Pharmacogenomics pharmacogenetics image

by Leah Samera, PharmD Candidate, Class of 2018

As with most things, when it comes selecting a drug regimen for the treatment of chronic disease, one size does not fit all. If you take medications, you may have wondered why that is the case. One reason is because of pharmacogenomics.

Pharmacogenomics refers to “the entire spectrum of genes that interact to determine drug efficacy and safety.” In practice, many people may use the terms pharmacogenomics and pharmacogenetics interchangeably.

Pharmacogenetics, however, also refers to variants of one gene that affect drug response. The study of both pharmacogenomics and pharmacogenetics can help to optimize drug therapy and minimize drug toxicity based on an individual’s genetic profile.

What is a gene?

A gene is a series of codons that specify a particular protein. Genetic variation may result in altered protein sequence and function or in altered protein levels. This is significant, because these proteins can have an effect on how your body interacts with medications.

How do pharmacogenomic variations affect drug response?

The impact of pharmacogenomic variations on drug response have traditionally been divided into four categories:

  1. Those that affect drug pharmacokinetics. Pharmacokinetics refers to how a medication moves through a person’s body, i.e., how the drug is absorbed, distributed, metabolized, and eliminated.  An example of a genetic variation that affects pharmacokinetics is one in which drug metabolism is altered, subsequently affecting plasma concentration.
  2. Those that effect on pharmacodynamics. Pharmacodynamics refers to a person’s therapeutic response to a medication; this depends on a medication’s affinity and activity at its site of action. An example of a genetic variation that affects pharmacodynamics is one in which binding of a drug to its receptor is reduced, thereby decreasing therapeutic efficacy.
  3. Those that affect idiosyncratic reactions. An idiosyncratic reaction is an adverse reaction to a medication that is both rare and unpredictable. An example of a genetic variation that affects idiosyncratic reactions is one in which the likelihood of a hypersensitivity reaction to a certain drug is increased.
  4. Those that affect disease pathogenesis or severity and response to specific therapies. Pathogenesis refers to the origination and development of a disease. An example of a genetic variation that affects pathogenesis is a specific molecular defect related to the development of certain malignancies for which there are targeted therapies.

How can the study of pharmacogenomics help to optimize your drug therapy and minimize side effects?

Organizations like 23andMe allow people to “access, understand, and benefit” from the study of pharmacogenomics. With their simple home-based saliva collection kits, all you have to do is order their Health + Ancestry service; register, and spit into, the provided tube; and mail the kit back to their lab via the pre-paid package. Next, their lab extracts, processes, and analyzes the DNA from the cells in your saliva. Within 6 to 8 weeks, you get an email notifying you that you can view your results in your online account and discover what your DNA says about you. By sharing those results with your healthcare providers, they then can use that information to ensure that you get the most benefit from your medications while minimizing the risk of side effects.

References:

  1. Cavallari LH, Lam Y. Pharmacogenetics. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: A Pathophysiologic Approach, 10e New York, NY: McGraw-Hill; . http://accesspharmacy.mhmedical.com.ezproxy4.library.arizona.edu/content.aspx?bookid=1861&sectionid=146077703. Accessed September 12, 2017.
  2. Roden DM. Pharmacogenetics. In: Brunton LL, Knollmann BC, Hilal-Dandan R. eds. Goodman & Gilman’s: The Pharmacological Basis of Therapeutics, 13e New York, NY: McGraw-Hill; . http://accesspharmacy.mhmedical.com.ezproxy4.library.arizona.edu/content.aspx?bookid=2189&sectionid=167889559. Accessed September 12, 2017.
  3. Tantisira K, Weiss ST. Overview of pharmacogenomics. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 13, 2017.
  4. Our Mission. 23andMe.com. https://mediacenter.23andme.com. Accessed September 13, 2017.
  5. How it works. 23andMe.com. https://www.23andme.com/howitworks. Accessed September 13, 2017.
  6. Our science. 23andMe.com. https://www.23andme.com/genetic-science. Accessed September 13, 2017.

ScriptSave WellRx Prescription Savings & Wellness News

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Visit www.WellRx.com to compare prices at pharmacies near you.

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Beating high prescription costs - WJLA

by Lisa Fletcher, ABC7 News

Washington, DC (WJLA) – Millions of Americans with health insurance still pay out-of-pocket for medications. And the cost can reach hundreds or even thousands of dollars a year.

But what many drugmakers and pharmacies don’t want you to know is that you could lower your medication costs, sometimes by as much as ten-times, by simply walking across the street to a competing pharmacy.

On a recent fall morning, ABC7 News caught up with Poet Taylor, the host of a popular Washington, DC radio show. As she regaled her listeners with stories and witty banter, you wouldn’t have guessed she suffers from asthma. Her job and her well-being depend on her ability to control it.

