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

Every year, millions of people in the U.S. and New Zealand pay hundreds or even thousands of dollars for medications they no longer need. You might be taking pills for a condition that’s improved, supplements your body doesn’t need, or drugs that interact badly with others. The good news? You don’t have to keep paying for them. Deprescribing-the safe, planned process of stopping medications that aren’t helping anymore-isn’t just about health. It’s one of the most direct ways to cut your prescription costs without sacrificing safety.

What Is Deprescribing (And Why It’s Not Just Stopping Pills)

Deprescribing isn’t about quitting drugs cold turkey. It’s a careful, step-by-step conversation with your doctor to remove medicines that are doing more harm than good. This happens most often with older adults who take five or more medications-a situation called polypharmacy. About 41% of adults over 65 are on this many drugs, according to JAMA Internal Medicine. And for many, at least two of those pills aren’t necessary anymore.

Think of it like cleaning out your closet. You keep things that still fit and serve a purpose. You toss what’s worn out, duplicated, or doesn’t match your life anymore. Medications are the same. A statin you started ten years ago for high cholesterol might not be needed if your numbers are now normal. A sleep aid you took for a short-term stress period might still be in your cabinet, causing dizziness and falls. A daily vitamin D supplement? If your blood test shows you’re not deficient, you’re just paying for urine.

The goal? Reduce side effects, lower your risk of hospital visits, and save money-all at the same time. Kaiser Permanente’s program cut medication costs by $1.2 million in one year while reducing dangerous drug reactions by 28%. That’s not luck. It’s strategy.

How Much Money Are You Really Spending on Unnecessary Meds?

Let’s do a quick math check. If you’re taking one unnecessary $50-a-month pill, that’s $600 a year. Two? $1,200. Three? $1,800. Now add in the cost of side effects: falls, confusion, stomach bleeding, kidney damage. Those can lead to ER visits that cost $15,700 on average, according to Medicare data.

Real people are saving big. One 72-year-old woman in Ohio stopped three meds during a doctor visit and saved $840 a year. Another Reddit user cut out a $90/month vitamin D supplement and a $75/month herbal remedy-totaling $1,980 saved annually. And these aren’t rare cases. The Lown Institute says medication overload costs the U.S. system $30 billion every year in preventable hospital visits and wasted prescriptions.

You don’t need to be rich to feel this pinch. Seniors on fixed incomes spend nearly 18.3% of their income just on prescription drugs, according to the Kaiser Family Foundation. That’s more than rent in some places. Deprescribing isn’t a luxury. It’s financial survival.

How to Start the Conversation With Your Doctor

Most doctors want to help you cut costs and stay safe. But they’re busy. The average primary care visit lasts just 15.7 minutes, according to MGMA data. So you need to come prepared.

Step 1: Do a brown bag review. Take every pill, capsule, patch, and supplement you take-even the ones you only use once in a while. Include over-the-counter drugs like ibuprofen, antacids, and herbal teas. Put them all in a bag and bring them to your appointment. Most doctors say this makes the conversation 68% more effective.

Step 2: Ask the right questions. Don’t wait for your doctor to bring it up. Be direct:

• Why am I still taking this?
• What’s it supposed to do for me right now?
• Could it be making me dizzy, confused, or tired?
• Is there a cheaper or safer alternative?
• Can I stop it completely-or reduce the dose?
• Who should I call if I feel worse after stopping?

These aren’t rude questions. They’re smart ones. The American Academy of Family Physicians says these are the core of any good deprescribing plan.

What Happens After You Decide to Stop?

You won’t just walk out with a prescription for nothing. Deprescribing is a process, not a single decision.

One at a time. Never stop multiple meds at once. Your doctor will pick the most likely unnecessary one-maybe a sleep aid, a daily aspirin you’ve been taking for years, or a cholesterol drug that’s no longer needed.

Slow and steady. Most meds need to be tapered. Stopping blood pressure pills too fast can cause rebound high blood pressure. Stopping antidepressants suddenly can cause brain zaps, nausea, or anxiety. Your doctor will give you a plan-maybe cutting the dose in half for two weeks, then stopping. They’ll ask you to check in after two weeks to see how you’re feeling.

Track your symptoms. Keep a simple log: date, medication stopped, how you felt each day. Did your sleep improve? Did your headaches go away? Did you feel more alert? This helps your doctor know if the change was right.

Use your pharmacist. Many community pharmacies offer free Medication Therapy Management (MTM) services under Medicare Part D. Pharmacists review your whole list, spot duplicates, check for interactions, and often find cheaper generic options. One study found they identify an average of $1,200 in annual savings per patient.

When Deprescribing Might Not Be Safe

Not every med can-or should-be stopped. Some drugs serve multiple purposes. For example, a beta-blocker might treat high blood pressure, heart rhythm issues, and migraines. Stopping it could trigger a migraine attack or worsen heart function.

Also, some conditions improve, but the meds stay because “it’s always been this way.” But if your heart failure has improved with lifestyle changes, your doctor might safely reduce your diuretics. If your diabetes is under control with diet and exercise, your metformin dose might be lowered.

The key is timing and monitoring. The Beers Criteria-a widely used list of potentially inappropriate medications for older adults-helps doctors spot risky drugs. It includes things like long-term benzodiazepines (sleep aids), certain anticholinergics (for overactive bladder), and NSAIDs (like ibuprofen) for people with kidney issues.

If your doctor says no, ask why. Get it in writing. Ask for a second opinion. You have the right to understand every medication you take.

What’s Changing in 2026 That Helps You Save

The system is catching up. Since 2023, the Inflation Reduction Act capped insulin at $35 a month. That’s huge. But it’s also pushing insurers to look at the whole picture.

Medicare Advantage plans now include medication safety scores in their quality ratings. Hospitals and clinics that reduce inappropriate prescribing get better ratings-and more funding. That means more clinics are hiring pharmacists to help with deprescribing.

AI tools like MedStopper are being used in 127 hospitals to flag drugs that can be safely stopped. These tools analyze your history, lab results, and current meds to suggest cost-saving cuts with 89% accuracy.

And if you’re on Medicare Part D, you’re eligible for free medication reviews. Ask your pharmacy or call your plan’s member services. You don’t need to wait for a doctor’s appointment.

What Happens If You Try to Deprescribe on Your Own?

It’s tempting. You see a pill you haven’t taken in months. You think, “I don’t need this anymore.” So you toss it. Bad idea.

A 2022 survey by the National Council on Aging found that 18% of people who stopped meds without medical supervision ended up in the ER or urgent care. The average cost of those visits? $1,200. That’s more than the cost of the meds you were trying to save on.

Withdrawal effects can be sneaky. Stopping a blood pressure pill too fast can spike your pressure. Stopping an antidepressant suddenly can cause brain zaps, dizziness, or panic attacks. Even stopping a daily antacid can cause rebound heartburn.

Deprescribing works because it’s guided. It’s not about willpower. It’s about science, timing, and support.

Final Thoughts: You’re in Control

Your medications are not permanent. They’re tools. And like any tool, they can be retired when they’re no longer useful. You don’t have to keep paying for pills that aren’t helping. You don’t have to live with side effects because “it’s always been this way.”

Start small. Bring your brown bag to your next appointment. Ask one question. Write down one change. You might save $500. You might avoid a fall. You might feel more like yourself again.

This isn’t about cutting corners. It’s about choosing better. And it’s your right to do so.