome option for plus members that they get 10 free generic medications for a one month supply. So that's really awesome. I switched a lot of people's insurance who will charge them a lot more to that card and it's $0 every month and it's unlimited, which is great. So they can get years of free medication. I know that Walgreens and cvs, they have a similar option on their website where you can Go and you can put in your medication. 16:31 Dr. Alexandria Yarborough But so in addition to just a universal discount card, certain pharmacies also have different things that they can offer. They might not be free because there are some limitations state to state with things like that, but you just never know the perks. I know there are other wholesale clubs out there that also offer the same type of services, but yeah, if you're able, ask your pharmacist, they will know. Or their pharmacy techs, they will know how to try to get you the best price. It'll still require work on your end, but there might be a hidden kind of unfamiliar benefit you hadn't heard of. 17:03 Melissa Schenkman Oh, that's really excellent advice and I think that'll be something new for so many people for sure. So great to know about that option as well. But that's a great one, I think that a lot of people are not aware of for sure. 17:16 Julie Woon Have you been living with symptoms doctors can't seem to explain, like constant fatigue, brain fog, dizziness, or a racing heart? You may be dealing with dysautonomia condition that affects how your autonomic nervous system works. At Diekman Dysautonomia, Dr. Sarah Diekman specializes in diagnosing and treating conditions like POTS and other forms of dysautonomia. She understands how frustrating it can be to go from appointment to appointment without real answers because she's not only a board certified physician, she's also a dysautonomia patient herself. That unique perspective means she listens differently, digs deeper, and works with you to create a plan that's tailored to your life. If you've been searching for a provider who truly understands dysautonomia, expert.com you don't have to keep wondering what's wrong. You can start finding answers today. 18:03 Melissa Schenkman I think we ask this question especially when we get handed a prescription that we look at the dollar amount and are like, really, is this possible? You know, why can prescriptions still be expensive with health insurance? 18:17 Dr. Alexandria Yarborough So it depends on the medication and then it depends on the insurance. So a lot of times medications are made somewhere else and then distributed somewhere else and there's a lot of different ingredients and things that go into it. And so when you think of all the steps of how medications actually get to you, they start in where they're made, which they have to source different ingredients and then they're shipped and then they go to a distributor and then they go to a wholesaler and then pharmacies have to get them so there are a lot of steps, and there's the regulation and quality control. It costs a lot of money to make sure that they're safe. So that's one of the things, and just the ingredients. 18:56 Dr. Alexandria Yarborough So depending on what's going on in the world and where we source certain things, if there's conflict in a country that supplies a certain part of a drug, then there's going to be a limited amount, and it's just kind of basic supply and demand. Then there's other medications that are just expensive to make. Certain ADHD medications, they require ingredients that have a lot of different steps, a lot of different clinical trials. They're just expensive. And then there's the insurance part of it. So the insurance, they have certain plans that will cover certain things, usually cheaper, older generics, but there's different tiers within those plans. So that's a kind of a glossary term that I always have fun explaining to people because they're like, well, why is it expensive on my insurance? Well, they could have tiered drugs. 19:44 Dr. Alexandria Yarborough So if you have like tier one, two and three, those prices go up and then that's when you get those denials because they become more expensive. So there's no insurance plan out there that's going to let every drug be $4 no matter what. It's just not good business for them. So depending on your plan, and if a certain medication is in a tier, that could affect the cost. So the tier usually requires like more work, more the doctor talking to your insurance, and then they can still deny it. But usually if it's a older generic medication, it's in a lower tier, it's not very expensive. If it's a newer and it's very specific, it can be much more expensive. It's in a higher tier. 20:25 Dr. Alexandria Yarborough And so that's kind of the reason why the medications can be expensive, either the medication itself or your specific insurance plan. 20:33 Melissa Schenkman Oh, that's all very interesting. And so many factors in there that I think a lot of us don't ever think about, but that you do, because you are so in the trenches with all of this and have been for so many years, and you've seen it from, you know, all the different angles and how the industry has evolved. But a lot of us don't think about that conflict or where the ingredients are from and things like that. So that really gives us a lot of perspective to think about as to why they're like that and why. Also, with the tier pricing tier, plant something new for many of us that how that works with insurance. 