“Asthma is a very serious, serious diagnosis,” said Taylor. “The wrong medication could result in me having an asthma attack and not being properly medicated.”

But Taylor, like millions of Americans, is in the center of a tug-of-war between insurance providers and drugmakers.

Big insurance companies threaten to take popular medications off their coverage list unless drugmakers reduce the price. It’s a multimillion dollar game of chicken and the drug companies don’t always flinch.

Taylor recalled a recent, surprising trip to her pharmacy. “I put in my normal refill. I’m feeling good. And I get a call from my pharmacy and the pharmacy is like, ‘nope, your insurance doesn’t cover that.’ Yes they do, I’ve been on it almost a year now. I know they do. They were like, ‘not anymore.’”

Taylor was forced to switch to another brand of inhaler that she and her doctor agree, doesn’t work as well for her asthma. Taylor says she feels like a pawn in the game of trying to force pharmaceutical companies to lower their costs.

“A company that would wager my life on, I don’t know what kind of extra money you get at the end of the year, it just reads loud and clear: We don’t really care about you. We care about the money that we make off of you,” said Taylor.

ABC7 News checked. If Taylor wanted the medication that works best for her she’d be out of pocket as much as $433.99 a month. We asked if that’s something she could afford.

“No,” said Taylor. “That would be the cost of my car insurance, my car payment and my phone bill.”

But what Taylor and millions of others like her didn’t know is that you can comparison shop for drugs just like you would a car, a bed, or the paper towels in your kitchen.

“The crazy thing we see every day is that same drug, same exact prescription, different pharmacy, much better price,” says Shawn Ohri. Ohri works for ScriptSave, a pharmacy benefits manager, or PBM.

There are about 30 PBM’s in the U.S. and they negotiate prices on prescriptions for their members.

Ohri says insured or not, everyone should comparison shop.

“Twenty-eight million people that we know are uninsured today, You’ve got 20 million people that are on high-deductible health plans in 2016 and that number’s growing year-over-year, and then you’ve got 10 to 20 percent of the people that have great coverage, but that particular drug that they’re using isn’t covered,” says Ohri.

One way to shop around is to call every pharmacy in your area. Another is to use an app.

Ohri’s company came up with an app called “WellRx.” There are a handful of others and each is likely to find different deals for you, depending on how they negotiate with the pharmaceutical companies.

Using the WellRx app, ABC7 News compiled the most popular prescriptions in DC, Maryland and Virginia and compared prices among the top 10 pharmacy retailers.

The antibiotic amoxicillin is the No. 1 most purchased drug in Maryland. It’s three and a half times more expensive at CVS than Walmart.

The high blood pressure medicine amlodipine besylate is one of the most popular prescriptions in Virginia. It’s nearly six-times more expensive at WalMart than it is at Kmart.

And in DC, the second most prescribed drug, sildenafil, used for high blood pressure in the lungs, or as a generic form of Viagra, is more than eleven-times more expensive at Walgreens than Costco…at $195.00 versus $17.60.

“It pays to shop around, even with these types of programs,” says Ohri.

And that’s something Taylor won’t soon forget as she tries to outmaneuver the insurance and drug companies.

“I’m a person who wants to live a healthy, happy life,” said Taylor. “I don’t know why you would want to stand in the way of that. And I would hope an extra thousand dollars, or extra million should not matter more than me living, me breathing, me being here.”

Remember that depending on what app you’re using, the prices can vary – sometimes by a lot.

See the original story on the WJLA website.


Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.
If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

 

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Anxiety medications and children photo

by Jenny Bingham, PharmD

Across the United States, the rate of antidepressant use in children is rising. It has led to prescription costs exceeding $100,000 in the four states with the highest antidepressant prescription rates for children: Colorado, Florida, Pennsylvania, and Texas.

As the number of antidepressant prescriptions rise, it’s only natural that parents will have a growing number of questions about those medications. Here’s a list of common questions other parents have had when starting pharmacotherapy for their child’s anxiety and/or depression:

How many pills will my child have to take?

The simplest answer is, it depends. Pharmacists are trained to know FDA approved indications for mental health medications. By incorporating pharmacists into the healthcare team, they can help find medications that have dual purposes and decrease the amount of pills in the regimen. Talk to your pharmacist about the medications and if there are alternatives.

How will pharmacotherapy affect my child?

Each patient responds differently to medications. Whereas some patients that are prescribed a common first-line antidepressant (fluoxetine) and tolerate it well, others may have an entirely different reaction. Certain medications can have negative side effects, including:

  • shaking
  • drowsiness
  • weight gain
  • insomnia
  • dizziness
  • dry mouth
  • blurred vision
  • bleeding, and,
  • constipation.

