We split pills in half or take the drugs every other day to stretch our doses. We stop filling the prescriptions for our most expensive drugs. We buy prescriptions from online pharmacies with questionable credentials.
As patients pay more for their prescription drugs - whether it's through higher insurance co-pays or shouldering the full costs - many people decide to opt out of taking the drugs altogether. But there are safer ways to cut costs than skimping on - or skipping - the medicines you need.
More emergency room visits, severe and uncontrolled asthma attacks, and an upswing in heart attacks and strokes are just some of the poor health outcomes associated with skipping a prescription due to its cost.
For a chronic disease like high blood pressure where the symptoms are not obvious, skipping the drug may seem like no big deal, according to Rebecca Snead, executive vice president of the National Alliance of State Pharmacy Associations.
But, "we don't want someone who can't afford a medicine to become someone who can't afford bypass surgery," warns John Michael O'Brien, a prescriptions cost expert at College of Notre Dame of Maryland.
That's exactly what happened with to Karen Merrill, who has heart disease. She felt worse when she stopped taking her prescriptions for a while after her heart attack, "and I ended up back in surgery for a bypass," she said.
When patients decide to stop taking a prescription or otherwise alter their doses without informing their doctors, they may put themselves at risk for overdose or harmful medicine interactions.
"A doctor may think a patient is taking a drug when he really isn't, and may prescribe another drug when it appears that the first drug isn't working," says Michelle Fritsch, a pharmacist and chair of the clinical and administrative sciences department at the College of Notre Dame.
Savings Plan
But maybe your insurance doesn't quite stretch to cover a brand-name antidepressant, or maybe you are stuck in Medicare's Part D "doughnut hole," waiting for your annual cap on prescription coverage to roll over. Maybe you have no insurance and no cash to spend at the pharmacy. How should you handle the costs?
"Every time you fill a prescription, talk to your pharmacist about lowering your drug costs," O'Brien advises. "Your pharmacist can explain your options and help your doctor choose a medicine that meets your needs."
However, "I don't know about you, but I know I would have a hard time standing in line with my pharmacist and saying, 'I can't afford this,'" says Merrill, who now works with the American Heart Association as a survivor-advocate.
In many cases, insurance companies directly notify pharmacies about less costly options in a class of cholesterol drugs, for instance, or a new generic version of a drug. "And if a generic is available for a drug you've been prescribed, you should take it," O'Brien says.