How to Work with Your Doctor to Deprescribe and Save Money on Medications

Many people take multiple medications every day - some because they need them, others because no one ever asked if they still do. If you’re on five or more prescriptions, you’re not alone. About 41% of adults over 65 are taking too many drugs, and many of those aren’t helping anymore. Worse, they’re costing you hundreds - sometimes thousands - each year. But here’s the good news: you can work with your doctor to safely stop some of them and save real money, without risking your health.

What Is Deprescribing, Really?

Deprescribing isn’t just about cutting pills. It’s a planned, step-by-step process of reviewing your medications to find the ones that aren’t doing enough good to justify their risks or cost. Think of it like cleaning out your closet: you keep what fits, what you use, and what’s still in good shape. Everything else gets tossed.

It’s not about stopping everything. It’s about stopping what’s unnecessary. For example, a 72-year-old woman in Ohio stopped three medications during a simple doctor visit. One was a $120/month sleep aid she hadn’t needed in years. Two were supplements her cardiologist said were pointless because her prescriptions already covered the same nutrients. She saved $840 that year. That’s not luck - that’s smart deprescribing.

The American Academy of Family Physicians says the goal is simple: reduce harm. Too many drugs can cause falls, confusion, kidney damage, and even hospital stays. In fact, 37% of medication-related hospitalizations in people over 65 could be avoided with proper medication reviews.

How Much Money Are You Really Spending?

Let’s do the math. If you’re taking one unnecessary $50/month pill, that’s $600 a year. Two? $1,200. Three? $1,800. Now add in the hidden costs: emergency room visits from side effects, lab tests to monitor drugs that shouldn’t even be taken, and doctor visits just to manage the side effects of other drugs.

A 2021 study found that stopping a proton pump inhibitor (a common heartburn drug) saved patients an average of $420 a year - and lowered their risk of pneumonia by 25%. Another Reddit user, "SeniorSaver87," stopped a $90/month vitamin D supplement after a blood test showed his levels were fine. He also quit a $75/month herbal remedy. Total annual savings: $1,980.

And it’s not just about what you pay out-of-pocket. Medicare Part D plans spent over $13 billion on potentially inappropriate medications in 2022. That money comes from your premiums, taxes, and system-wide costs.

How to Start the Conversation With Your Doctor

Most doctors want to help - but they’re pressed for time. The average primary care visit lasts just 15.7 minutes. That’s not enough to review 10 medications unless you come prepared.

Do this before your appointment:

• Collect every pill, patch, liquid, and supplement you take - including over-the-counter stuff like ibuprofen, antacids, and herbal remedies.
• Write down the reason you take each one. If you don’t know, write "I’m not sure."
• Check the cost of each. Use your pharmacy receipt or a site like GoodRx to find the monthly price.
• Bring the list. Don’t rely on memory.

Doctors call this a "brown bag review." It’s one of the most effective tools we have. A 2021 study found that when patients brought their full medication list, doctors were 68% more likely to identify something to stop.

Ask These Five Questions

When you sit down with your doctor, use these questions to guide the talk. They’re simple, direct, and designed to get real answers:

1. Why am I taking this? Is it for high blood pressure? Sleep? Heartburn? Make sure the reason still applies.
2. What are the benefits right now? Are you still at risk for the condition it treats? Has your health changed?
3. What are the risks? Can it cause dizziness? Confusion? Falls? Kidney trouble? These risks grow with age.
4. Can I stop or reduce this? Not all drugs need to be taken daily. Some can be cut in half, taken every other day, or stopped entirely.
5. Who should I check in with if I feel different after stopping? Always have a plan - even if it’s just calling the pharmacy or scheduling a follow-up in 4 weeks.

What Happens When You Stop a Drug?

You might worry about withdrawal or rebound effects. That’s valid - but only if you stop suddenly. Deprescribing isn’t a quick cut. It’s a slow taper.

For example, if you’re on a blood pressure pill that’s no longer needed, your doctor won’t just say "stop." They’ll reduce the dose over 4 to 12 weeks, monitor your numbers, and watch for symptoms. A 2019 study found that if you stop too fast, your blood pressure can spike back up - but if you taper, you’re fine.

Some medications are easier to stop than others:

• Easier: Sleeping pills, acid reducers, certain supplements, cholesterol drugs for people with limited life expectancy.
• Need caution: Antidepressants, blood thinners, diabetes meds, heart failure drugs - these need close monitoring.

The key is to stop one at a time. Don’t try to quit five drugs at once. That’s asking for trouble.

Pharmacists Can Help Too

Your pharmacist knows more about your meds than you think. Most offer free Medication Therapy Management (MTM) services under Medicare Part D. They’ll review your entire list, flag duplicates, check for interactions, and even find cheaper alternatives.

One 2022 study found that pharmacists identified an average of $1,200 in annual savings per patient just by reviewing prescriptions. They can also help you switch to generics, use mail-order pharmacies, or apply for patient assistance programs.

Don’t wait for your doctor to bring it up. Walk into your pharmacy and say: "Can you review my medications? I want to make sure I’m not taking anything I don’t need."

When Deprescribing Doesn’t Work

Not every drug can be stopped. Some serve multiple purposes - like a blood pressure pill that also helps with migraines. Others are needed long-term, like insulin or thyroid meds.

The real danger is when people try to stop on their own. A 2022 survey found that 18% of patients who stopped meds without doctor supervision had bad reactions - dizziness, anxiety, seizures - and ended up in the ER. Those visits cost an average of $1,200. You save money by doing it right, not by doing it alone.

Also, don’t fall for the myth that "more is better." Taking ten pills doesn’t make you healthier. It just makes you more likely to have side effects.

What’s Changing in 2026?

The system is catching up. Since 2023, Medicare has started tying payments to how well doctors manage medications. Hospitals and clinics that reduce unnecessary prescriptions get better ratings and more funding.

New tools are helping too. AI programs like MedStopper scan patient records and flag risky or redundant drugs with 89% accuracy. Twelve-seven hospitals now use them. In 2024, CMS added medication safety to Medicare Advantage quality scores - meaning doctors are now rewarded for deprescribing.

And with insulin capped at $35/month and new rules pushing for comprehensive medication reviews, the financial pressure to cut waste is stronger than ever.

Real Savings, Real Results

Kaiser Permanente ran a program from 2018 to 2022 that helped over 100,000 older adults review their meds. They stopped 35% of inappropriate prescriptions. Result? A $1.2 million annual drop in drug costs and a 28% drop in adverse drug events.

One patient, a 78-year-old man from Texas, stopped four unnecessary pills. He was taking a statin for cholesterol, even though his heart doctor said his risk was low. He was on a sleep aid he’d been on since 2010. Two supplements his wife bought him "just in case." After the review, he cut all four. His monthly drug bill dropped from $380 to $95. He felt more alert. His balance improved. He didn’t fall once all year.

That’s what deprescribing looks like in real life. Not magic. Not a miracle. Just smart, simple, step-by-step care.

Next Steps

If you’re on five or more medications, start today. Gather your pills. Write down what each one is for and how much you pay. Make an appointment with your doctor or pharmacist. Say: "I want to make sure I’m not taking anything I don’t need. Can we review my meds?"

You don’t need to be sick to benefit. You don’t need to be poor. You just need to ask. And in 2026, the system is finally set up to help you do it - safely and affordably.