These side effects can be extremely detrimental to a child’s quality of life. It’s important to have open communication with your healthcare provider to ensure that side effects don’t get in the way of medication adherence, school performance, or self-esteem. Current literature provides clinicians a wide variety of information about which side effects are more prominently reported in individual cases. This database of knowledge helps further individualize therapy and avoid potential side effects.

What risks are associated with pharmacotherapy?

Parents should be aware of the potential for abuse, especially with commonly prescribed anxiety medications (ex. alprazolam) that are rated as controlled substances.

Adolescents are at an increased risk of suicidal ideation when initiating certain medications. Family members must be educated on how to monitor, identify, and report these to the provider.

One must also consider the risks of not seeking appropriate treatment, like self-medication with illicit drugs, tobacco, and alcohol. Self-medication can unfavorable effects on one’s mental and physical health.

Are there alternatives to pharmacotherapy?

If a parent decides against using medications, trained therapists can provide alternative options, if appropriate. Cognitive behavioral therapy is a common tool that incorporates education, relaxation exercises, coping skills, stress management, and assertiveness training.1

Other approaches include: interpersonal therapy, motivational interviewing, dialectical behavior therapy, supportive therapy, and family therapy. These tools can also be used in combination with medication to improve depression and anxiety. Parents should work closely with their physician to determine if this is a safe option as monotherapy.

Final Thoughts

Decisions about using medications to treat anxiety and/or depression in children must be catered specifically to the patient. It is imperative for health care providers to approach this sensitive topic as a group, including the patient and parents. Pharmacists are a great resource for optimizing medication effectiveness and reducing pill burden.

References:

  1. Beck JS. Cognitive Behavior Therapy: Basics and Beyond, 2nd ed, Guilford Press, New York 2011. p.391.

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

 

 

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Dry eye treatment eye drops

by Kali Schweitzer, PharmD candidate 2018
University of Arizona College of Pharmacy

For many people, dry eyes may only be a minor inconvenience. But for those who experience chronic dry eye, it can be a major problem, causing extreme discomfort. Left untreated, dry eye can have long term effects on your vision as well as your quality of life.

What causes dry eyes?

Dry eye occurs when you do not produce enough tears or if you are not producing quality tears.  As a result, there is not enough lubrication for the eye, leading to the gritty, burning, and irritated feeling that is most often associated with this condition.  There are a variety of things that may cause dry eye, including:

  1. Dry climate
  2. Wind
  3. Exposure to smoke
  4. Age
  5. Gender
  6. Certain medications and medical conditions.

For some, dry eye may be unavoidable, which is when finding an effective treatment that is not too costly becomes very important. In fact, one study found that the average direct cost for a patient seeking medical care for dry eye was $738 per year, and the cost to society per patient per year was over $11,000. So, the question is, what are your options if you are one of the millions of people in the United States who suffer from this condition?

Over-the-counter treatment for dry eyes

The key to managing dry eye symptoms and avoiding spending a fortune on prescriptions is to take advantage of the various over-the-counter options available.

The most popular over-the-counter treatment for dry eye is artificial tears, which help to lubricate the eye when you do not have enough tears of your own. There are many different varieties of artificial tears in the pharmacy aisle, and the most important distinction between them is that some are preservative-free while others are not. The preservative-free options tend to be more costly, but they are better for those who have more chronic symptoms because they are less likely to irritate the eyes following frequent use.

Another option that is available without a prescription is an omega-3 fatty acid supplement, which helps to increase tear production. Depending on what your doctor determines to be the cause of your dry eyes, they may have other recommendations for you that do not require a prescription for dry eyes.

Home treatment for dry eyes

In addition to over-the-counter medications, there are a number of other things you can try to prevent and/or reduce the symptoms of dry eyes. Some suggestions include blinking regularly, wearing sunglasses outside to protect your eyes, and drinking more water. If eyelid inflammation contributes to your dry eye symptoms, you may consider gently washing your eyelids, which can be done using a mild soap. Applying a warm compress over your eyes may also provide relief.

When do you need a prescription for dry eyes?

If prescription treatment does become a necessity, your doctor will discuss the different options with you. The ones most commonly used are Restasis (cyclosporine), which reduces inflammation, and Xiidra (lifitegrast), which helps you make more, quality tears. Another option is Lacrisert (hydroxypropyl cellulose), which is inserted between the eyeball and lower eyelid and slowly dissolves to release a lubricating substance. For now, these are only available as brand name medications, therefore price may be a barrier depending on your insurance coverage.

Finding the right dry eye treatment

Whether you seldom experience dry eyes or if you have constant symptoms, finding the right treatment is crucial. Dry eye can be irritating, costly, and even life-altering if not controlled. By working with your doctor, your pharmacist, your insurance company, and even prescription savings companies like ScriptSave, you will be in a better position to control your symptoms and save some money in the process.