21:04 Melissa Schenkman And speaking of health insurance and having different prices depending on your insurance plan, when you're bringing in a prescription to be filled and you know about these different Options, about the GoodRx that you're talking about and the discount cards and the potential pharmacy discount program, when does it make the most sense to really go with health insurance as opposed to going these other routes, each providing some form of discount? 21:30 Dr. Alexandria Yarborough So I would use insurance anytime. It's the less expensive option. So if Your copay is $0 or under $5, no matter what, for certain generics and your everyday medications, I would always use insurance. Or if you happen to have a certain type of plan where you have a deductible and you need to reach that threshold amount, because then once you do hit that amount, it will be completely covered. That tends to happen in if you're under 65 and only certain instances. Usually it is for people who are on Medicare, but I have seen it in millennials and other people who plan. So it is good to mention. But if you have a deductible you need to reach, then I would always use your insurance. Because if we use a discount card, it doesn't go towards that amount. 22:16 Dr. Alexandria Yarborough So those are the only instances I would use it. 22:20 Melissa Schenkman Okay, and then what about for the discount card or the cash price? When would that typically be cheaper? 22:26 Dr. Alexandria Yarborough If you can't use your insurance or if your insurance just isn't providing any savings, definitely use a discount card. Now, there's a caveat to that. So the discount cards can't be used in every pharmacy on every prescription. Some of them have limitations, such as if it's a controlled substance, but some of them allow certain controlled substances to be used on them. So it all just kind of depends. But then you have to also think about the pharmacy laws as well, because there's also that part of it. So if you want to get a medication early, say you're going on vacation and your insurance won't pay for it for a certain date, we can always put it on a discount card then. 23:05 Dr. Alexandria Yarborough But if it's still too early by the law, if it's a controlled substance, which you have to go by certain dates, then we can't just override that part of the medications rules. So you can always get it on a discount card or cash, unless it has the kind of the fine print with that. But like, yeah, if you're going out of town or if you lost your medication, your insurance might not pay for you to get another refill, then you can use a discount card and it might not be as low, might not be $0 for, but it could be 10 and that's okay once in a while. So those are kind of the only instances I would use those. But if it's just cheaper. Absolutely. And we can usually check for you, it might take some time. 23:43 Dr. Alexandria Yarborough I will say that my pharmacy is a medium volume pharmacy so I have a little bit more time than most to kind of check and make sure I'm getting you the best price. But always ask, it might take a day or so. Call the pharmacist and just say would it be cheaper if I didn't get this on insurance? Would a discount card better? So just advocate for yourself and just see if there's anything that can be done. The worst they can say is no, yeah, no, absolutely. 24:06 Melissa Schenkman And that's great advice and that's true. I have talked to many people who, because of the cycles with insurance, a lot of things, certain things you can only get a 30 day supply and if you're traveling it can be an issue or if you lose the medication it can be an issue with cost. So excellent points to bring both of those up. And then as far as when you do pay cash, what happens to the deductible? 24:27 Dr. Alexandria Yarborough So it just doesn't apply to it, unfortunately. Hopefully it's not too much money that's lost because you definitely want to try to put as much as you can towards the deductible. But yeah, if you don't use your insurance, any payment doesn't usually go towards it. You can submit receipts in some instances, but I haven't really heard of much success with that. 24:46 Melissa Schenkman Okay, that's super helpful to know because I think a lot of us people understand, I think the concept of the deductible when it comes to going into be seen by your physician. But I don't think a lot of people, yeah, understand, oh, if I pay cash, well then the cash goes towards the deductible in terms of medication. So I really appreciate you bringing up that because that's a key piece of information. And you talked a little bit about this earlier with your phenomenal cake analogy. We've heard the terms generic and brand for years. Those are two very common terms. And the perception out there from most people is that generic drugs are less effective or not as high quality as a brand name because they're cheaper. And that's the only reason why is because they're cheaper. But that's what I can afford. 