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

More than 4 in 10 adults over 65 take five or more prescription drugs every day. Many of these aren’t helping anymore-but they’re still costing you hundreds, sometimes thousands, each year. You’re not alone. People are paying for pills they don’t need, and their doctors often don’t know they’re still taking them. The good news? You can fix this. Working with your doctor to stop unnecessary medications-called deprescribing-can cut your drug bills, lower your risk of side effects, and even keep you out of the hospital.

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

Deprescribing isn’t about quitting meds cold turkey. It’s a careful, step-by-step process where you and your doctor review every pill, patch, and supplement you’re taking-and decide which ones you can safely stop. This isn’t just for older adults. About 15% of people between 40 and 64 are also taking too many drugs. The goal? Remove medications that don’t do enough good to justify the risk or cost.

For example, someone might still be taking a proton pump inhibitor (PPI) for heartburn five years after their symptoms disappeared. Or they’re on a statin for cholesterol even though their life expectancy is now limited due to other health issues. These drugs cost money and can cause real harm: dizziness, falls, memory problems, kidney stress, even infections.

Studies show that stopping just one unnecessary $50-a-month drug saves $600 a year. Avoiding a single medication-related hospital stay-which costs an average of $15,700-saves far more. Kaiser Permanente’s program cut inappropriate medication use by 35% and saved $1.2 million in one year alone. That’s not magic. That’s smart medicine.

How to Prepare for Your Deprescribing Conversation

You can’t fix this in a 10-minute visit. You need to come prepared. Start by doing a brown bag review. Empty every pill bottle, capsule, patch, and supplement you take into a bag-yes, even the ones from the dollar store or the herbal remedies your cousin swore by.

Bring this bag to your appointment. Include:

• All prescription drugs
• All over-the-counter meds (like ibuprofen, antacids, sleep aids)
• Vitamins, minerals, and supplements (even if they’re labeled "natural")
• Any medications you stopped taking but still have in your cabinet

While you’re at it, write down the cost of each item. Many people don’t realize how much they’re spending. One woman in Ohio found she was paying $120 a month for a sleep aid she hadn’t needed in two years. Another cut $1,980 a year by stopping a $90/month vitamin D supplement after her blood test showed she wasn’t deficient.

Doctors say patients who bring a complete list make deprescribing discussions 68% more productive. That’s because they see the full picture-not just what’s in the electronic record.

Ask These Five Questions at Your Appointment

Don’t let your doctor rush you. Use this moment to get clarity. Here are five questions that work:

1. Why am I taking this medication? What condition is it meant to treat? Is it still relevant?
2. What are the benefits versus the risks? Is this drug preventing a serious problem-or just causing new ones like dizziness, confusion, or stomach bleeding?
3. Can this drug cause falls or memory problems? Many common meds (like antihistamines, benzodiazepines, or certain blood pressure drugs) increase fall risk in older adults. Falls are the leading cause of injury-related hospitalizations in seniors.
4. Can I stop or reduce this dose? Not all meds need to be taken daily. Some can be lowered, taken every other day, or stopped entirely.
5. Who should I follow up with, and when? If you stop a drug, you need to know what to watch for and when to call back.

These questions aren’t confrontational-they’re practical. Your doctor wants you to be safe. They just might not have had the time to ask these things themselves.

What Tools Do Doctors Use to Decide What to Stop?

Doctors don’t guess. They use evidence-based tools. One of the most trusted is the Beers Criteria, a list of 53 medications that are often inappropriate for older adults because of side effects. If you’re on any of these, it’s worth asking about.

Another tool is the Medication Appropriateness Index (MAI). It scores each drug across 10 factors: Is it needed? Is the dose right? Are there better alternatives? Is it causing harm? It takes about 7 minutes per medication-but it’s worth it.

Some clinics now use AI tools like MedStopper, which scans your medication list and flags high-risk or low-benefit drugs with 89% accuracy. These tools aren’t replacing doctors-they’re helping them do their job better.

How Deprescribing Actually Works: Tapering, Not Stopping

You won’t walk out with a prescription to stop everything. That’s dangerous. Deprescribing is slow. Usually, one drug at a time. Sometimes over weeks or months.