References:

  1. Yu J, Asche C, Fairchild C. The Economic Burden of Dry Eye Disease in the United States: A Decision Tree Analysis. 2011 April. 30(4):379-387.
  2. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/dry-eye?sso=y
  3. http://www.mayoclinic.org/diseases-conditions/dry-eyes/basics/lifestyle-home-remedies/con-20024129
  4. Micromedex

 

 

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Pharmacist help manage epilepsy drugs

by Jenny Bingham, PharmD

Choosing the correct medication to treat epilepsy is a multifaceted process. Pharmacists can have a huge impact on the patient’s therapeutic response as a valued member of the healthcare team. 1

Medications used to treat seizures are called anti-epileptic drugs. Pharmacists review reams of information to ensure medication safety and suitability. The three primary concepts involved in this evaluation include:

  1. Pharmacogenetics – the role of genetic differences on an individual’s response to a drug.
  2. Pharmacokinetics – how a drug moves through the body.
  3. Pharmacodynamics – an individual’s therapeutic response to a drug.

It is important to assess for drug interactions

When medications interact with one another it is called a drug-drug interaction. Medications can enhance the effects of another drug (agonize). They can also block the effects of another drug (antagonize).

Monitoring for kidney or liver function

Medications are either metabolized in the liver or kidneys. If an individual has impaired organ function or damage, it changes how the body responds to that drug. Some medications, like Carbamazepine and Phenytoin may have more of an impact than Gabapentin.

Medications that are metabolized in the liver have an affinity for certain enzymes:

  • If a medication induces a particular enzyme, it can increase the body’s metabolism of it. The result is decreased serum concentration levels, or decreased effects.
  • If a medication inhibits, it can decrease the body’s metabolism of it. The result is an increased serum concentration level. Individuals might experience increased side effects when this happens.

What to expect for the duration of treatment

The goals of treating seizures are:

  1. Improve the patients quality of life; and,
  2. Decrease seizure frequency.

An individual’s type of seizure and previous medical history dictate how long they must take anti-epileptic drug. Patients should only make changes to their medication as directed by their provider.

In general, there is no one size fits all approach to treating seizures. However, pharmacists can prevent medication-related issues by performing a comprehensive safety evaluation as a member of the healthcare team.

References:

  1. Koshy S. Role of pharmacists in the management of patients with epilepsy. Int J Pharm Pract. 2012 Feb; 20 (1):65-8.
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noacs - warfarin alternatives

by Kali Schweitzer, PharmD candidate 2018
University of Arizona College of Pharmacy

Not so long ago, a diagnosis of atrial fibrillation (AFib), deep vein thrombosis (DVT), or pulmonary embolism (PE) meant that a prescription for the blood thinner, warfarin (Coumadin), was likely coming your way. In recent years, multiple other blood thinners have become available, and you may have wondered if any of them could be right for you.

What are NOACs?

The NOACs, or novel oral anticoagulants, are a new breed of blood thinner that have arrived on the market within the last ten years. This class of medications includes:

How are NOACs Different from Warfarin?

Multiple clinical trials comparing these alternative warfarin medications have all shown that the NOACs are just as effective as warfarin, and that they have a similar (or lower) risk of bleeding. Warfarin has been around for decades and has been proven to be both safe and effective at preventing blood clots, but it’s no secret that it has its problems. Here are some key differences to note when comparing the newer anticoagulants with warfarin and when deciding what is right for you:

  1. Warfarin requires frequent trips to the lab to have your INR (international normalized ratio) checked. Also referred to as PT time, Prothrombin time is a blood test that measures how long it takes blood to clot, or how well the medication is working. You may potentially need to change your dose to increase or decrease the clotting time. NOACs do not require lab monitoring or frequent dose changes.
  2. NOACs do not have the high potential to interact with food or other medications like warfarin does, meaning there are fewer restrictions. This means no more worrying about how much salad you can eat on a day-to-day basis, or if you are allowed to have that glass of grapefruit juice in the morning. It is still recommended, however, to check with your doctor or pharmacist before starting any new medications, as there are still some medications that may increase your risk of bleeding when taken with the NOACs.
  3. NOACs begin working quickly, while warfarin may take up to a week to start working. Because of this, patients with a DVT or PE starting warfarin may require “bridge” therapy with heparin or enoxaparin (other fast acting blood thinners) to prevent clots while waiting for the warfarin to take effect. This “bridge” therapy is not necessary with the NOACs.
  4. Unlike warfarin, not all of the NOACs have a reliable reversal agent if you were to begin bleeding. With warfarin, if your INR becomes too high or if you are having signs of bleeding, you may be given vitamin K, or phytonadione, to reverse its effects. Currently, Pradaxa is the only NOAC that has an approved reversal agent, called Praxbind (idarucizumab). While bleeding is rare while on the NOACs, the lack of reversal agent is something to keep in mind when deciding which medication may be right for you.
  5. NOACs may not be appropriate if you have decreased kidney and/or liver function. Your doctor will review your labs and information to determine if your kidneys/liver are functioning well enough for you to take one of these medications.

