Six Ways to Save Money on Prescriptions

What if paying less for your prescriptions was not just possible, but predictable? Speaking of Women's Health Podcast host Dr. Holly Thacker walks us through a clear, six-step playbook to cut medication costs without cutting corners, drawing on years of women’s health practice, patient stories, and the latest programs reshaping access and pricing.

Dr. Thacker shares how to use discount cards and price comparison sites to uncover true cash prices in your zip code, when to skip insurance at the counter, and how 30- versus 90-day fills change your bottom line. She highlights new manufacturer pathways—direct discounts, MFN-priced listings, and printable coupons—that bring branded therapies back within reach, plus practical tips for navigating supply hiccups and keeping a smart buffer on hand.

Throughout, Dr. Thacker keeps two goals in view: better health and a saner budget. You’ll leave with a checklist you can act on today—compare prices, verify manufacturer offers, coordinate with your insurer, optimize dose, and diversify sourcing—plus long-term moves like using an HSA and scheduling preventive care to avoid last-minute spikes. If this helped you save, subscribe, leave a quick review, and share the episode with someone who needs a lower bill at the pharmacy. Your voice helps more women be strong, be healthy, and be in charge.

Transcript

Welcome & Why Costs Matter

Dr. \ 0:15

Welcome to the Speaking of Women's Health podcast. I'm your host, Dr. Holly Thacker, and I am back in the Sunflower House. I am the executive director of Speaking of Women's Health, and I am your host, and we're in season four, and we're going to talk about a really very important topic. And it becomes more and more important, particularly if finances are tight, as you get older, as insurance coverage may change. And that's the topic on how to save money on medicine. So we have had several columns over the years on speaking of women's health.com updated with tips from several of our nurses who talk with patients, who do prior authorizations, who handle my chart messages about medications. And we update this periodically. And if you haven't bookmarked our website, speaking at woman's health.com, then you're missing out on some free empowering, non-branded health information. And even if you've uh been on our site and thought that you already know the information on the topic, we are continuously updating. We have information on breaking health news, we have free treatment guidebooks, we have health calculators and tools, we have a search feature for this podcast. Because if you're in your podcast app listening to this, you can't search for different topics inside the podcast app. But if you go on our website under podcast and you're looking for a specific topic, say such as medications or cost of medicines or sleep or anything on nutrition or exercise or longevity, any topics you're interested in that you want to listen to in a podcast, or if you want to watch on YouTube or Rumble, Speaking of Women's Health is our channel, you can do that in the search feature. Now, if you're on the website or on the mobile version, it's the upper right hand corner, the little magnifying glass to search for everything on the site. Now, when I recorded the first podcast on saving money on medicines in season one, that was in 2023. And I just had had my third grandchild then. Now it's 2026, and I'm expecting my sixth grandchild. I'm so excited. And um, sixth is kind of a special number because we're going to talk about six big ways that you can save money on medicine. I wanted to remind uh our listeners that if you like getting a monthly email from speaking of women's health, you can go on our website and sign up for the free newsletter. We have links to health information on Cleveland Clinic Health Essentials. And uh we have a lot of different topics that are of interest to women. So if you haven't done that, uh you might want to do that. Um, although some people don't like to get their inbox um all clogged up when I see patients. Well, usually our nurse helps them uh put the bookmark to speaking of women's health on on their phone. Uh, but sometimes I'll actually go and say, well, open up your podcast app to speaking of women's health and hit follow. It's free. Or if I want to get them to the article on how to save money on medicines, I have them put in the word money to do the search. And the reason I do that, and then I have them text that article to themselves is because there's several embedded links in this article that take you right to the sites. And like I said, we update them regularly. We find out information. Sometimes our patients give us information. Certainly, if there's any topic that you want us to cover, uh, you can go on speakingofwomen's health.com under the contact us, send us an email if there's a topic that you're interested in. Uh, if you like to do social media, Instagram seems particularly popular these days for perimetopause and menopause. Uh, we're on all the different social media channels as speaking of