It’s almost a rite of passage for most older adults: a growing number of bottles fill your medicine cabinet (did you know that may not be the best place to store your medications?) for the array of medical problems so many of us have as we age: pain, blood pressure, gastrointestinal, cardiac conditions, bone weakness, and neurological disorders, to name a few possible areas. In fact, while older adults are currently 13% of the US population, we account for 34% of all prescriptions and 30% of the sales of all over-the-counter medications. That’s a lot of drugs for just one segment of the population, and that volume is not without its risk and costs to older adults.  

In fact, the cost of medications is an ongoing source of real distress to millions of Americans. While bringing down medication costs is a complex and often controversial political topic (yet to be worked out), many are having to confront the wrenching dilemma of whether they can afford the medicines they need, or must make trade-offs with such other necessary expenses as food, housing, and transportation. A recent AARP post implores older adults not to forego medications in favor of other essentials, at least until you try some recommended “hacks,” including asking your provider or pharmacist for a cheaper alternative to a pricey drug you’ve been prescribed, utilizing mail-order or online pharmacies when you can, and accessing prescription discount programs and cards, including SingleCare.com or Mark Cuban’s CostPlus Company. You may also be able to use some of your medications beyond the expiration date provided if you somehow have extras that weren’t used.

Another way to save money on your prescription drugs? Cut back on the number of drugs you take, which may not only be harming your wallet but harming your health as well. We’ve previously touched on the concept of “deprescribing,” by reviewing with a health care professional or pharmacist the range of medications you use in order to confirm their value and necessity and to ensure the risks do not outweigh their current benefits. In a recent interview with deprescribing expert Dr. Dee Mangin, The Med Shadow Foundation quoted her as stating that older adults are especially vulnerable to extended and unwarranted prescriptions for such drugs as anti-depressants, proton-pump inhibitors, and osteoporosis drugs. As she made clear, “Half the patients started on these drugs continue with them long after they should be stopped. A drug that you might have started at age 45 may not carry the same benefits when you reach 65, 75, or 85.”

Dr. Mangin recommends a yearly appointment to discuss your drug regimen with your provider. However, a recent study published in The Journals of Gerontology and conducted by the National Poll on Healthy Aging of the University of Michigan found that older adults are by and large unaware of the service to which they may be entitled of having their drug regimen reviewed for potential deprescribing. The study of 960 people between the ages of 65-80 found that most older adults take multiple medications but 80% haven’t had a medication review to determine the safety and efficacy of their drug regimen, let alone to see if the costs of those medications are warranted. That same percentage are unaware that Medicare Part D actually will pay for such a review. If eligible, patients can review with a pharmacist or other health care providers both prescription and non-prescription medications, to help weigh the risks and benefits and perhaps even cut costs with cheaper substitutes or streamlined doses.

So before you throw up your hands and assume you will need to make awful trade-offs when paying for life’s necessities, do yourself a favor and determine whether the drugs you currently take are necessary, safe, and cost-effective.