How to Work with Your Doctor to Deprescribe and Save Money

Every year, millions of people in the U.S. and Australia take medications they no longer need. Some started years ago for a short-term issue. Others were added by different doctors without a full review. And many are still on the list simply because no one ever asked if they were still necessary. The result? Higher bills, more side effects, and unnecessary risk - all while the cost of prescriptions keeps climbing.

You don’t have to accept this. Working with your doctor to deprescribe - the careful, planned process of stopping medications that aren’t helping anymore - isn’t just about safety. It’s one of the most direct ways to cut your monthly drug costs without losing any health benefits.

What Is Deprescribing, Really?

Deprescribing isn’t about quitting all your meds. It’s about removing the ones that don’t belong anymore. Think of it like cleaning out your closet: you keep what fits, what you use, and what still serves you. Everything else gets tossed.

According to the American Academy of Family Physicians, nearly 41% of adults over 65 take five or more medications at once - a situation called polypharmacy. That number jumps even higher for people with chronic conditions. And while some of those drugs are essential, studies show that up to 30% of them are unnecessary, outdated, or even harmful.

For example, a 2021 study in JAMA Network Open found that patients who stopped taking proton pump inhibitors (PPIs) for heartburn - after their condition had improved - saved an average of $420 a year. At the same time, their risk of getting pneumonia dropped by 25%. That’s not a coincidence. Many long-term medications have hidden downsides: dizziness, confusion, falls, kidney stress, or even interactions with other pills you’re taking.

And the financial side? The Lown Institute estimates that inappropriate polypharmacy costs the U.S. healthcare system over $30 billion each year in avoidable hospital visits and ER trips. For you personally, cutting just one unnecessary $50/month pill saves $600 a year. Eliminate three, and you’re saving over $1,800 - money that could go toward groceries, travel, or an emergency fund.

How to Start the Conversation

Most doctors support deprescribing. But they don’t always bring it up. That’s because appointments are short - often just 15 minutes - and they’re focused on your newest concern. So you need to lead.

Before your next visit, do this:

1. Make a full list of everything you take - prescription, over-the-counter, vitamins, supplements, and herbal remedies. Don’t leave anything out. Even that daily gummy you think is harmless.
2. Write down the cost of each one. You can find this on your pharmacy receipt or through your insurer’s app. Seeing the numbers side by side can be eye-opening.
3. Bring the actual pills in a brown bag. This simple step - called a “brown bag review” - helps your doctor spot duplicates, expired meds, or pills you might be taking wrong.

At the appointment, ask these five questions:

• Why am I taking this medication?
• What am I supposed to gain from it - and how do we know it’s still working?
• Could this be causing side effects like dizziness, memory issues, or fatigue?
• Is there a chance I can stop or lower the dose?
• If I stop, who should I check in with, and how often?

These aren’t confrontational questions. They’re smart, evidence-based ones. In fact, a 2021 study in the Journal of the American Board of Family Medicine found that when patients came prepared with a full list and cost details, doctors were 68% more likely to consider deprescribing.

What Happens After You Ask?

Your doctor won’t say, “Stop everything tomorrow.” That’s dangerous. Deprescribing is a process, not an event. It’s slow, careful, and monitored.

Here’s how it usually works:

1. Prioritize - Not all meds are equal. Your doctor will look at which ones have the highest risk or lowest benefit. For example, a statin for someone with advanced dementia might be stopped before a blood pressure pill. Tools like the Beers Criteria (a list of potentially inappropriate drugs for older adults) help guide this.
2. Start with one - You’ll likely begin by tapering off just one medication. This could mean reducing the dose slowly over weeks or switching to a less frequent schedule.
3. Monitor closely - You might be asked to track symptoms like sleep, energy, or mood. If you feel worse, you’ll go back to the original dose. If you feel better or notice no change, you may continue to reduce.
4. Revisit every few months - Your body changes. So should your meds. A review every 6 to 12 months is standard. For high-risk drugs (like sleeping pills or painkillers), check-ins may be more frequent.

Real stories show this works. A 72-year-old woman in Ohio stopped three medications after a brown bag review: a $120/month sleep aid she didn’t need, a $70/month supplement her cardiologist said was redundant, and an old anxiety pill that was causing dizziness. Her annual drug cost dropped by $840. She also slept better and stopped falling.

Who Else Can Help?

You don’t have to do this alone. Pharmacists are your secret weapon.

Under Medicare Part D and many private plans, community pharmacists offer free Medication Therapy Management (MTM) services. That means they’ll sit down with you, review all your meds, check for interactions, and spot savings.

A 2022 study in the Journal of Managed Care & Specialty Pharmacy found that pharmacists using MTM identified an average of $1,200 in annual savings per patient - often by switching to generics, eliminating duplicates, or catching expired prescriptions.

Some clinics even have dedicated deprescribing programs. Kaiser Permanente, for example, reduced medication costs by $1.2 million annually across its system while cutting adverse drug events by 28%. Their success? Structured reviews, trained staff, and patient education.

Don’t hesitate to ask your pharmacist: “Can you help me review my meds for possible savings or risks?” Many don’t even know this service exists - but it’s legally required to be offered to high-risk patients.

What If You’re Scared to Stop?

It’s normal to worry. What if I get my old symptoms back? What if I feel worse?

Here’s the truth: most people don’t feel worse when they stop unnecessary drugs. In fact, they feel better. A 2023 review of 127 studies found that 73% of patients reported improved energy, fewer side effects, or better sleep after deprescribing.

But if you’ve been on a medication for years - especially something like a blood pressure pill or antidepressant - stopping suddenly can be risky. That’s why tapering matters. Your doctor will create a safe plan. You might go from one pill a day to half a pill every other day over six weeks. Then, you’ll pause and see how you feel.

And if you do have a rebound? That’s why follow-ups exist. Your doctor won’t abandon you. They’ll help you adjust.

On the flip side, trying to stop meds on your own? That’s where things go wrong. A 2022 survey by the National Council on Aging found that 18% of people who tried self-deprescribing ended up in the ER with avoidable problems - costing an average of $1,200 in extra care. Don’t risk it. Always work with a professional.

Why This Matters More Than Ever

Prescription prices have risen 60% since 2014. For seniors on fixed incomes, medication costs now eat up 18.3% of their income - more than food or housing in some cases. The 2023 Inflation Reduction Act helped by capping insulin at $35/month and expanding coverage for medication reviews. But it’s not enough.

Deprescribing is the most underused tool we have. The U.S. Deprescribing Research Network estimates that 37% of hospitalizations in adults over 65 are caused by medication errors - and most of them are preventable.

And it’s not just about money. It’s about quality of life. Fewer pills means fewer side effects. Fewer trips to the pharmacy. Fewer worries about interactions. More clarity. More energy.

Think of it this way: if you’re taking ten pills a day and five of them don’t do anything anymore, you’re spending time, money, and mental energy on something that doesn’t help. Why keep doing that?

What to Do Next

Here’s your simple action plan:

1. Get your complete medication list - including supplements and OTCs.
2. Write down the cost of each one.
3. Bring the pills to your next doctor’s visit in a bag.
4. Ask the five key questions listed above.
5. Ask your pharmacist for a free medication review.
6. Schedule a follow-up in 3 months to check how you’re doing.

You don’t need to be perfect. You don’t need to stop everything at once. Just start the conversation. One less pill can mean hundreds - even thousands - of dollars saved. And maybe, just maybe, a better day.