women's health. So getting into this important topic, and why is this important? Well, several years ago, um, I had a patient who was on Medicare ask me for printed prescriptions. And we've been on the electronic medical record now for about a quarter of a century. And uh most prescriptions are e-scripted, electronically scripted to the pharmacy so the patient doesn't have to have the physical copy of the prescription. Sometimes when I give people physical copies of the prescription in their folder, they like forget it or they don't remember that they have it because they're not really used to getting physical scripts. Um, and when I ask this lady, well, why don't you just tell me where you want me to send your medicines to which pharmacies? I can pick different pharmacies for different medications. And she said, Doctor, I can't afford food and my medicines. It's one or the other. I need to have a printed prescription to order my medications out of the country online. Now, back then, uh, that was not legally allowed. Now, I'm taping this in 2026. It is allowed currently at the time of this taping. And again, this podcast, it's not medical advice, it's just educational, hopefully a little entertaining, and it's informational to empower you to live our mission at our nonprofit, speaking of women's health, and that's to be well and to be strong and to be in charge. And obviously, you've got to be in charge of your finances, and there are certainly health determinants that relate to finances. So, what this lady let me know about was that the cost of medications that are pretty old and have been around a long time have been highly inflated in the United States. And um sometimes people were scrimping on medications and life-saving drugs like insulin for type 1 diabetics. If you don't have insulin, you die. Okay. And that's happened to people trying to space out their medicines until the next paycheck, even though it's only pennies to make insulin. So I really started to dig deep into this problem. And um I discovered that we have these middlemen uh that don't research the medications, don't manufacture them, don't distribute them, uh, just are the middlemen that uh control the market. And in the United States, a lot of the medications we've been paying a lot more for than, say, other countries. And I see patients at the Cleveland Clinic from all around the world. I see some people who can't get certain medicines in some company countries and they go to other countries. Uh, I had a patient recently tell me that uh she wanted all her prescriptions because she was traveling to Spain and she could get these medications very easily. Some medications that are prescription in America might be over the counter in other countries, and vice versa. Uh, so it's all very interesting. But I would say that many women, and certainly many Americans of all stripes, colors, backgrounds, uh, political persuasions, um, you know, any type of identifying characteristics that you can come up with are looking for ways to save money on prescription medications. And because almost half of Americans have trouble paying for their prescriptions, and a whopping quarter of Americans don't even fill their prescriptions because they can't afford to. That's a really, really big problem. And uh, it's something that I spend, unfortunately, a lot of my time on. Early in my career, not nearly, nearly as much. Um, I mean, certainly new medications or medicines that weren't didn't have generics or that weren't on patent there would be issues. I'm not saying that it wasn't, but in the last 15 plus years, it's exponential. In fact, a lot of times we end up um looking at what the patient's insurance is and kind of already having an idea what may or may not be on their formula. Are it's governmental insurance? Because some medications, coupons don't apply. If you have Medicaid, Medicare, or TRICARE as an example. Some people are self-pay uh and don't have insurance. Um ironically, sometimes it's cheaper to buy a medication and say you don't have insurance and not, quote, go through your insurance than it is and just to pay the cash pay amount. And this is because there was a 1986 uh Medicare law uh called Safe Harbor. And I mean, I think that the thought behind it was good. It was to bring together groups of people to uh purchase kind of in bulk and get better deals. But unfortunately, this loophole, there's a loophole in the law that allow kickbacks to the middlemen. And it's like legalized kickbacks. And that is what's kind of perverted the free market. And drugs that I used to prescribe all the time, like estrogen patches that have been around for decades, you know, insulin, drugs that have been around a long time, um went up exponentially, like things that would be$30 a month or$500 a month, like just shockingly increased. And um it's really a problem on both sides of the aisle because it's a big lobby and they're getting kickbacks. So there's, you know, an effort and a push by nonpartisan consumer groups representing patients and physicians to repeal Safe Harbor. Um, but it's very