What Your Clients Need to Know About the Increasing Cost of Name-Brand Drugs

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Published on March 14, 2022

Learn more about helping your clients with the rising costs of name-brand drugs

Prescription drugs are often an expensive concern for many seniors. And with prices rising on name-brand drugs, the worries are valid. But there are things you and your clients can do to plan ahead for rising prescription drug costs. 

Learn more about what your clients need to know about the increasing costs of name-brand drugs and how you can help them, then reach out to us at American Senior Benefits for more details. 

The Rising Costs of Name-Brand Drugs 

The Congressional Budget Office released a recent report noting the concerning trend in name-brand drug price increases. The office found name-brand drugs rose from $149 to $353 in the Medicare program and from $147 to $218 in Medicaid from 2009 to 2018. 

Name-brand prescription drug prices are rising for a few reasons: 

  • There were a series of high-profile drugs developed beginning in the mid-1990s that generated at least $1 billion in sales each. These “blockbuster” drugs drove up average price increases that have continued over time. 
  • Expensive stand-alone drugs have been released which impacted price increases, such as a pricey drug to treat hepatitis C. 
  • When new name-brand drugs are introduced, they can be hard to replicate, making a generic solution take longer to create. 

How to Help Your Clients with Name-Brand Prescription Concerns 

There are options for patients who need to take maintenance medications but cannot afford the rising costs of name-brand drugs. 

  • Generic drug options are growing. The use of generic drugs rose from 75% in 2009 to 90% in 2018. You can help your client understand their options for other drugs, like generic ones, that may work just as well as their name-brand comparisons. 
  • Review what Medicare Part D covers. Help your policyholders understand their Medicare coverage. Review the Medicare Part D options with them so they know if a generic or name-brand drug is covered, and at what rate. 
  • Consider a Medicare Advantage Plan. Review Medicare Advantage Plans with your clients. Many Advantage plans offer prescription drug reimbursement or coverage. Your client will have to purchase this coverage, so make sure to discuss it with them if they are considering a Medicare Advantage Plan. 
  • Help your policyholders plan ahead for rising drug costs. If your policyholders take maintenance medications, discuss the possibility of further name-brand drug cost increases with them. As an agent, it is better to be proactive so your client can anticipate changes. Some people plan to use their savings or a portion of their income to cover rising drug costs. 
  • Discuss the anticipated costs over time. Your client may expect to pay more for name-brand drugs as they age. Drug costs are on a rising trend, so if your policyholder takes long-term prescriptions, they should include drug inflation costs in their annual budget plan. 

Help Your Clients Shop Around for the Best Rates 

The best way for your clients to manage their rising prescription drug costs is to compare health care plans and drug costs. If your policyholder is on Medicare, they might consider changing to a Medicare Advantage Plan. And regardless of the type of insurance your client has, they should compare the prices of generic versus brand-name drugs when they get a new prescription. 

As their agent, advise your client to ask their doctor if a generic drug will work just as well if they are prescribed a new drug in a name-brand form. Many pharmacies will automatically fill prescriptions with the generic version unless the doctor specifies that is not acceptable. Your client can help advocate for themselves by checking drug prices, comparing rates, and asking for the generic version. Some mail order pharmacies can provide better rates on maintenance drugs, so you can also help your client find a pharmacy to try. 

How Do I Learn More?

To learn more about the increasing costs of name-brand drugs, contact us at American Senior Benefits. Our affiliated experts will be happy to answer any questions you have.  

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