The recent approval of the NOACs has provided prescribers and patients with more options to choose from when a blood thinner is necessary. Because these medications are still relatively new, there is a lot left to learn about their use and limitations, so they may not be appropriate for everyone. It is always important to discuss any questions or concerns with your doctor when starting any of these medications or when switching from one to another.

 

References

Leung LLK, Direct oral anticoagulants and parenteral direct thrombin inhibitors: Dosing and adverse effects. In: UpToDate, Mannucci PM (Ed.), UpToDate, Waltham, MA.

Hanley CM, Kowey PR. Are the novel anticoagulants better than warfarin for patients with atrial fibrillation? Journal of Thoracic Disease. 2015;7(2):165-171. doi:10.3978/j.issn.2072-1439.2015.01.23.


Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

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Always ask the cash price - you could save on your prescriptions

The “he said/she said” of Rx pricing tools

If you’ve ever used a prescription price-check tool for an Rx savings program (like ScriptSave WellRx), only to have been told a different price when the time came to collect & pay for the prescription at the pharmacy, then the next few paragraphs are for you.

Regardless of the product or service, it’s an infuriating thing to be quoted one price online, but to then be confronted with a different reality at the store (unless, of course, the price comes down – then we love it).

What can be done to avoid bad price-quotes?

For patients using prescription savings programs, there are a few steps that can be taken to help reduce the potential for errors with an Rx price-check tool.

In short, there are some very important things to keep in mind when doing a price look-up with a prescription discount card and overlooking any single one of them has the potential to make a mess of things.

In no particular order, at ScriptSave WellRx we always recommend that our members keep the following pointers in mind:

    • Potential Problem #1
      Prescription prices can be volatile and it’s not uncommon to find regular (even daily) price changes across pharmacies in any given zip code.
    • Recommendation
      When using a price-check tool or mobile app to review the lowest prescription prices in your zip code, be sure to perform one final look-up on the same day that you end up collecting & paying for your script. As frustrating as it might be to discover that prices changed for your medication overnight, it’s far less frustrating to realize this before you leave home. Especially if you also discover that the same medication actually came down in price at a different pharmacy nearby (perhaps even giving you the opportunity to make arrangements to transfer the prescription).

     

    • Potential Problem #2
      Prescription medications come in many different strengths, forms, quantities, etc. There’s also the matter of brands & generics. However, a price-check tool for a prescriptions savings card like ScriptSave WellRx has to start somewhere – and the default settings on the website will generally only return pricing results for one very specific version of each medication. For example, perhaps the price-check tool will show results for the most commonly filled strength, quantity, form and manufacturer of the medication that you’re searching for.
    • Recommendation
      When the results of your price-check are returned by the website or mobile app, ALWAYS take a few minutes to review the details against the details on your prescription … and make the necessary manual changes (if any are needed) using the drop-down menus that determine the drug’s Strength, Quantity, Form, Brand/Generic, etc. (see Fig.1)

     

    FIGURE 1
    ask cash price filter - results image

    • Potential Problem #3
      Your pharmacist does not recognize or is not familiar with your prescription savings card.
    • Recommendation
      If you’re using the ScriptSave WellRx card or mobile app, you can be confident that if your pharmacy showed up in our price-check tool, it’s more than likely that we have a contract with them to accept your savings card. We do our best to keep our database up-to-date so as not to send members on a wild goose chase. Perhaps the best way to approach using a ScriptSave WellRx card is to do so with confidence. Although this program is NOT insurance, an Rx savings card includes the same pharmacy processing information that pharmacists see & use every day on all the different insurance cards they deal with. That being case, simply hand your ScriptSave WellRx card to the pharmacist, point to where the card shows the Rx BIN, Rx PCN, etc. and ask,
    “Would you please process my prescription using these details and let me know what my out-of-pocket cost will be?”

     

    If you’re absolutely sure that you’ve taken care of these 3 common issues and yet you’re still facing prices at the pharmacy that are higher than the quotes being shown on the ScriptSave WellRx website/app, there’s one more thing to double-check…

     

    • Potential Problem #4
      Your pharmacist used a different discount card.
    • Recommendation
      There are a number of reasons why this might have happened – and it can certainly be the result of an easy & honest mistake. For example, the ScriptSave WellRx card includes a set of codes that the pharmacist must enter into the computer before being able to tell you the price of your medication. If you look at your ScriptSave WellRx savings card or coupon, you’ll see where it says “RxBIN: 006053” (together with RxPCN, Group # and ID #). Similar codes also appear on insurance cards and they work in the same way.
       