difficult because it's very, very uh entrenched. And both sides of the aisle uh benefit off of it. And, you know, lots of medications are life-saving. And if you have a fourth of your patients in such a wealthy country, America, not be able to afford their medication, that's a problem. And it's important to understand that prices for prescription medicines can vary widely between pharmacies. So the price you pay at one pharmacy may be very different from another, just right down the road. And both insured and uninsured patients can get better prices on prescriptions by using these six uh tips. Uh, number one is medication discount cards. So when you're in your physician or nurse practitioner's office, be on the look for lookout for medication discount cards because they can allow you to purchase certain medications for 15 to 40% right off the top. Um, many times there's pharmaceutical representatives that visit medical offices to promote and save patients money on their prescription medications. Uh, sometimes sending the prescription to certain pharmacies that are used to doing the paperwork for prior authorizations and applying discounts and coupons can. So you just don't have to accept the sticker price. And you also don't have to go through your insurance either. Now, uh the second tip um is cost-saving medication websites. So goodrx.com, I like to say it's the crumbs from the pharmacy benefit managers, but if they're offering them and it's a discount, even though I have a lot of criticisms with the system that enable this to happen, you might as well take advantage of it. And so what's really nice about it, and I have a lot of my patients open up their smartphone if they have one in the office and go to goodrx.com. And if they have um their uh um location availability setting, because it it varies, and I see people from you know other states, so it's it's different depending on what zip code you're in, but it pulls in the current zip code that you're looking at for what medication, either brand or generic, whether you want it for one month or three months, and what the cheapest price is. And it is so eye-opening this educational experience for people to do. And I recommend you, the listener, when you're done listening to this podcast, go to goodrx.com, you know, bookmark it or save it on your home screen, and just put in various medicines that you or maybe your family members may be on. And you can see that the prices can be wildly different at different pharmacies. And um, you can see what pharmacies are in your area. So it offers an overview of the medicine, prices, potential side effects of the medicines, and other savings tips. There's another website, Universal RX Savings, and it's designed to help people save money on expensive prescription medicines, whether they're insured or uninsured. Uh, one of the newest um websites on the block is trumprx.gov. And it is a website that lists discounted drugs directly from the manufacturer, those manufacturers, those pharmaceutical companies that have agreed to the most favored nation, MFN pricing. So Americans can use this site to see what drugs and go directly to the manufacturer and purchase these medications in cash outside of their insurance. And many times again, this is cheaper, but it has to be obtained at uh the participating pharmacies either using the coupon cards that are displayed, um, or what I've seen as this has just been rolled out is directly from the manufacturer's website. And there's a lot of news about the obesity medications, uh, because in a lot of other countries they're paying a fraction of the cost. And while I think it's important since weight is women's, no pun intended, biggest concern, it's not classically anopausal symptom, but it's an age-related symptom, and it's increased exponentially in our society for various reasons, and it's something that so many women are very focused on. And uh, while I am not an obesity prescribing uh physician, all these sites have proliferated online of these compounded substances, which I'm not sure of exactly what people are getting uh or not. And there is a definite group of people that these medications have uh really helped control their diabetes, resolve their sleep apnea. And we have podcasts on sleep and weight uh and sleep apnea and nutrition and exercise and intermittent fasting, things that are really very, very important. But sometimes medications are needed, even though we usually always try to focus on, of course, lifestyle first. And so the first rollout of these uh medicines, and I would just encourage people to check because it depends on which are the companies that have agreed to doing this, um, because not all of them have, and even the companies that have, it's interesting. Like I was just looking today, duave, which is a designer hormone that uh in specialized women's health we may prescribe to women at high risk for breast cancer. There's no progesterone in it, but it protects the uterus. There's some women who just can't tolerate any progesterone, even natural progesterone because of breast tenderness