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

More than 4 in 10 adults over 65 are taking five or more medications. Many of them don’t need all of them. And yet, most people never ask if they can stop. It’s not because they’re okay with the cost - it’s because they don’t know how to bring it up. A $120-a-month sleep aid you’ve been taking for years. A vitamin D pill your doctor prescribed two years ago but never checked your levels again. A daily pill for acid reflux you haven’t needed since you changed your diet. These aren’t just habits - they’re money drains. And worse, they’re risks. Deprescribing - the careful, planned process of stopping medications that aren’t helping anymore - isn’t about cutting corners. It’s about working with your doctor to keep you safer and save you hundreds, even thousands, of dollars a year.

Why You’re Paying for Medications You Don’t Need

It’s easy to assume every pill in your medicine cabinet is still necessary. But medications aren’t like a gym membership - they don’t automatically renew in your body’s favor. Over time, your health changes. Your liver processes drugs differently. Your conditions improve or stabilize. New guidelines come out. A statin you started after a heart attack might no longer be useful if your cholesterol is under control and your life expectancy is limited. A proton pump inhibitor for heartburn might be causing more harm than good after five years of use, increasing your risk of pneumonia and bone fractures. The American Academy of Family Physicians found that during a simple "brown bag" review - where patients bring all their meds to an appointment - doctors found an average of 2.3 unnecessary or harmful medications per person. That’s not a fluke. That’s the norm.

What Deprescribing Really Means (And What It Doesn’t)

Deprescribing isn’t quitting your meds cold turkey. It’s not ignoring your doctor’s advice. It’s a planned, step-by-step process to safely stop drugs that no longer serve you. The goal isn’t to reduce pills for the sake of fewer pills - it’s to reduce harm and waste. Think of it like cleaning out your closet. You keep what fits, what you wear, what still works. You get rid of the things you haven’t touched in years, even if they’re still in good shape. The same logic applies to your meds. The Beers Criteria, a widely used list of potentially inappropriate medications for older adults, identifies 53 drugs that often cause more trouble than benefit. These include certain sleep aids, anticholinergics, and long-term proton pump inhibitors. But the list isn’t a rulebook - it’s a starting point for conversation. Your doctor doesn’t just look at the list. They look at you: your age, your other conditions, your goals, your budget.

How to Prepare for Your Deprescribing Conversation

Don’t wait for your doctor to bring it up. Most primary care visits last less than 16 minutes. That’s not enough time to sort through a medicine cabinet full of bottles. Take control. Before your appointment:

• Gather every pill, capsule, patch, and supplement - including over-the-counter drugs and herbal remedies.
• Write down why you take each one. If you don’t know, write "don’t know."
• Write down the cost of each, even if you’re on insurance. Some cost $10 a month. Others cost $150.
• Write down any side effects you’ve noticed: dizziness, confusion, dry mouth, stomach upset, falls.

This list is your power. Doctors who’ve seen it say it makes deprescribing discussions 68% more productive. When you show up with a real list, not just a vague feeling that "I’m on too many pills," your doctor can actually help.

Ask These Five Questions at Your Appointment

Bring your list. Then ask:

1. Why am I taking this medication? What condition is it for? Is it still being monitored?
2. What are the benefits - and what are the risks? Is this pill preventing a heart attack, or just making me drowsy?
3. Can this cause falls, memory problems, or confusion? Many meds, especially sleep aids and antihistamines, increase fall risk in older adults.
4. Can I stop, reduce, or switch to something cheaper? Is there a generic? A lower dose? A non-drug alternative?
5. Who should I check in with if I feel different after stopping? Don’t leave without a plan.

These aren’t aggressive questions. They’re smart ones. The American Geriatrics Society says asking these is one of the top five things you can do for your health.

What Happens After You Say "Stop"?

You won’t stop everything at once. Deprescribing is slow. It’s one pill at a time. For blood pressure or antidepressants, it might take 4 to 12 weeks to taper down safely. Your doctor might ask you to track symptoms - like headaches, sleep changes, or mood - in a simple journal. You might need a follow-up visit in 2 weeks or a blood test in 6 weeks. Don’t be surprised if your doctor suggests a trial period: "Let’s cut this in half for 4 weeks and see how you feel." That’s not indecision. That’s good medicine. The key is monitoring. A 2019 study in the BMJ found that when antihypertensives were stopped too fast, 12% of patients had dangerous spikes in blood pressure. That’s why you need a plan, not just permission.

Where Else to Look for Savings

Your pharmacist is your secret weapon. Most community pharmacies offer free Medication Therapy Management (MTM) services under Medicare Part D. They’ll review your whole list, spot duplicates, check for interactions, and find cheaper alternatives. One 2022 study found pharmacists identified an average of $1,200 in annual savings per patient just by suggesting generic switches or discontinuing redundant supplements. If you’re taking a $90/month vitamin D supplement but your blood levels are normal? Your pharmacist can tell you to stop. If you’re on two different acid reflux meds? They can help you drop one. And don’t forget: the Inflation Reduction Act now caps insulin at $35/month. If you’re paying more, ask your doctor for a prescription change.

Real Savings, Real Stories

One woman in Ohio stopped three unnecessary medications after a brown bag review: a $120/month sleep aid, a $45/month supplement she didn’t need, and a $100/month migraine med that was being used for high blood pressure - and wasn’t even working for that. Her annual savings: $840. A Reddit user in Michigan cut a $75/month herbal remedy and a $90/month vitamin D pill after his blood test showed normal levels. He saved $1,980 in a year. Kaiser Permanente’s system-wide deprescribing program saved $1.2 million in one year - and reduced hospitalizations by 28%. For every dollar spent on structured deprescribing, health systems get $3.50 back in avoided costs. That’s not theory. That’s data.

What to Watch Out For

Not everyone can safely stop meds on their own. If you try to quit without medical guidance, you’re at risk. A 2022 survey by the National Council on Aging found 18% of people who self-discontinued meds ended up in the ER or doctor’s office with side effects - costing an average of $1,200 in unexpected care. That’s the opposite of saving. Also, don’t assume your specialist knows what your primary doctor is prescribing. If you see a cardiologist, a neurologist, and a pain specialist, each might add a new pill without knowing the others. That’s how polypharmacy happens. Ask your primary doctor to be the quarterback. Request a medication reconciliation - a full review of every drug you’re taking - every time you see a new specialist.

Why This Matters More Than Ever

Medication costs have risen 60% since 2014. For seniors on fixed incomes, prescriptions now eat up nearly 18% of their income. Meanwhile, 4.9 million older Americans are taking drugs that are more likely to hurt than help. The Lown Institute calls this "medication overload" - and says deprescribing is the #1 solution. It’s not just about saving money. It’s about living better. Fewer pills means fewer side effects. Fewer falls. Clearer thinking. More energy. And yes - less stress over monthly co-pays. You don’t have to accept that your meds are a financial burden. You have the right to ask if they’re still working. And you have the right to stop what’s no longer helping.

Next Steps: What to Do Right Now

1. Grab your medicine cabinet. Pull out every pill, bottle, and supplement - even the ones you haven’t opened.

2. Make a list. Write down the name, why you take it, and the monthly cost.

3. Call your pharmacist. Ask if they offer free Medication Therapy Management. They can spot savings you didn’t know existed.

4. Book your next appointment. Bring your list. Ask the five questions. Don’t leave without a plan.

5. Track your progress. If you stop or reduce a med, note how you feel - sleep, energy, mood, dizziness. Share it at your next visit.

You’re not asking to be let off the hook. You’re asking to be treated like a person - not a prescription list. And that’s worth every conversation.