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

Many people over 65 take five or more medications every day. Some of these drugs may no longer be helping - and could even be hurting. You might be paying $100 a month for a sleep aid you haven’t needed in years, or taking a vitamin supplement your blood tests show you don’t need. The good news? You can talk to your doctor about stopping these medications - and save hundreds, even thousands, of dollars a year. This isn’t about skipping treatment. It’s about deprescribing: the smart, safe process of removing drugs that don’t belong anymore.

What Deprescribing Really Means

Deprescribing isn’t just quitting pills. It’s a planned, step-by-step approach to stopping medications that are no longer necessary, too risky, or too expensive. The idea started gaining real traction around 2012, when Canadian researchers began documenting how older adults were being overmedicated. Today, experts in the U.S. have built clear guidelines. The American Academy of Family Physicians says most people on multiple medications can safely reduce their list - if done right.

Why does this matter? Because polypharmacy - taking five or more prescriptions - affects 41% of adults over 65. And it’s not just dangerous. It’s expensive. One unnecessary $50-a-month drug adds up to $600 a year. A single avoidable hospital stay from a bad drug reaction can cost $15,700. The U.S. spends $30 billion a year on preventable hospital visits caused by too many meds. You don’t need to be sick to benefit from deprescribing. You just need to be paying too much.

Start with a Full Medication List

Before you walk into your doctor’s office, get every pill, patch, capsule, and supplement you take - even the ones you only use once in a while. Put them all in a brown bag. That’s the first step most doctors recommend. Don’t rely on memory. Write down the name, dose, why you take it, and how much you pay each month.

Most people bring in an average of 2.3 unnecessary medications during this review. One woman in Ohio stopped three drugs after her brown bag review: a $120/month sleep aid, a $45/month herbal remedy, and a $100/month vitamin combo. Her annual savings? $840. Another Reddit user cut out a $90/month vitamin D supplement after a blood test showed normal levels - and saved $1,080 in a year. These aren’t rare cases. They’re common.

Don’t forget over-the-counter drugs. Antacids, pain relievers, sleep aids, and even herbal products like melatonin or turmeric can interact with prescriptions or be completely redundant. Your pharmacist can help you sort through them. Most Medicare Part D plans offer free medication reviews with a pharmacist - no appointment needed.

Ask These Five Questions

Your doctor doesn’t know everything you’re taking unless you tell them. And they won’t automatically question every pill on your list. You have to lead the conversation. Here are five simple, powerful questions to ask at your next visit:

1. Why am I still taking this medication?
2. What’s the benefit right now - and is it still worth it?
3. Could this drug cause falls, confusion, or memory problems?
4. Can I stop it, reduce the dose, or switch to something cheaper?
5. Who should I call if I feel different after stopping it - and when?

These aren’t hard questions. They’re expected. The American Geriatrics Society says deprescribing should be part of every routine checkup for older adults. If your doctor seems surprised or dismissive, it’s not you - it’s the system. Most primary care visits last only 15 minutes. That’s not enough time for a full med review. So come prepared. Bring your list. Ask your questions. Push for clarity.

Know the Red Flags

Some drugs are more likely to cause harm than others - especially in older adults. The Beers Criteria, updated every few years by experts, lists 53 medications that should be avoided or used with extreme caution in people over 65. Common ones include:

• Benadryl (diphenhydramine) - for allergies or sleep
• Proton pump inhibitors (like omeprazole) - for heartburn, often taken for years without need
• Anticholinergics - used for overactive bladder or Parkinson’s
• Benzodiazepines - for anxiety or insomnia

These drugs increase the risk of falls, dementia, and hospitalization. A 2021 study found that stopping proton pump inhibitors reduced pneumonia risk by 25% - and saved patients $420 a year. If you’re on one of these, ask: “Is this still helping me? Or is it just sitting on my list?”

Deprescribing Is a Process - Not a Single Decision

You won’t stop all your meds at once. That’s dangerous. The goal is to reduce one drug at a time, over weeks or months. For example, if you’re on a blood pressure pill that’s no longer needed, your doctor might lower the dose slowly over six weeks while checking your numbers weekly. If you’re on a sleep aid, they might switch you to a non-drug approach first - like better sleep hygiene - before tapering off.

Stopping too fast can cause rebound effects. One study found that 12% of patients who quit blood pressure meds too quickly saw their numbers spike dangerously. That’s why monitoring matters. Your doctor should schedule a follow-up within two to four weeks after any change. Keep a journal: note how you feel, any new symptoms, sleep, energy levels, or dizziness. Bring it to your next visit.

Pharmacists Are Your Secret Weapon

Most people don’t realize their pharmacist can help with deprescribing. Under Medicare Part D, you’re entitled to a free medication therapy management (MTM) session with a pharmacist. They’ll review your entire list, check for interactions, spot duplicates, and suggest cheaper alternatives.

One 2022 study found that pharmacists identified an average of $1,200 in annual savings per patient just by finding duplicates or switching to generics. A $150/month brand-name drug might have a $15 generic equivalent. A supplement you’re paying $75 for might be covered by your diet. Your pharmacist knows these details - and they’re trained to help you cut costs safely.

What If You’re Afraid to Stop?

Fear is normal. What if I get worse? What if I need this? What if my doctor says no?

Here’s the truth: most medications lose their benefit over time. Statins for heart disease? Great for the first five years. After that, if you’re stable and healthy, the extra benefit drops off - but the cost and side effects stay the same. A 2021 JAMA Network Open study showed that older adults who stopped statins after age 75 had no increase in heart attacks - but saved hundreds per year.

If your doctor says no, ask why. Request evidence. Ask for a trial. Say: “Can we try stopping this for 30 days and see how I feel?” Most doctors will agree - especially if you’re willing to monitor your symptoms. If they refuse without explanation, consider a second opinion. Your health - and your wallet - deserve better.

The Big Picture: Why This Matters Now

Prescription drug prices have risen 60% since 2014. For seniors on fixed incomes, meds now eat up 18.3% of their income - more than rent in some places. The Inflation Reduction Act capped insulin at $35/month - a huge win. But it doesn’t cover the other 20 pills on your shelf.

Health systems are catching on. Kaiser Permanente cut inappropriate meds by 35% in just two years - and saved $1.2 million annually. Medicare Advantage plans now rate providers based on medication safety. Hospitals are using AI tools like MedStopper to flag high-risk prescriptions. This isn’t a fringe idea anymore. It’s becoming standard care.

Deprescribing isn’t about taking less medicine. It’s about taking the right medicine. And paying only for what actually helps you.

Next Steps: What to Do Today

1. Gather every medication you take - prescriptions, OTCs, supplements, creams, patches. Put them in a bag. 2. Write down the name, dose, reason, and monthly cost for each. 3. Call your pharmacist and ask if you qualify for a free medication review. 4. Write down your five questions before your next doctor’s visit. 5. Ask: “Which of these can we safely stop or reduce?” You don’t need to be sick to benefit from deprescribing. You just need to be paying too much. Start today. Your body - and your bank account - will thank you.