remove symptoms. So duavet, which is a designer hormone, has really been uh just a huge benefit for our patients. And it went away, you know, Pfizer stopped making it during COVID and then restarted making it. And we, of course, put that news on our website because we had lots of patients who had gone off it and really wanted to go back on it. But when it came back on, a lot of formularies weren't covering it. And it's one of those medicines that's not, at least currently, on any of the Canadian drug websites that we direct our lot, a lot of our patients to go to who are on patches of estrogen and progesterone or various um specialty combinations of oral estrogen with drosperinone, which is particularly good for skin and hair, people with acne, androgenic hair thinning. Got a lot of podcasts on hair thinning and skin care. I know people are so interested in that. Uh, and you have been listening to the Speaking of Women's Health podcast. I'm your host, Dr. Holly Thacker, in the Sunflower House, doing an updated version on how to save money on medications. So initially, some of the most common medications on this site were uh weight loss drugs, certainly very expensive infertility drugs. And there are some hormone uh drugs, some like duave, I'm very impressed with. I was really happy to um see that. It's kind of what stimulated me to say, we got to do an updated podcast on this topic today. Uh, but other medicines that are pretty old and have been around a long time, like conjugated estrogen's premarin, uh, and I have patients on that and they feel great on it. They're like, you're gonna pry this out of my cold, dead hands. I'm like, well, you know, we're all gonna die, but your hands won't be cold as soon as they might have been if you're on estrogen, because estrogen is anti-aging. And generally, the bulk of the data shows an expanded health span and lifespan on uh hormones. And since I did the first podcast and the first columns on saving money on medicines, finally, uh, this FDA has lifted the boxed warnings off of estrogen on local vaginal estrogen, which yes, it's been studied even in breast cancer survivors. This is an option. No woman who is menopausal has to suffer with vaginal atrophy. Now, there are non-hormonal options, um, so it's not that one size fits all. And that's the great thing about practicing menopausal specialty women's health in 2026, is that there's so many options. We don't have to just use one thing. There's hormonal and non-hormonal options for hot flashes, for osteoporosis, for genitourinary syndrome of menopause. So that's really exciting. Now, getting to number three, the drug manufacturer's website. Um, many companies do offer discounted coupons that you can print off yourself or take to the pharmacy or text to yourself to show the pharmacist. So always Google or go to the manufacturer's website, always do cost comparisons. Don't just assume that you only have to go through your insurance and you only have to do the one option that your doctor gave, and that you have to, quote, go through your insurance. So sometimes if a certain hormone replacement drug isn't covered under your prescription tier, you can go to the manufacturer's website and you still may be able to get it for a reasonable price. Now, there was an article in the Wall Street Journal going over the fact that estrogen patches have been uh having some supply chain problems, and we've got a lot of calls about that recently. And there's been various supply chain problems, and I always tell patients if you're on any kind of medication that you can't just stop, whether it's insulin or whether it's your thyroid or whether it's your postmenopausal hormones, because if you stop or miss a dose and you have a uterus, chances are you're gonna bleed, get recurrence of the symptoms. It's always good to have extra medications on hand. And not wait till the last moment. That's like really one of my pet peeves. People find out, oh, I'm all out of medicine, so let me call for refills. Well, they haven't been in to see me or my colleagues or available nurse practitioners for a yearly check-in. And this is really important to do. So, number four option, you can contact your insurance company. Um, if you get to the pharmacy and find out that it's just too expensive or it's not covered, um, you can contact your insurance company. Sometimes they may have uh something that you can do. Uh, you can also ask for the formulary, the list of medicines that are covered. And it's important for you to find this in it out before hopefully you go to your physician's office, in that you might be able to provide them with, well, these are the formulary that's covered. I also think it's important, though, to ask if there is a medication that might be better for you, say, for instance, two of A, because maybe you're a breast cancer survivor or you have a genetic mutation that puts your risk increased, because you don't want the physician necessarily to only offer you what they know will easily go through. And even though many times generic options are very safe and effective