      As with insurance, if you visit the same pharmacy each time, your name, address, DoB, etc. are saved on file for speed & convenience. As part of your saved pharmacy record, the pharmacy also stores a record of any insurance card or Rx Savings program that has been used in the past. Therefore, if you’ve used a different savings card but have since discovered more favorable pricing with ScriptSave WellRx, it’s very possible that the pharmacist simply assumed that your stored details were the same as the details on the WellRx card that you just handed him/her. Also keep in mind that no pharmacist ever wants a patient not to be able to afford their physician-prescribed medications. As such, they’re often on the lookout for ways to help their patients afford their meds (even if the patient doesn’t realize it). Therefore, even if you think you’ve never used another prescription savings card in your life before, it’s certainly not unheard of for a pharmacist to have used one on your behalf because he or she knew that it would save you some money and help you out. If that’s the case, the details pertaining to the RxBIN, RxPCN, etc. from that other card may very well be saved to your profile. This would explain why you’re receiving a discount … but not at the level that was indicated on the ScriptSave WellRx website.
       
      Take a few minutes to familiarize yourself with your savings card and next time you think you might be in this situation, politely ask the pharmacist,
    “Is there any chance you can double-check the processing details, please? Can we just be sure that we’re using the ScriptSave WellRx details as shown here on this card/coupon/app, because I was quoted a slightly lower price earlier this morning, and I’m sure it was for the same strength & quantity that’s on this prescription?”

    U.S. Based Call Center Support

    Another useful hint to keep in mind is that all ScriptSave WellRx members are serviced by a toll-free customer support number (staffed by real people right here in the U.S.). If you ever have a problem, you can call the support line toll-free at 1-800-407-8156, Monday through Friday, from 9am to 8pm EST, and our friendly staff will be glad to help get to the bottom of any issues. Given the real-time need that many patients face with filling their prescriptions, if you’ve had issues at a particular pharmacy in the past, it might be helpful to call our support staff ahead of your next visit to fill your prescription. If necessary, our staff may be able to call your pharmacy on your behalf – ahead of your visit – so that everything is smoothed out before you arrive to pick-up and pay.

    Final Thought – Love your Pharmacist (and Always Ask the Cash Price)

    Please always keep in mind that pharmacists have a LOT going on and they can be incredibly busy. Although they can make it look simple at times, that’s generally a reflection of their professionalism & experience, and their role in a patient’s healthcare is not to be underestimated. Pharmacists are a truly valuable resource and they juggle a lot of different tasks. If you meet a pharmacist who looks at your prescription savings card and doesn’t immediately recognize it, don’t be surprised. We can’t expect every pharmacist, at every pharmacy, to recognize and remember every single savings card and insurance program that they have a contract with. More often than not, if you ask your pharmacist (politely) to try processing your prescription using the details on the card, they will be happy to give it a try. If that doesn’t work, and if you’re using a card from ScriptSave, you have a tollfree support number to call for assistance.

    As for “Always Ask the Cash Price” … that’s a must-do for patients who don’t want to over-pay (especially for those WITH prescription insurance). For more insights on this, read our blog post on why you should Always Ask the Cash Price.


    Download the free WellRx app from the iOS app store or the Google Play Store,
    and get registered to take advantage of our free medication adherence tools.

    If you’re struggling to afford your medications,
    visit www.WellRx.com to compare the cash price at pharmacies near you.
    You may find prices lower than your insurance co-pay!

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WNCT9 prescription savings story

GREENVILLE N.C. (WNCT) – Pharmacy prices can differ from store to store and should be treated like buying a car.

Most people think of just going to the pharmacy closest to them instead of looking around for their medication.

When in reality, it can differ by sometimes a significant amount.

There are different ways that you can go about finding these prices.

Certain apps will bring up every pharmacy within a number of miles of your current location.

From there, you type in the medication that you’re looking for and all of the prices will come up right in front of you.

A creator of one of those apps says he looks for the cheapest prices for everything else – so why not do it for our medication.

“Any pharmacies have an in store savings program for low cost drugs,” said Shawn Ohri, creator of ScriptSave WellRx. “But it doesn’t mean all drugs are low cost at that pharmacy, they’re bringing in a good number of prescriptions at a low cost but there may be others that don’t have a low cost.”

You can find apps like this in the Apple Store or the Google Play Store.

Some are free and others require a subscription.

9 On Your Side looked up some of the top medications used in Greenville and found a difference of almost $30 in some of the different locations, showing it really does work to look before you shop.

