Americans may be surprised to learn that they could be paying more for their medications with their insurance copay instead of the cash price available to those without insurance. A study published last week found that Pharmacy Benefit Managers (PBMs) undermine claims that negotiated “rebates” with pharmaceutical companies are passed on to consumers. This follows a federal lawsuit filed over the summer after a California woman paid a $164 copay on a medication that can be purchased for $92 from the same pharmacy by anyone not using insurance. This practice is known as “clawback” and is instituted by PBMs who then receive the excess payments from the pharmacy.

Pharmacy Benefit Managers are being found to frequently charge a copay that exceeds a medication’s cash price for generic drugs. Moreover, pharmacists around the country are not allowed to disclose the price discrepancy to patients due to “gag clauses” in their contracts that forbid them

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Medication prices continue to be a major concern for many Americans.  Recent months have seen a deluge of stories of drugs with $100,000+ price tags.  A 2015 poll found that a third of patients saw a price increase in their medications last year.  The problem is that these price increases have different causes, making it difficult to solve all the issues.

With advances in science we have seen development of new, highly successful drugs sometimes costing as much as $1000 per pill.  These prices are often seen as justified when researchers look at the benefits of a curative versus the potential long-term cost of living with a condition and less effective treatments.  This is frequently called “value pricing.” The companies that develop these drugs reap profits for the medications patent life (typically 7-12 years) until generic medications are able to enter the market at more affordable prices. The question that remains is whether these exceedingly high prices and several years of wait are worth some patients not being able to afford a medication that could cure them.

The problems of expensive effective brand-name drugs

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Earlier this year, we announced a project we would be releasing in 2015. After months of work and research, we are now offering information on discount generic medications. These $4 Generic Discount Drug Programs offer 30- or 90-day supplies of prescribed generic medications for prices as low as $4-$15. With over 120 of these programs nationwide, this is the first time information for them is searchable and available in one place.

Using the new resource, one can search for prices for thousands of generic medications as well as programs in their area or national pharmacies such as Walmart, CVS, and Walgreens along with local and regional pharmacies. “Our goal at NeedyMeds is to provide all the purchasing options so individuals can find the best price for their medicines,” said Dr. Richard Sagall, president and co-founder of NeedyMeds. “This information complements our data on patient assistance programs, coupons, copay assistance programs and rebates.”

Part of NeedyMeds’ mission statement has always been to help people facing problems paying for medications and health care.  With the new information available on

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NeedyMeds has always been a leading resource for information on patient assistance programs to help cover the costs of brand name drugs. There are hundreds of programs providing free or low-cost brand name medication, but there is yet to be an assistance program to help with the cost of expensive generic drugs. It is a common misconception that generic medications are all inexpensive. The truth is that there are many that cost hundreds of dollars per year, and are essential to the health of many people. With the help of Rx Outreach, the largest non-profit pharmacy in the country, NeedyMeds is launching a first-of-its-kind generic medication assistance program, called GAP (Generic Assistance Program).

The Generic Assistance Program will offer nearly 20 generic medications at no cost to people who meet program eligibility guidelines. The guidelines include:

  • Must have no prescription coverage for needed medication
  • At or below 100% Federal Poverty Level
  • Must be US citizen, legal entrant, or have a work visa

NeedyMeds and Rx Outreach provided the initial funding for the program and have launched a crowdfunding campaign on

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