Recently, I went to the pharmacy to pick up a prescription. It was for a retinol face product that I’ve used before, but was refilling with a new insurance. I was relieved to be able to pick up the prescription, because my insurance company had initially denied the medication. My dermatologist filled out a prior authorization, and after about a week’s worth of time and several interactions between my pharmacy, the dermatology group, and the insurance company, the approval finally went through. I walked up to the counter and the pharmacist’s assistant rang up the prescription, informing me the cost would be $450! I was shocked. Surely there could be an over the counter medication that I could try first before having to pay this much money. I told the assistant that I was not going to get the prescription at that time and with that, I left the pharmacy.

When I got home I began doing some research, trying to figure out if there was an over the counter medicine that would be similarly effective that I could try first. I planned to go to the store later that week to see what was available. The next day, though, I received a phone call from my pharmacist.

“I heard you didn’t pick up your prescription yesterday because it was too expensive. Had I been in yesterday I would have let you know about a coupon we have! Can you come in today?”

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I decided to go in and see how much the prescription would cost. As I approached the counter, I calculated in my head how much I would be willing to pay for the prescription. The pharmacist rang it up, and with the coupon the total was of $35. Sold. I walked out of the pharmacy feeling like I’d won the lottery. I was incredibly thankful that the pharmacist took the time to call me and help me save money. He went out of his way to do something that he didn’t need to do, but the results had a significant impact for me.

When I got home later that day, I told my family about the story. As I was telling them what happened, I realized that what I went through is very similar to what our patients go through when deciding whether or not they can afford a medication we prescribe. Fortunately for me, the medication was a facial cream, and wasn’t prescribed for a life threatening condition. I can only imagine the decision I would have had to make if this medication had been a necessity. It’s always sad when a patient comes into the emergency department for something that could have been prevented if the patient had been able to take the prescribed medication. Unfortunately, our patients too often have to make the decision to forgo medications because that money is needed for food and rent.

I have started encouraging all of my patients to ask their pharmacy if they have coupons available for medications that may otherwise be too expensive. I also direct my patients to websites like, which helps them compare the cost of medication from pharmacy to pharmacy.  A lot of patients are unaware that medication costs differ between pharmacies, and that sometimes the difference is substantial. The final thing I do is inform patients about the discounted medication lists.  Some pharmacies will charge $3 or $4 for certain medications, and others will give certain antibiotics for free if the patient has a store card. These pharmacies vary in location, but a quick search can find participating pharmacies in the area.

By informing patients of the available ways to save money, I hope they will be able to take necessary medications that they otherwise might not be able to afford. This keeps our patients healthy, happy, and prevents them from returning to the emergency department for preventable situation.

Jillian Knowles, MMS, PA-C, works as an emergency medicine physician assistant in the Philadelphia area.