Top 10 Drugs (non-controls)  Greenville, NC
Reporting Period: Jan 2017 – June 2017
Date Prepared: 07/27/2017
Rank Drug     Lowest Pharmacy
1 AMLODIPINE BESYLATE     Harris Teeter Pharmacy
2 Generic form of Norvasc (High blood pressure, chest pain)

ATORVASTATIN CALCIUM

    Hometown Discount Pharmacy of Greenville
3 Generic form of Lipitor (High Cholesterol)

HYDROCHLOROTHIAZIDE

    Harris Teeter Pharmacy
4 Waterpill/Diuretic (High blood pressure and fluid retention)

METOPROLOL SUCCINATE

    Rite Aid Pharmacy
5 Generic form of Toprol (High blood pressure, chest pain, and heart failure)

GABAPENTIN

    Rite Aid Pharmacy
6 Generic form of Neurontin (Nerve pain medication – very common)

METOPROLOL TARTRATE

    Walmart Pharmacy
7 Generic form of Lopressor (High blood pressure, chest pain, and heart failure)

LEVOTHYROXINE SODIUM

    Walmart Pharmacy
8 Generic form of Synthroid (Thyroid hormone)

SERTRALINE HCL

    Harris Teeter Pharmacy
9 Generic form of Zoloft (Anxiety/Deperession)

LISINOPRIL

    Harris Teeter Pharmacy
10 Very common heart failure / high blood pressure medication.

PREDNISONE  Steroid used for inflammation.

    Walmart Pharmacy
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Emergency Preparedness - medications, ScriptSave WellRx

by Leah Samera
University of Arizona College of Pharmacy
PharmD Candidate, Class of 2018

Ready, a public service campaign designed to educate and empower citizens to prepare for emergencies such as natural and man-made disasters, proclaims September to be National Preparedness Month (NPM). In the aftermath of Hurricane Harvey and in anticipation of Hurricane Irma, you may be wondering how to go about preparing for such events. This is especially important to consider if you have a chronic disease or condition.

Illness Follows Disaster

Studies have found that upwards of 70% of the Hurricane Katrina survivors had at least one chronic condition. Additionally, 58% of the visits to emergency treatment facilities in New Orleans after Hurricane Katrina were due to illness, 24% of which were associated with chronic diseases. The research on disasters’ effects on chronically ill patients only serves to reinforce the fact that these emergency situations can lead to both exacerbation and death from chronic illnesses due to direct stress of the disaster, interruption of care, or both.

Emergency Plans and Kits

Organizations like the American Red Cross recommend having an emergency plan and kit prepared for use during a disaster. Some obvious items that should be included in such a kit are water, food, and first aid supplies. However, it is also critical that you have a 7-day supply of your medications on hand as well as any other tools or devices used for your health such as hearing aids with extra batteries, syringes, blood pressure cuffs, et cetera. In order to have at least a 7-day supply of your medications, you must order refills of your prescription medications as soon as you are able rather than before you run out. It is best to keep these items together and in a location that is easy to get to in an emergency.

Planning Ahead

Medications should be stored away from heat, light, and moisture; if possible, keep them in their original bottles and store the bottles in a waterproof bag or container. If you have medications such as insulin that need refrigeration, have a freezer pack and cooler available. It is also important to stay up-to-date on all immunizations, including tetanus, especially if you have diabetes. Additionally, because the stress of these disasters can exacerbate your conditions, it is best to also make appropriate lifestyle changes such as restricting salt intake if you have high blood pressure or learning the carbohydrate counting approach if you have diabetes.

Other Handy Emergency Items

Other items that you should have handy in case of an emergency include any over-the-counter medications you may need like pain relievers, as well as your medication list and insurance card. It is important to keep an up-to-date medication list that not only catalogs the names of your current medications but also their strengths, indications, directions, and prescribers; any bad or allergic reactions you may have had to medications in the past should also be documented. Your prescription benefit card may be needed for approval of an emergency supply if you run out of or lose your medications, or if your medications get damaged or contaminated.

In the event that you end up requiring medications and health resources:

  • RxOpen.org maps open and closed pharmacies, American Red Cross shelters, and infusion centers in areas affected by disasters.
  • The charity Direct Relief provides free prescription drugs and medical supplies to low-income patients at community health centers or clinics.
  • Keep a list of nearby pharmacies and hospitals as well as their phone numbers.

By doing what you can to prepare for disasters, you can lower your risk of exacerbations of your health conditions. As the theme for NPM states: “Disasters Don’t Plan Ahead. You Can.”

