How to Work with Your Doctor to Deprescribe and Save Money

Many people over 65 take five or more medications every day. Some of them have been on the same pills for years-maybe since a hospital stay, a specialist visit, or even a routine checkup. But here’s the truth: not all of those pills are still helping you. Some might even be hurting you. And they’re costing you hundreds, sometimes thousands, of dollars a year.

Why You Might Be Taking Pills You Don’t Need

Polypharmacy-the use of five or more medications-is common in older adults. About 41% of people over 65 are on this many drugs, according to a 2019 JAMA Internal Medicine study. But the problem isn’t just the number. It’s what’s in the list. A pill prescribed for high blood pressure might now be causing dizziness. A sleep aid you started ten years ago might be making your memory worse. A vitamin or supplement your doctor once recommended might no longer be needed after blood tests showed normal levels.

The cost adds up fast. One unnecessary $50-a-month medication means $600 a year gone. Stop three of them, and you’re saving over $1,800. That’s not pocket change. That’s groceries, gas, or a new pair of shoes. And it gets worse: medication-related hospitalizations cost an average of $15,700 each, according to 2022 Medicare data. Many of these are preventable.

What Deprescribing Really Means

Deprescribing isn’t about quitting pills cold turkey. It’s not about ignoring your doctor. It’s a careful, step-by-step process of reviewing your meds and stopping the ones that don’t do enough good-or do too much harm.

It started in Canada in the early 2010s, led by researchers like Dr. Barbara Farrell and Dr. Cara Tannenbaum. Now, it’s a growing movement in the U.S., backed by the American Academy of Family Physicians, the American Geriatrics Society, and even Kaiser Permanente. In one program, they cut inappropriate medications by 35% and saved $1.2 million in a single year. That’s not magic. That’s smart medicine.

The goal? Reduce side effects, lower fall risks, improve memory, and save money-all at the same time. A 2021 JAMA Network Open study found that stopping proton pump inhibitors (common stomach acid pills) saved patients $420 a year and lowered the chance of pneumonia by 25%. That’s a win-win.

How to Start the Conversation

You don’t need to wait for your doctor to bring it up. Take control. Before your next appointment, do this:

• Gather every pill, capsule, patch, and supplement you take-including over-the-counter drugs and herbal remedies.
• Write down why you take each one, how often, and how much you pay per month.
• Bring the whole pile to your appointment. Doctors call this the “brown bag review.”

A 2021 study in the Journal of the American Board of Family Medicine found that when patients bring their actual meds to appointments, doctors identify an average of 2.3 unnecessary ones. That’s more than $1,000 a year you could save just by showing up with your pills in a bag.

Ask These Five Questions

Don’t just nod along when your doctor says, “Keep taking this.” Ask:

1. Why am I taking this? What condition is it meant to treat? Has that condition changed?
2. What are the benefits? Is it still working? Have I felt better since I started it?
3. What are the risks? Could it cause dizziness, confusion, falls, or memory problems?
4. Can I stop or reduce it? Is there a safer, cheaper, or no-pill alternative?
5. Who do I call if something changes? What signs should I watch for if we stop it?

These questions aren’t confrontational. They’re necessary. Most doctors want to help you cut costs and avoid harm-but they’re pressed for time. The average primary care visit lasts just 15.7 minutes, according to MGMA data. If you come prepared, you make their job easier-and your savings bigger.

What Happens When You Stop a Pill

You won’t stop everything at once. That’s dangerous. Deprescribing is slow. One medication at a time. Maybe over 4 to 12 weeks.

For example: if you’re on a blood pressure pill that’s causing dizziness, your doctor might lower the dose first. Then, after a few weeks, try stopping it entirely-with regular check-ins. A 2019 BMJ study showed that stopping antihypertensives too fast led to a 12% rebound in blood pressure. That’s why timing matters.

Some pills can be stopped safely right away. Others need a taper. Your pharmacist can help with this. In fact, 85% of community pharmacies in the U.S. offer free medication reviews under Medicare Part D. They’ll check for duplicates, outdated prescriptions, and cheaper alternatives. One 2022 study found they identified $1,200 in annual savings per patient on average.

Real People, Real Savings

A 72-year-old woman from Ohio stopped three medications after a brown bag review: a $120/month sleep aid she didn’t need, a $45/month supplement her cardiologist said was redundant, and a $110/month acid reflux pill she’d been on since 2015. Her annual savings? $840. She also stopped feeling foggy in the mornings.

On Reddit, a user named SeniorSaver87 cut out a $90/month vitamin D supplement (after a blood test showed normal levels) and a $75/month herbal remedy. That’s $1,980 saved in a year.

But not everyone succeeds. The National Council on Aging found that 18% of people who tried stopping meds on their own ended up in the ER with side effects-costing an average of $1,200 in emergency care. That’s why you never do this alone.

Who Can Help You

You don’t have to figure this out by yourself.

• Your primary care doctor is your main partner. They know your full history.
• Your pharmacist can spot duplicate prescriptions, expired meds, and cheaper generics. Ask for a free Medication Therapy Management (MTM) session.
• Specialists (like your cardiologist or neurologist) may have prescribed a pill that’s no longer needed. Ask your primary doctor to coordinate with them.

Tools like the Beers Criteria (a list of 53 potentially harmful meds for older adults) and the Medication Appropriateness Index (MAI) help doctors decide what to stop. The MAI takes about 7 minutes per pill to assess-but it’s worth it.

What’s Changing Right Now

The system is starting to catch up. Since 2011, Medicare Part D has required plans to offer free medication reviews to high-risk patients. The 2023 Inflation Reduction Act capped insulin at $35/month and expanded coverage for comprehensive medication reviews. In 2024, Medicare Advantage plans started using medication safety as part of their quality ratings-meaning doctors and hospitals get paid more for helping patients deprescribe.

AI tools like MedStopper are now used in 127 hospitals to flag unnecessary prescriptions. One 2023 JAMA study showed they spot cost-saving opportunities with 89% accuracy.

Don’t Wait for a Crisis

Medication overload is now the #1 recommended intervention for reducing harm in older adults, according to the Lown Institute. It’s not just about saving money-it’s about staying independent, avoiding falls, and keeping your mind sharp.

You don’t need to be sick to start. You don’t need to wait for a hospital visit. Just bring your pills to your next appointment. Ask the five questions. Let your doctor know you’re thinking about cutting costs and improving safety.

The right pills help. The wrong ones hurt. And you deserve to be on only what truly matters.