For example, if you’re on a sleeping pill like zolpidem, your doctor might suggest cutting the dose in half for two weeks, then taking it every other night, then stopping. Why? Because sudden stops can cause rebound insomnia, anxiety, or even seizures.

Same with blood pressure meds. Stopping too fast can cause your pressure to spike dangerously. That’s why 12% of people who tried to quit on their own ended up in the ER, according to the National Council on Aging.

Good deprescribing includes a plan: what to watch for, when to call, how to track symptoms. Your pharmacist can help here too. Most offer free Medication Therapy Management (MTM) services under Medicare Part D. They’ll review your whole list, spot duplicates, suggest cheaper generics, and even call your doctor with recommendations.

Real Savings: What You Can Expect to Save

Let’s get specific. Here’s what people actually saved:

• Stopping a $120/month sleep aid = $1,440/year
• Discontinuing a $90/month vitamin D supplement = $1,080/year
• Getting off a $75/month herbal remedy = $900/year
• Stopping an unnecessary statin = $600-$1,200/year
• Switching from a brand-name PPI to a generic = $300-$500/year

One patient in a Kaiser study stopped three unnecessary drugs and saved $840 in one year. Another avoided a hospitalization by stopping a drug that caused confusion and falls-saving $15,700.

And it’s not just about the pills. The U.S. spends $30 billion a year on preventable hospital visits from bad drug reactions. Deprescribing cuts that. For every dollar spent on structured deprescribing programs, systems save $3.50.

When Deprescribing Might Not Be Right

It’s not always simple. Some drugs serve multiple purposes. A blood pressure pill might also help with migraines. An antidepressant might be used for nerve pain. Stopping one could affect another condition.

Also, if you have a chronic illness like heart failure or kidney disease, some meds are critical-even if they’re expensive. The goal isn’t to cut costs at all costs. It’s to cut unnecessary costs.

And if you’re seeing multiple doctors? That’s a red flag. One study found that patients who see three or more prescribers are 300% more likely to get duplicate or conflicting prescriptions. Talk to your primary doctor about coordinating care. Ask if they can be your medication “captain.”

What’s Changing in 2025 to Help You Save

The system is starting to catch up. Since 2023, the Inflation Reduction Act capped insulin at $35/month and expanded access to comprehensive medication reviews under Medicare. Starting in 2024, Medicare Advantage plans are being scored on medication safety-meaning hospitals and clinics now get paid more for helping patients deprescribe.

And more insurers are covering MTM services. Community pharmacists are now key players in this process. You don’t need a doctor’s referral-just walk in with your bag of meds.

By 2025, 72% of major health systems will have formal deprescribing programs. That’s up from 28% in 2018. The momentum is real. But you still have to start the conversation.

What Happens If You Don’t Do Anything?

If you keep taking drugs you don’t need, you’re not just wasting money. You’re increasing your risk of:

• Falls and fractures
• Memory loss and confusion
• Stomach bleeding from NSAIDs or blood thinners
• Kidney damage from too many painkillers
• Emergency room visits and hospital stays

One in three hospital admissions for people over 85 is caused by a medication problem. That’s not bad luck. That’s preventable.

And the financial toll? The Lown Institute estimates 4.9 million older Americans are taking inappropriate meds right now-costing $13.6 billion in drug expenses and another $16.4 billion in extra care. You don’t have to be part of that statistic.

Next Steps: What to Do Right Now

1. Empty your medicine cabinet into a bag. Include everything-even expired pills.

2. Write down the cost of each item. Use your pharmacy receipt or a free app like GoodRx.

3. Call your primary care doctor and ask for a medication review. Say: “I’d like to go over my meds to see if anything can be safely stopped or lowered.”

4. Ask about MTM services at your pharmacy. Most offer them for free under Medicare.

5. Don’t stop anything on your own. Even if it seems harmless, some drugs need to be tapered.

6. Follow up in 4-8 weeks. Track how you feel. Did your sleep improve? Did your dizziness go away? Share it with your doctor.

Deprescribing isn’t about giving up treatment. It’s about getting back control. It’s about making sure every pill you take is doing real work-and not just taking money out of your wallet.