25:31 Melissa Schenkman So I'm going to Go with that and hope for the best. And the cost of the medications aside, I know I would love to get your in depth knowledge, I know our community would. On what a generic drug is versus a brand drug when it comes to each of their levels of effectiveness and why really do they differ in cost? 25:49 Dr. Alexandria Yarborough Sure. So I think a lot of people, when they think about brand name and generic medications, compare them to over the counter items. So if you're thinking about going shopping for a T shirt and you get a $200 cotton t shirt that fits you perfectly, it's a really cool color and it'll probably last you decades. Now if you go out and get a shirt that's about $3, that's a just a normal shirt, it probably isn't going to last that long. Now I think that's how most people view medications as if the cheaper one is just it's not as good, it's not as quality, it's not going to work for me. And that's not true at all. So medications by law have to be the exact same active ingredient. 26:33 Dr. Alexandria Yarborough So if you are getting a brand or a generic, they have the main ingredient the exact same. Now some of the things that can differ can be the color or some of the inactive ingredients or the binders. And that's just some of the things that kind of hold the medication together. In 99% of cases there is absolutely no difference unless you have a specific allergy. So I have a particular patient that is allergic to a certain dye, she can't have a certain generic. There's another option available. I just always make sure that dye isn't in there, but it doesn't actually affect the effectiveness of the drug, it just has given her an A side effect that isn't preferable. But overall they are always the same. 27:14 Dr. Alexandria Yarborough The things that make it different is the fact that the brand names, they're the ones who went through the clinical trials, they're the ones that have all the data and the research and that's why they're so expensive, is because they had to have the funding and then they had the patent. And so that's why medications are on brand only for years is because there's a certain patent and usually it's because they're a novel drug for a certain type of disease state or for condition. Then once we get to the generics, anyone can have that. They don't have to do the clinical trials, they don't have to do any of the research. So all they can do is just copy the recipe. So it's not that they're really any different. It's just another company said, well, I can do that too. 27:54 Dr. Alexandria Yarborough And so then that's why we get those options. 27:56 Melissa Schenkman That is absolutely fascinating because to your point, people we have like this perception and always wondering are they both as effective? And I think that just that helps so much to hear that alone to know that they are required by law. So many people do not know that to have that same level of effectiveness. And also the cost side of things, that is extremely interesting that it has to do with the clinical trials and all of that, which is definitely going to be new for a lot of our listeners. So I really appreciate you sharing that with us. 28:29 Dr. Alexandria Yarborough Oh for sure. And there's actually a specific rating systems. I don't want to have to go in too depth into this, but there is a rating system to make sure they're equivalent that we have to check. So anytime a new generic comes out, we have to make sure it is equivalent no matter what. And there's ratings and if it's not, it gets thrown out. 28:48 Julie Woon If you're a practice owner or health entrepreneur, you probably got into healthcare because you wanted to help people, not because you wanted to become an expert in bookkeeping, taxes or CFO strategy. But the money side of running a practice can get complicated fast. That's where Lucid comes in. Lucid brings all of your business finances together in one place. Bookkeeping, taxes, tax credits and CFO services. It's smart technology combined with real financial experts who understand healthcare businesses. And right now Lucid is offering free IRS tax credit research. They'll look for tax credits your business may be owed. And there's no upfront cost. Lucid only gets paid 15%. If you actually get paid, you also have real CPAs and CFOs available 24,7 with answers right in Slack. Not a response three months later. It's basically like having a full finance team on demand. 29:39 Julie Woon And Lucid isn't just for huge practices. It's designed to be affordable for practices at every stage. So if you're great at running your practice, but the money side isn't exactly your specialty. Check, check out Lucid at Lucid now that's L U C I D N O W. 29:57 Dr. Alexandria Yarborough One of the things that a lot of people also don't realize is when your doctor sends over a medication, it's always going to substitute for the generic if it's available, unless they specify otherwise. So even the doctors know that unless a certain patient has a certain allergy To a certain ingredient that is known in a generic, they're always going to write substitution permitted. So that way that's kind of the standard we're always going to put it in for a generic. 