Library Guides: Resources for Medical Students: Cost of Drugs & Tests

Sources for Drug Prices & Costs

Formulary Search app
Find out if a drug is covered by your patient's insurance. A single source of formulary drug status and restriction information updated nightly. Free iOS app (as of 11/7/16)
GoodRx
Web-based company providing price transparency for prescription drugs. Also provides coupons for patients
Medical Letter on Drugs and Therapeutics
Reference tables list cost of drugs
NeedyMeds
A non-profit information resource devoted to helping people find assistance for medications and health care costs.
NLM Drug Information Portal
National Library of Medicine's portal to drug info. See Paying for Prescriptions for ways to save money.
Open Payments
Discloses financial relationships between drug and health care companies and doctors or hospitals.
UpToDate
Search drug name, then select Drug Information from list. Look for "Pricing: US (Medi-Span)" in left side bar.

Additional Reading on Health Care Costs

Your patients may read articles such as these. (Registrations might be required for access.)

Understanding Health Care Costs - MU Health Care
Overview on health care pricing and links to standard charges
NEJM - what happens when patients are treated by multiple providers participating in different Medicare payment models
2016 Interview with Robert Mechanic, scholar of social policy, on confusion of payments for Medicare. (Note: don't multitask while listening.)
Planning a medical procedure? Check the prices first.
Money.MSN 6/24/2013
Article on variation in cost of procedures and where to find cost information
Same generic drug, many prices
Consumer Reports magazine May 2013
Article on significant difference in cost of meds and how to save money
How a secretive panel uses data that distort doctors’ pay
The Washington Post 7/20/13
Article on the AMA's Relative Value Update Committee (RUC), its history and how it impacts Medicare & health care costs.
How to Research Health Care Prices.
WSJ 12/4/2009
Wall Street Journal article on variety of pricing for procedures and sites that provide cost/price information.

Sources for Test & Procedure Costs

Fair Health
provides an estimate of how much procedures cost by area
Healthcare Blue Book
Shows the typical fee that providers in specified area accept as payment from insurance companies
Medicare Provider Charge Data
Charges that providers send to Medicare for common services. Currently 2012-2016 data, depending on file.
New Choice Health
Directory of medical procedures and their costs. Covers US only. Lists cost out by hospital, clinic. Add on service of "Quote Request". (Paid for by the health care providers looking for customer referrals.)
Pocket Guide to Diagnostic Tests ( in AccessMedicine)
Provides price ranges for tests shown by number of dollar signs $.

Affordable Care Act

From the 9-30-13 InSight

Resources available for patients about new health coverage options
In January 2014, most Americans will be required to have health insurance as a result of the Affordable Care Act. Starting Tuesday, Oct. 1, individuals who need insurance can buy health coverage through the new Health Insurance Marketplace. Enrollment will be open from Oct. 1, 2013, to March 31, 2014. To learn more about Missouri’s marketplace, please visit http://www.covermissouri.org.

Here are four key facts to share with your patients about the new Health Insurance Marketplace:

1. All plans must cover the care patients need, including doctor visits, hospital stays, preventive care, prescriptions and more.

2. Low-cost plans are available. Financial help is available based on income.

3. No one can be denied coverage because of pre-existing conditions.

4. The marketplace will provide side-by-side comparisons of each plan, without sales pitches or fine print.

If you would like more information about the Health Insurance Marketplace, or if someone asks you about resources, the following resources are available:

· To speak to someone in person, you will be able to get a listing of in-person assistance available nearby at http://www.covermissouri.org, visit your University Extension county office, or visit a community health center. To find the nearest community health center, please visit http://www.mo-pca.org/tools/find.

· To chat online, visit www.healthcare.gov to chat in English or go to www.cuidadodesalud.gov to chat in Spanish.

· Contact the call center, open 24/7, toll-free at (800) 318-2596. If using text telephones or telecommunications devices for the deaf (TTY/TDD), please call (855) 889-4325.

· To watch videos about the marketplace’s application process and other educational videos created by the Centers for Medicare & Medicaid Services (CMS), please visit http://marketplace.cms.gov/getofficialresources/multimedia/multimedia.html.