References:

  • National Preparedness Month. https://www.ready.gov/september. Accessed September 7, 2017.
  • Kessler RC, Hurricane Katrina Community Advisory Group Hurricane Katrina’s impact on the care of survivors with chronic medical conditions. J Gen Intern Med. 2007;22(9):1225–1230. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219784. Accessed September 8, 2017.
  • Sharma AJ, Weiss EC, Young SL, et al. Chronic disease and related conditions at emergency treatment facilities in the New Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2(1):27–32. https://www.ncbi.nlm.nih.gov/pubmed/18388655. Accessed September 8, 2017.
  • Be Prepared for an Emergency. Be Red Cross Ready! http://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit. Accessed September 7, 2017.
  • Emergency Preparedness for Prescription Medications. http://www.mayo.edu/pmts/mc6000-mc6099/mc6012-39.pdf. Published 2016. Accessed September 7, 2017.

Are you concerned Hurricane Irma
may impact your prescription refills?
The State Law may be on your side; early refills are permissible.

For medications not covered by insurance,
the ScriptSave® WellRx program is here to help.

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Savings card vs. savings coupon image scriptsave wellrx

What’s in a name and why does it matter?

Although many patients tend to think of the ScriptSave WellRx program as a coupon for their meds, your free prescription savings card is actually a lot more powerful.

In addition to the obvious differences, like the fact that you would normally only get to use a regular coupon for one transaction (related to just one very specific product, as stated on the face of the coupon), there are some additional and very important features that make for big differences between an Rx discount card (like ScriptSave WellRx) and a coupon.

Here are a couple of important things to keep in mind. Understanding these differences will also help to explain why an insurance provider can’t allow you use the ScriptSave discount in addition to their own reduced rates, or why a pharmaceutical manufacturer won’t allow you to apply their copay savings program together with our low prices.

  • A regular coupon works by lowering the end-price of a product, cutting it by the exact amount shown on the coupon. The coupon has a fixed value, and the retailer will subtract that fixed value from the current sales price. For example, the regular coupon might say, “Take $5 off the price of XYZ.” When this happens, the savvy consumer might decide to shop around in order to find the store that sells this product for the very lowest price…THEN s/he will receive an additional $5 off that lowest price upon surrendering the coupon.
  • In contrast, what we do with the ScriptSave WellRx program is to negotiate lower final costs for each specific medication. We don’t negotiate a fixed coupon value. Instead, we negotiate a final discounted price. This is a subtle but important difference. With our program we’re saying, “We can get you a specific medication for a negotiated final price of $X.” This being the case, if the patient can find a pharmacy that will fill their prescription for a final out-of-pocket cost that’s lower than our negotiated price (perhaps as a result of the drug being on a low copay list with their insurer), they may not want to use their Rx discount card for that particular medication. Meanwhile, the same patient may have a second prescription that’s not covered by insurance and where the ScriptSave out-of-pocket cost is the lowest discounted price available…in which case one script gets filled with ScriptSave and the other does not.

Can it be used with insurance, Medicare, Medicaid, etc.?

Here’s another example to help illustrate. We’ll start by laying out three basic pricing options for filling a prescription at a given pharmacy…

  1. An insurance policy (including Medicare and Medicaid) includes a list of drugs (known as the Formulary) for which covered patients will pay a predetermined negotiated rate.
  2. Similar to the prescription drug formulary at an insurance company, the contracts that ScriptSave has negotiated with its pharmacy partners also result in pre-determined out-of-pocket costs. These rates are available to ANY patient who chooses to pay cash.
  3. At the same time, a generic drug list at a retail pharmacy shows the final prices for certain drugs at that pharmacy.

Of the three pricing options listed above, a patient is free to choose the price that makes the most sense for each of the prescriptions they are filling. However, this is a one-or-other choice. There’s simply no way to “stack/combine” the savings from an insurance payer together with the savings from a cash discount card, because the prices being offered under each option are contractually agreed and final.

Another way to put this is to say that, in the world of a regular coupon, the value of the coupon is always the same no matter which store it gets redeemed it at. Therefore, the final out-of-pocket cost for any product that has a coupon will vary based on how much the store is selling the product for in the first place. Meanwhile, an Rx savings card like the ScriptSave WellRx card will deliver a fixed final out-of-pocket cost (and so it’s the value of the discount that changes with every prescription being filled, relative to the original cash price for the drug in question).

In short, prescription savings programs are NOT coupons. While it might be easy to think of them in this way (and you may even hear us refer to them as such), it’s important to keep the differences in mind. Furthermore, you’ll want to choose your savings program based on its reputation and relationship with pharmacies … because it’s these relationships that matter when it comes time for the pharmacist to honor the savings card or mobile app.

As part of the Medical Security Card Company and ScriptSave suite of pharmacy programs, the ScriptSave WellRx program boasts well over 20 years (founded in 1994) of history and relationships with our pharmacy partners. We believe this helps make ScriptSave WellRx second-to-none.


Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.
If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!