30:22 Melissa Schenkman Very, very interesting. That makes a lot of sense because I've always, I've wondered even on my own personal end when something is written and then I think I'm going to end up with the. Or they are telling me the brand name and then I go and get the generic. And then you don't realize until you look it up like a lot of people, because it's not like we're all walking around, you are, but the rest of us are not walking around knowing the brand name versus the generic name of the same drug. You look it up and you're like, oh, it's the same one. They just wrote me for the generic. So, yeah, so that's super interesting in talking about costs, right? And we think about, obviously generics, the cost is better. 30:58 Melissa Schenkman Cost is on the mind of so many people when it comes to getting their medications now. Not only because of a higher cost, what insurance will and will not cover, but also the fact that there are a lot of people in our generation who now work in a gig economy. They're either self employed or they're doing freelance contract work as well as many because of different shifts in the country and the economy, who have been in between jobs. And because health insurance has gotten so expensive, there have been periods of time where people have gone uninsured. And so I was wondering, if you're in that situation and you still need to be able to get access to medications, where can we get affordable prescriptions without having health insurance coverage? 31:40 Dr. Alexandria Yarborough So I would look up your medication on Goodrx because that's going to be your primary way to pay for your medication with a discount card if you're underinsured. And each pharmacy is going to have a different price. It makes no sense. I don't know the science behind it, but every pharmacy can have a price. So I would absolutely go to a preferred pharmacy and that actually goes for insurance as well. Sometimes you might be paying a higher price just because your insurance plan isn't preferred at that pharmacy. So if you don't have insurance, look and see which one is the most cost effective for you. It can be a substantial difference. You could go to Walmart and have a medication cost $30 and then at CVS it could be over 300. You just never know. 32:24 Dr. Alexandria Yarborough So you do have to unfortunately do your own research. But I would go to that pharmacy. And then a side note, wholesale clubs like BJ's, Sam's Club, Costco, places like that, their pharmacies are open to the public. So that there's that option. But yeah, so if you don't have insurance, look it up, go to that pharmacy, print out the discount card, make it easy for the pharmacy staff. But even if you are insured, make sure that the pharmacy that you're going to is preferred by your plan. It can change annually and that way you can get the best price because you might be paying more just because you're going to cvs. And it could be half the price at Walgreens, even with insurance, which is. 33:02 Melissa Schenkman Just incredible to hear when you think about it. And those are very helpful steps because yeah, we want to figure out how can we get that best price. And you would know the best because you've been doing this a long time and have seen so many different scenarios. And like you said, it's incredible. And I find this in recent years, things are changing every year now, like with a lot. And if you don't keep up, they'll get you with the prices. Incredibly far as different steps we can take because I'm wondering if we need to start even sooner before we get to you at the pharmacy. What are some steps to get that best price at the pharmacy? What are some steps that we should take starting from the doctor's office when we're getting prescribed something onward. Coming to you guys. 33:43 Dr. Alexandria Yarborough So I would make sure, if you're using insurance, make sure you have your most up to date information on hand. Most times we have an online account and we can download our insurance card, make sure your pharmacy has it as well. That's going to save a ton of time because sometimes if we get a medication come over and the insurance isn't working, it's just going to go in our resolution queue and we'll just deal with it later because we're trying to fill medications and do other things and it's just going to be pending waiting for that updated information. So that's the first thing. The second thing is if you get prescribed a new medication, look it up, see if it's a brand or generic. If it's a brand, absolutely. 34:21 Dr. Alexandria Yarborough Look and see if you can get a manufacturer coupon card and go ahead and do that. You have to sign up. It'll be sent to your email but you can download that and you can do it on your phone as well. And then the discount card, have that ready too. It makes it so easy for the pharmacy to go ahead and process your prescription to get you the best price if you're aware of those things. If it's a medication that you're not getting a lot of headway with, you can't find answer. You still don't understand if it's expensive or not. Call your insurance. I think a lot of people are afraid to call insurance. They do not care. They talk to people all day long. 34:54 Dr. Alexandria Yarborough I call them all the time and all you have to say is, hey, like I got prescribed this medication, how much is it going to cost? If it's super expensive, ask is it cheaper somewhere else? What can I do? Is there something the doctor can do to make it less expensive? You just talk to them like they're a person. You don't have to know about prior authorization, step therapies, all those