and less expensive, sometimes that's not the best option for you. So you don't only want to get care that's quote, covered under your insurance. Um, and that's it's important for you to know what's on your formulary, and you can't expect your clinician who's writing the medication to know all of that because there's so many different um plans out there. Now, one tip that we use frequently in getting back to the patch shortage is it is completely fine to cut the patch in half. Now, the pharmacists tell you not to do it. We've been doing it for decades. And getting a patch that maybe is twice the dose you need, if it's 100, and the standard dose for women in their 50s, menopausal is 50, cutting that in half to 50, that cuts your price in half. Some people even cut the patch in quarters. Uh, many of our Medicare patients that have a uterus that are on the uh combination patch, combi patch, or a voral conte, which has bioidentical estrogen and orethendroid acetate combined, protects the uterus. The patch is changed every three and a half days, which is 84 hours. And we want you to be very specific if you're on a twice-a-week patch. It's not just twice a week when you think about it, or two days in the morning, like Monday morning and Thursday morning. No, it's Monday morning and Thursday evening, 3.5 days. But many of our patients over 65 can get by on half the dose because their metabolism is slower. The same thing with tablets. Many tablets are scored. Some tablets are not scored. I'm thinking of oral drosmerinome slind. We use that uh post-menopausally in women who really need something to calm down the skin and hair from androgen stimulation. And uh we recommend that people get a pill splitter to cut that pill in half. If they don't need a contraceptive dose, which is four milligrams, they only need a uterine protection dose, which could be low as low as a half a milligram. It's just can't really cut the pill that small. But two milligrams is a dose that's in the European formulation of angelique, which is particularly popular with postmenopausal women who might have had skin or hair problems of an androgenic kind of testosterone-based problem. And they might have been on a drosperinone containing contraceptive like Yes, BS, saffron, any of the generic drosperinone hormonal contraceptives, or the newer hormonal contraceptive next telus, that has uh estetrol, which is E4, a natural estrogen, with three milligrams of drosperinone. So there's a one milligram of estrogen, two milligram uh drosperinone, a one milligram estrogen, one milligram drosperinone that are only available in Europe. So some of our patients will get printed prescriptions, take a picture of it, and then order it on one of the Canada drug sites. So the fifth option for um saving money on medicines is potentially choosing generic medications that are cheaper, but not always accomplishing the same outcome. Because by law, generics only have to be 80 to 125% equivalent. But generic estrogen tablets in bulk can be as inexpensive as$10 to$30 per month. The caveat, and this is a mistake I see a lot of prescribers make, even experienced women's health prescribers, is they just dose it once a day. And estradiol, when it's combined with another agent, like a progesterone or progestin, can last the whole 24 hours. But when it's separate, it's a much shorter half-life, like 12 hours, and has to be dosed twice a day. Um, generic progesterone, um, which uh the only brand name that's available is prometrium. It's in peanut oil, so people with peanut allergies uh cannot take that. Generic progesterone is about$20 to$30 per month. Um now some tablets can be cut in half, but capsules like progesterone obviously cannot be cut in half. And medications that have an extended release formulation are also medicines that cannot be cut in half. So the sixth option for saving money on medicines is actually going on a Canadian uh drug websites, and there's several of them, and I've had patients uh let me know about um new ones coming up. It was previously prohibited, but it has been reinstated. But of course, laws can change, and so you know it's important for you to do your due diligence. But many Americans take a picture of a hard copy prescription and they upload it to a Canadian drugs website, and many times purchase the exact same medication by the exact same manufacturer for a much lower cost. Now, one of the first websites that I was introduced to from that Medicare patient who could only afford medicines or foods, but not both. And obviously she needed to eat and take her medicines was Northdrugstore.com, uh Canada Drug. It's now um a uh universal drugs.com. I think when you go to that one URL, it flips you to their new site. Totalcaremart.com. That's a site I've sent people to who want the a string vaginal ring. I saw that on trumprx.gov today, but it's much cheaper still on totalcaremart.com. Northwestpharmacy.com is another site. Uh your Canada drug, uh YcdSCC.com is another site. And the newest one that we've been using a lot for the combination estrogen progestin patch is