Americans over 60 spend an average of $4,600 per year on prescription medications — and that's WITH insurance. For those on specialty drugs for conditions like rheumatoid arthritis, cancer, or MS, the number can exceed $10,000 annually in copays alone. The pharmaceutical pricing system in the United States is deliberately opaque, and the opacity benefits the industry, not you. Here are eight legal, proven strategies to pay less for the exact same medications.
Strategy 1: Use Cost Plus Drugs (Mark Cuban's Pharmacy)
Cost Plus Drugs (costplusdrugs.com) sells generic medications at manufacturer cost plus a flat 15% markup plus a $5 pharmacist fee plus $5 shipping. That's it. No insurance games, no hidden PBM markups. A medication that costs $300/month at a retail pharmacy might cost $12 through Cost Plus. They carry 2,000+ generic medications and are adding more monthly.
Strategy 2: GoodRx and RxSaver Coupons
These free apps compare prices across every pharmacy near you and provide discount coupons accepted at most chains. The catch: these prices often beat your insurance copay, especially for generics. Always check GoodRx BEFORE using insurance at the counter — you might pay less without your insurance card.
Strategy 3: The $2,000 Part D Cap
Starting in 2025 and continuing in 2026, Medicare Part D out-of-pocket costs are capped at $2,000 per year. After hitting that cap, you pay $0 for the rest of the year. If you take expensive brand-name drugs, this cap saves thousands. You can also spread the $2,000 across monthly payments through the Medicare Prescription Payment Plan — no interest, no fees.
8 Drug Cost Strategies Compared
| Strategy | Best For | Potential Savings | Effort Level |
|---|---|---|---|
| Cost Plus Drugs | Generic medications | 50-90% | Low — order online |
| GoodRx/RxSaver coupons | Generics at retail pharmacies | 20-80% | Low — show coupon at pickup |
| Part D $2,000 cap + payment plan | High-cost brand drugs on Medicare | $1,000-$10,000+/year | Low — automatic |
| Manufacturer patient assistance | Brand-name drugs, income-qualified | Up to 100% free | Medium — application required |
| Pill splitting (doctor approved) | Tablets that are safe to split | Up to 50% | Low — ask your doctor |
| 90-day mail order | Maintenance medications | 10-30% vs. monthly fills | Low — set up once |
| Therapeutic substitution | Drugs within the same class | 30-70% | Medium — doctor conversation |
| International pharmacies (licensed) | Brand drugs not available generically | 40-80% | Medium — verification needed |
Strategy 4: Manufacturer Patient Assistance Programs
Almost every pharmaceutical company offers a patient assistance program (PAP) for people who can't afford their medications. Income thresholds are more generous than you'd expect — often 400% of the federal poverty level ($62,400 for an individual in 2026). NeedyMeds.org and RxAssist.org maintain searchable databases of every program.
Strategy 5: Pill Splitting
Many medications cost the same regardless of dose — a 40mg tablet costs the same as a 20mg tablet. If your doctor prescribes double the dose with instructions to split, you cut your cost in half. This ONLY works for scored tablets that are safe to split. Never split capsules, extended-release tablets, or medications with narrow therapeutic windows. Always get your doctor's approval.
Strategies 6-8: Additional Savings
- Never skip or stretch medications to save money — the cost of a hospitalization from uncontrolled conditions dwarfs any drug savings
- Ask your pharmacist for a cash price before running insurance — sometimes it's cheaper to NOT use your insurance
- Review your Part D plan every year during open enrollment (Oct 15 - Dec 7) — formularies change annually and your cheapest plan last year may not be cheapest this year
- Use Medicare's Plan Finder tool (medicare.gov/plan-compare) to compare Part D plans using YOUR actual medication list
- If you're on expensive brand drugs, check whether authorized generics exist — these are identical to the brand but sold under the generic label at lower prices
The pharmaceutical pricing system is designed to be confusing. These eight strategies cut through the confusion and put money back in your pocket — legally, safely, and without sacrificing the medications you need.