things. They might not give you all the information, but if you just ask them a lot of times, you'll learn a lot. 35:22 Melissa Schenkman Oh absolutely. That's excellent advice and excellent steps for all of us to take to really get something at a cost we can afford and also to maintain our health in the process. So really appreciate that. And what should people know and keep in mind in addition to having that updated insurance when handing the prescription to their pharmacist and the pharmacy staff? When it comes to cost, so just. 35:49 Dr. Alexandria Yarborough Remember that it takes time to get all this accomplished and to give you the best price. So if you can try to drop it off and maybe pick it up later that day, or if you have a lot of questions about costs, try to catch them at a time where they're not so busy or just say like hey, by tomorrow do you think you can get me the best price on this? Because we're here to help you, we want to help you, but a lot of times our volume and our day to day activities don't give us enough time to do it right then and there. And that also goes for pet medications. I know we've been talking about medications for humans, but we can also help save you money on pet medications as well. 36:22 Dr. Alexandria Yarborough And we're happy to do it, but that's one of the biggest thing is to be patient, advocate for yourself, have all of your information ready to go and then just ask for help if you are so confused and don't know what's going on. Just be kind, be patient and we really will try our best to get you the best price. 36:39 Melissa Schenkman Thank you. No, that's incredibly helpful to hear. Incredibly. And something that each of us can do and have the ability and advocating for ourselves to do that. And as we wrap up this episode, which has been an amazing conversation, you've taught us so much as a pharmacist. What is your key takeaway for listeners when it comes to what we should know about and navigating, getting our prescription medications and working with our pharmacies to do that? 37:07 Dr. Alexandria Yarborough I think the biggest thing is to not worry about what you don't know. You're not expected to know what's a brand and what's a generic. But we have so many tools at our disposal that we can inform ourselves. It's just like shopping online for something that we've been looking for. There's Amazon prime deals and days and things like that. We do the research for things that we understand. You're not expected to understand how the medication works, the formulas behind it and how it gets so expensive, but you are expected to do a little bit of work on your end to advocate. So just come prepared, be patient. We are here for you. And if it doesn't work, there are other options too. There is not one medication for every disease state, so there might not be one that you immediately get. 37:53 Dr. Alexandria Yarborough We might have to order it, you might have to go back to the doctor. But just don't give up because if you need a medication for something and it's way too expensive, there are other options that are out there. Just give it some time and advocate for yourself. Awesome. 38:07 Melissa Schenkman Well, definitely we will be advocating with for ourselves using all of this newfound information that is incredibly helpful in taking these steps. And we're going to make sure we add things into the show notes on this for sure. Because these are just such helpful steps to know to make things both as a patient go more smoothly, but also for our pharmacist and the pharmacy team for sure. Well, thank you so much for taking the time to talk with us and to share your incredible wealth of expertise on what is like, as I say all the time, the most complex healthcare system it really, truly is. And getting medications I think in addition to other aspects of the healthcare system has become much more complex in recent years. And so having these insider tips really could make a difference. 38:56 Dr. Alexandria Yarborough Well, I'm happy to help. Anytime anyone wants to reach out with questions, I'm always here. But yeah, it's hard to navigate. And we're here to help you, the whole pharmacy team, so if we can, we will. 39:07 Melissa Schenkman Well, thank you so much. We greatly appreciate that. And I just want to remind everyone as we wrap up if you enjoyed listening today's episode and have learned new things, and I know there have been so many new things that we have learned. Please like and share the episode and also write us a review on whatever podcasting platform you are listening to us from. We greatly appreciate that here at why My Health, but thank you so much again, Dr. Alexandria Yarbrough, and we will see everybody next time. 39:38 Dr. Alexandria Yarborough Great. Thanks for having me. 39:39 Melissa Schenkman You're so welcome. 39:40 Julie Woon Thanks for tuning in today. The why My Health podcast. We hope you're leaving inspired and informed. 39:45 Melissa Schenkman Be sure to follow us on your favorite podcast platform so you never miss an episode and share why My Health with your friends. 39:51 Julie Woon Have a story to share or a question for us? Connect with us at ymyhealth on social media or visit our website@ymyhealth.com until next. 40:00 Melissa Schenkman Time, remember, your health journey starts with the right information. Stay healthy.