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Sally’s Savings

How Checking the Cash Price Can Save You More Than Your Copay

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Why this matters right now

Many patients assume their copay is the cheapest option. But KFF reports that nearly 1 in 4 adults struggle to afford prescriptions — often because copays do NOT reflect the lowest market price.

 

What’s happening

Pharmacies have multiple prices for the same drug:

  • insurance price
  • cash price
  • discount program price
  • manufacturer coupon price

 

Most patients never see the alternatives. In 2025, Sally demonstrated the difference on camera:

“This prescription card could cost you less than your insurance copay… sometimes the prices are even cheaper.”
 — Sally Figueroa

 

What you can do

  • Ask the pharmacy to run three prices: insurance, cash, discount.
  • Never assume your copay is lowest.
  • Compare pharmacies—prices vary widely.
  • Check nonprofit prescription assistance tools.

 

What to avoid

  • Auto-refilling without comparing.
  • Assuming “covered” means “cheapest.”

 

How to move forward

A 30-second question at the counter can cut costs by hundreds a year.

 

Our Pay It Forward Approach

Every small act of sharing creates a ripple. If this piece resonated with you, consider sending it to someone who might need the same hope today—or leave us a comment in the section below with your own saving story so thousands can benefit from it. No one should have to navigate the cost of illness alone.

 

 

Verification Note

Checked and verified active December 2025.

All sources are nonprofit, government, or primary research organizations directly supporting claims made in this article.

Copays vs. cash prices and affordability gaps

Kaiser Family Foundation (KFF) — Issue Brief: How Many Adults Struggle to Afford Prescription Drugs?
Documents that nearly 1 in 4 U.S. adults report difficulty affording prescription medications and explains how insurance cost-sharing contributes to underuse.
https://www.kff.org/health-costs/issue-brief/how-many-adults-struggle-with-prescription-drug-costs/

KFF — Prescription Drug Cost-Sharing and Affordability
Explains how copays and coinsurance often do not reflect the lowest available market price.
https://www.kff.org/health-costs/issue-brief/prescription-drug-cost-sharing-and-affordability/

Multiple pricing structures at pharmacies

Federal Trade Commission (FTC) — Pharmacy Benefit Managers and Drug Pricing
Describes how insured prices, cash prices, PBM-negotiated rates, and discount pricing can differ substantially for the same medication.
https://www.ftc.gov/system/files/ftc_gov/pdf/pbm_report.pdf

National Community Pharmacists Association (NCPA) — Prescription Drug Pricing Explained
Explains pharmacy pricing layers, including usual & customary prices, cash prices, and third-party discount programs.
https://ncpa.org/pharmacy-pricing

Cash prices and discount programs saving patients money

GoodRx Research — Cash Prices vs. Insurance Copays
Demonstrates that cash prices using discount programs can be lower than insurance copays, even for insured patients.
https://www.goodrx.com/healthcare-access/research/cash-price-vs-insurance

Health Affairs (Nonprofit Journal) — Prescription Drug Pricing Complexity
Analyzes how patients can pay more with insurance than without it due to benefit design and pricing opacity.
https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.01428

Pharmacy price variation by location

U.S. Government Accountability Office (GAO) — Prescription Drug Pricing Variation
Confirms that drug prices vary significantly by pharmacy and region for identical medications.
https://www.gao.gov/products/gao-21-282

GoodRx — Why Prescription Prices Vary by Pharmacy
Consumer-facing explanation of geographic and pharmacy-level price variation.
https://www.goodrx.com/conditions/general-health/why-prescription-prices-vary

Nonprofit prescription assistance tools

NeedyMeds — Drug Discount and Assistance Programs
National nonprofit database documenting cash prices, coupons, and patient assistance programs.
https://www.needymeds.org

Patient Advocate Foundation — Prescription Cost Assistance
Outlines patient strategies for reducing medication costs through discounts and assistance programs.
https://www.patientadvocate.org/explore-our-resources/prescription-cost-assistance/

 

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Our Pay It Forward Approach: Every small act of sharing creates a ripple. If this piece resonated with you, consider sending it to someone who might need the same hope today — or click on Share Your Story so thousands can benefit from it. No one should have to navigate the cost of illness alone.