How to navigate the maze of drug discounts to get the best price

When Trump launched in February, it joined a group of websites that claimed to have deals on prescription drugs.

Despite the hype, many of Trump’s Rx drugs include brand-name drugs that patients can find cheaper elsewhere — as generics.

For example, Protonix for heartburn and gastroesophageal reflux disease is available at Trump Rx for $200. But the generic version, called pantoprazole, costs less than $30 with a coupon from GoodRx, another discount drug website. And depending on the health plan, using the insurance could mean a $5 or $0 copay.

So with sites like TrumpRx, GoodRx, Mark Cuban Cost Plus Medicine and a dizzying list of patient assistance, copay cards and even cash options from drug companies, what can you do to make sure you’re getting the best deal on your prescription?

Well, there is no shortcut, and it will take a little work to figure it out.

“I’m not sure all the options make things better,” says Ben Rome, a medicine and drug policy researcher at Brigham and Women’s Hospital in Boston. “In some cases they do, and in some cases they may make things more confusing if you’re a patient or a doctor trying to figure out where you should go to get your medication.”

“There’s not a store,” he says.

Start by talking to your doctor and asking about low-cost options. But because insurance plans vary and the rebate landscape is constantly changing, it’s possible that neither of you will know your share of the cost of the drug until you go to pay at the pharmacy counter, Rome says.

Here are a few steps you can take to enter the growing world of drug discounting.

Ask about a common one

When your doctor writes a prescription, it’s not a bad idea to ask if the drug is available as a generic. But don’t sweat it if you forget. You can also ask your pharmacist about generics.

Generic drugs are copies of brand-name versions that are often cheaper while still being available at your regular pharmacy. For example, the generic name of the blockbuster cholesterol drug Liptor is atorvastatin.

According to the Generics Trade Group Association for Accessible Medicines, 90% of prescriptions filled in 2024 are generics, but they account for only 12% of all drug spending. Translation: they are much less expensive.

“Most generics — not 100%, but most generics — are relatively cheap, relatively low-cost,” says Douglas Hoy of the National Association of Community Pharmacists. “Low cost and affordability may vary from person to person, but generally, they will be less than $30, $40 and sometimes even less than $10.”

However, not all brands have generic versions. This is because they are only allowed on the market after brand-name drugs’ patents and other government-granted protections expire. Generic prescriptions then go through the Food and Drug Administration’s approval process and finally hit pharmacy shelves.

You can ask your pharmacist about the general status of your medication, ask your doctor or check your insurance company’s app if they have one, says Lou Zulu, a former pharmacist who is now vice president and national pharmacy practice leader at consulting firm Seagull. You can also search online – try a pharmacy or drugstore website.

What if not generic?

There may be another drug in the same category. For example, take Eliquis and Xarelto, two brand-name blood thinners that are similar. They are not the same, but sometimes your doctor will be comfortable with you taking one. And one may be cheaper than the other, depending on your insurance.

“You, the average consumer, I don’t think you’ll have the information to know if it has an equivalent to a less expensive treatment,” Zulu says, explaining that you can ask your pharmacist about alternatives.

And sometimes, alternative medicine even has a common one. It can’t hurt to ask. Again, it’s always best to ask as soon as possible – just as your doctor is writing the prescription. But if you forget, your pharmacist can help.

“Your pharmacist is a medicine specialist,” says Hui. “We have at least six years of college education in medicine. So that’s your best bet.”

But it’s a little more difficult to switch to a different drug once you’re at the pharmacy because you’ll need a new prescription, Zulu says: “Now it comes back to the prescription to say, ‘Hey, can I try this instead?’ “

Ok, so you definitely need a brand name drug…now what?

While there are many ways to go outside of your insurance and get a discount, you should check with your doctor and let them know that the price is causing problems if you haven’t already.

“As a primary care physician, I want to know if my patient is struggling to take medication,” says Rome, adding that patients often mistakenly think their doctors already know.

Often, they can help you make a plan. For example, your doctor can appeal the insurance company’s decision or get prior authorization if your insurance requires a doctor-prescribed drug.

If it is not covered or your copay is excessive

Now that you’ve exhausted other options, you’ll want to look for a drug discount. You have a few options.

You can start by checking out the drug search tool maintained by the Pharmaceutical Research and Manufacturers of America, the brand-name drug industry trade group. It can pull you a list of brand-name savings options from the drug companies themselves.

These include patient assistance programs for people who are uninsured or underinsured, as well as copay cards, which help patients pay for copays at the pharmacy counter. Drug companies sometimes have discounts for customers who don’t use their insurance and pay cash.

But Rome offered a word of caution: “They’re looking at the manufacturer and manufacturers can discontinue or change these programs at any time. So just because you have access to a coupon program this year doesn’t mean the program will continue next year.”

Depending on the company’s program, you may need to prepare paperwork to qualify. And people with Medicare or Medicaid are not eligible for some.

What about all those discount sites?

Before paying cash and walking away from your health insurance, you should check coupon or discount sites to see if they have a lower rate, Rome says. Never pay more than the cash price on a discount site, unless you know you’ll meet the deductible and it will save you money over the year.

The major ones are GoodRx, Cost Plus Medicine, Amazon Pharmacy, Costco and Walmart. But according to Rome, who has conducted studies examining these sites, there is no easy answer to who will have the best price on any given day. You should search and compare.

“Prices vary a lot and can vary over time. And so it’s not clear where you go first,” Rome says. “Now where is the cheapest option for you for this drug? Trump Rx is in the mix. Is that going to be the cheapest option? Maybe in some cases, yes. Maybe in other cases, no.”

He admits it takes time, and encourages patients to keep their doctor in the loop.

For what it’s worth, the National Association of Community Pharmacists says your local pharmacist may prefer cost-plus drug coupons. The price includes an administration fee and Cost Plus Medicine does not charge back the pharmacy for dispensing the medicine at a loss.

“It’s become more complicated simply because there are more choices and more options,” says Zulu, a consultant at Segal. “And I’m not sure from a consumer point of view that any more is necessary.”

Want to share yours? Experienced navigating drug discounts with NPR? Email slupkin@npr.org.