Prescription drug prices have gone sky-high in the United States and they will likely keep rising.

Medication prices rose by an average of 57 percent between 2006 and 2014, the Washington Post reports. Prescriptions with no generic substitutes increased by 142 percent in that same time span.

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These higher prices are taking a toll on Americans’ wallets and their health. Nearly a quarter of American adults and senior citizens report finding it difficult to pay for their prescription meds, according to a 2019 poll by the Henry J. Kaiser Family Foundation.

In addition, one in ten adults said they didn’t take their medicines as prescribed at some point in the past year due to drug costs. Stopping or altering a prescribed medication schedule can be harmful, even fatal, depending on the prescription; these are the medications you should never stop taking abruptly.

Most people assume health insurance will keep them from paying for expensive drugs out of pocket, but the truth is your prescriptions may not be covered by your insurance.

“Many plans make patients pay full drug costs until they meet their deductible, and other plans require coinsurance—both of which are based on the list price,” Robin Feldman, author of the upcoming book Drugs, Money, and Secret Handshakes, writes in the Washington Post. “Thus, people are forced to pay the full price at various times.”

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Understanding what your policy covers and doesn’t cover can be perplexing; these are some of the secrets your health insurance company is probably not telling you. If you are unlucky enough to be prescribed one of the most expensive drugs in America, this can be bad news, indeed.

GoodRx, a mobile app and website that helps Americans save money on their prescriptions, rounded up a list of the most expensive drugs in America and the prize for the most costly prescription drug goes to Actimmune, at $52,000 a month!

The drug is approved to treat the bone disease osteopetrosis and a rare immune disorder, chronic granulomatous disease, which causes the immune system to malfunction. Most patients typically take 12 vials a month at a list price of $4,360 per vial.

The drug manufacturer, Horizon Pharma, does help consumers who can’t afford the drug by offering a patient assistance program to provide uninsured or low-income patients with an Actimmune prescription at no cost.

Most drugs with jaw-dropping price tags are approved to treat rare conditions, though a couple medications for common health conditions also made the list. For example, the drug H.P. Acthar by Mallinckrodt Pharmaceuticals, which is prescribed to help treat people with lupus, rheumatoid arthritis, psoriatic arthritis, and multiple sclerosis, costs patients $38,892 a month. The medication was the subject of a 60 Minutes story on rising drug prices.

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If you’re being prescribed a new medication that comes with a high price tag, ask your doctor about generic alternatives or even OTCs that may offer the same benefits. To cut your pharmacy costs even more, learn the 16 questions to ask that could save you money on your medicine.

This article first appeared on Reader's Digest.