Good advice to cut prescription drug costs

Just like saving money on groceries or finding the best deal on gas, smart consumers can cut their prescription drug costs with just a little bit of work, say pharmacists at the University of North Carolina at Chapel Hill.

Stefanie Ferreri, Pharm.D., and Jena Ivey, Pharm.D., both practicing pharmacists and clinical assistant professors at the UNC Eshelman School of Pharmacy, offer the following tips to help lessen the sting of prescription drug prices for patients of all ages and conditions.

Individuals should review all their medications with their doctor or a pharmacist to be sure that everything is necessary, Ferreri advised. People often continue to fill prescriptions after the need for them has passed or may end up taking different medicines that do the same thing.

"Put all your medicines in a paper bag and take them to your doctor or a pharmacist. Make sure that you're taking all of them for a good reason and aren't taking duplicates," Ferreri said. "You may also be taking nonprescription medicines or supplements that you don't need or of dubious value."

Reviewing everything at once is also the best way to spot drugs that could have undesirable interactions when taken together.

Generic drugs are easily the best way to save on prescriptions, Ferreri recommended, noting that they are as effective as brand names but cost 30 to 80 percent less. In 2007, the average price of a generic prescription drug was $34.34, while the average price of a brand-name prescription drug was $119.51, more than three times as much. In addition, many health plans require a lower co-pay for generic drugs.

Since Wal-Mart introduced its $4 generic-drug program, many other retailers have followed suit. Target, CVS, Kroger and others - including many independent pharmacies - offer the same pricing on a standard list of drugs.

"While the $4 list is not even close to comprehensive, there are many useful, tried-and-true drugs there," Ferreri said.

To find out whether particular medications have generic equivalents, talk to a pharmacist or check the FDA's definitive Orange Book available at http://www.fda.gov/cder/ob.

Physicians do not always know the prices of the drugs they are prescribing or might be uncomfortable bringing up the subject of money with a patient, Ferreri said.

"Tell your doctor if a drug is too expensive and ask if there are alternatives. Even if there is no generic equivalent for one drug, there may be a similar drug out there that does have a less expensive generic.

"For example, Lipitor has no generic equivalent, but Zocor does. Both drugs help lower cholesterol," Ferreri said. "If your doctor agrees, switching to simvastatin, which is Zocor's generic version, could save you around $90 a month."

"Just because one place has the best price on one of your drugs, it doesn't mean they have the best price on all of them," Ivey said. "I have seen prices on brand-name drugs vary significantly from one pharmacy to the next."

However, be cautious about going online, Ivey said. Beware of buying from a Web site that is or claims to be in another country.

"There's no way for you to be sure of what you are actually getting." Ivey said. "If I'm going to put something in my body that has the potential to make me very sick or kill me, I'm going to be very picky about where I get it."

Consider whether the standard 30-day supply of a medicine is the best value. Buying more pills at once will lower the cost per dose. This is true even for drugs on retailers' generic $4 programs, Ferreri noted. While a 30-day supply is $4, a 90-day supply is only $10, not $12.

On the flip side, buying a 30-day supply is a waste if trying a new drug which quickly turns out to not be effective or has intolerable side effects, she cautioned.

"There is no sense in buying a month's supply of a new drug if you find out it doesn't work after a week of taking it," Ferreri said. "You can't return it for store credit."

While doctors do have free samples of some drugs, those medications may not be the best option, Ivey said.

"Drug company reps tend to provide doctors with the latest medicines that may or may not be better than old standbys," she said. "You may experience some sticker shock once the freebies dry up."

Physicians are also required to keep tabs on their samples the same way a pharmacy tracks its inventory. Fewer doctors are willing to devote limited time and resources to doing so, Ivey said.

Buying higher-dose pills and cutting them in two is an option for some people. Double-strength medicines are usually nowhere close to double the price, Ivey said.

However, be sure to talk to a doctor and pharmacist before trying this, she warned, because many medicines such as time-release formulas, capsules and oddly shaped pills cannot be safely divided at home. The composition of some pills also makes them difficult to split accurately. Be precise when cutting. Inexpensive pill splitters available at pharmacies can help.