Canadadrugsdirect.com. And some of these sites even sell over-the-counter medications that you don't need a prescription for. If you've gotten a year prescription for your hormones, for example, I always tell people to not delete the picture of their prescription off their phone. And I always tell them to take the picture of the medicine first because if they surrender that prescription because they find a place locally that the pharmacist will dispense it, then they've lost that prescription. And if they've ordered it online, it can take up to four weeks. There have sometimes been glitches. Um of these pharmacies use the Canadian uh Postal Service and they were on strike for a while. Um, there's been some concern about tariff cost, although uh there's been some exceptions with medicine. So I don't think that's disrupted most of my patients. Um, but all of these kind of factors can change. And that's why knowing about a lot of different options, thinking about this in advance, planning for it, having an adequate supply of medication so that if there is a hiccup or there is a delay in getting your medications. Um, we had a few patients say that their medicine was seized at the border because of drug enforcement, wanted to make sure fentanyl wasn't coming over the border. So it does take a little bit more work and a little more planning. But when you go to get a refill, that pharmacy doesn't keep the image of your prescription. They're going to want you to upload it, even though you already had a full year prescription. So you might want to make a folder and not necessarily have that prescription mixed in with your grandchildren's pictures. Like I have so many pictures of my grandchildren. Uh, but you want to keep that in a folder. And then, of course, once a year passes, that prescription has expired. And when you're on your last refill of any medication, even sometimes before that, uh, if you're a physician, books out a long time, you really want to make your appointments six months uh in advance. And we have some podcasts on scheduling appointments and tricks to do that. And um, you know, it does take some work for your healthcare, and you're worth it. And the older you are, the more appointments many times there are. Um, if you're over 50, I'm telling people, have you had your eye exam done once a year? I mean, starting from a younger age, of course, we want you to have your dental checks. We've had a couple great podcasts with dentists, and we've got some that are upcoming. Um, people at risk for skin cancer should definitely get skin cancer checks, potentially with their dermatologist. Uh, you should see your primary care physician once a year. If you've got chronic medical conditions, it may need to be twice a year. If you've got serious health conditions, um, you may need to see a number of different uh specialists. So it's important for you to stay on top of all of that for sure. And we really appreciate you tuning in to our podcast and insurance coverage, medication prices, the law can be changing. So maintain your awareness. Know that we have resources available. Check in on speaking of woman's health.com. And it's important, you know, to advocate. Um, if you are talking to any of your elected representatives on both sides of the aisle, you have to let them know this is important and they need to repeal safe harbor because it's not fair for these drug prices to be so inflated because of the middlemen. Um, think about ways with your healthcare team that you could reduce your cost. I mean, many people can get off of medications by improving their diet and lifestyle. Um, having twice the dose prescribed and being very specific that you're cutting it in half. And it's important that you uh bring in your medications when you see your physician and your supplements and not just say, oh, look in the computer, because there's several different ways that what we write, what's the pharmacist thinks, what's dispensed, what's on the label, how you interpret it. There can be some differences. And it's important. And even experienced patients I see that are medical themselves make these mistakes. And prioritize your financial needs because sometimes it may be worth it to pay more for a certain medication. Um, and forego that latest outfit uh or expensive purse. On the other hand, many times less expensive generic medications may work well. And even if you can't afford the higher price, um, save it for a rainy day. If you have the ability to put money in a health savings account, I mean that's one of the best investment strategies because it grows tax-free. You take it out tax-free, you can save your receipts and years later use it, like even for your um Medicare uh premiums. So it's important to be savvy uh with your health. And thanks so much for tuning in to this episode. If you don't already subscribe, hit subscribe or follow. Give us a five-star rating, share this with your friends and family, and make sure to tune back in next week for another edition of our Speaking of Women's Health podcast. Remember, be strong, be healthy, and be in charge.