(Editor's Note: This is the first in a three-part series of articles on trimming your personal health care spending. The other articles offer tips on reducing the costs of doctor visits and medical tests and cutting the cost of children's care.)
Dec. 9, 2008 -- In these tight economic times, people are looking for ways to stretch their money. But when it comes to your medications, some cost-cutting strategies make sense, while others may be penny wise but pound foolish.
Here are expert dos and don'ts for cutting drug costs without compromising your health.
1. Do ask your doctor about generic drugs and over-the-counter drugs.
Many people "think they should be on brand-name medications," says Adam Goldstein, MD, MPH, professor of family medicine at the University of North Carolina Medical School.
But Goldstein tells WebMD that, with very rare exceptions, generic options are OK. For example, researchers recently reported in The Journal of the American Medical Association that heart disease patients typically do as well on generic drugs as on brand-name drugs.
2. Do ask if you can get higher-dose pills to cut in half.
That can be a way to make your pills last longer and for you to save money.
Ballantyne explains that high and low doses of drugs often cost the same amount. So getting a higher dose and cutting the pills in half could make your pills last twice as long.
For instance, Ballantyne says a patient who takes 20-milligram doses each day of a drug that costs $100 per month could save $600 a year if his doctor prescribes a 40-milligram dose and the patient cuts each pill in half.
Some pills don't work properly if they're split, warns Joel Zive, PharmD, vice president of Zive Pharmacy in the Bronx, N.Y. and spokesman for the American Pharmacists Association.
"Splitting pills is not necessarily a bad thing to do," says Zive. "It depends on the drugs." Your doctor or pharmacist can tell you if splitting your pills is an option.
3. Do ask if you can take a higher-dose pill to take less frequently.
This strategy is another way to make your pills last longer.
"A lot of folks are taking medication twice a day, and it may be actually cheaper to get a higher dose and take them once a day," Goldstein says.
4. Do consider switching from a combination pill to separate pills.
"Physicians are very open to the issues if someone is having financial problems," says Ballantyne.
Goldstein agrees. "A lot of my patients are being real frank about things they can afford and cannot afford," he says. For instance, he says some patients have told him, 'I can only take three or four medications; which ones should I take?'
"That's when we really have to turn to nonpharmaceutical ways of managing the issues," Goldstein says.
Zive suggests asking your pharmacist, privately, about costs. "You say, 'Look, I'm having a problem. Can you help me out a little bit with this?' and sometimes they can; sometimes they can't. ... it doesn't hurt to ask."
For instance, Zive says at his own pharmacy, "if somebody has an issue with a co-pay and they get paid at the end of the week, I say no problem, I'd rather you take this medication and you pay me in a few days, or I'll give you a couple pills now and you can come back."
6. Do look for the best price on your prescription drugs.
The cost of your prescription drugs may vary from store to store, so it may pay off to research prices.
"Not all pharmacies are created equal," Goldstein says. "It really can make a difference; it may be cheaper to shop around."
7. Do look into drug companies' assistance programs.
Drug companies have assistance programs to help cover medication costs for people who meet certain financial criteria.
"They're not always easy to navigate, and sometimes you need to fill out paperwork or go see your doctor and usually, for legal reasons, they won't deliver the medications to the pharmacy, but they're a good way to start," Zive says.
8. Do consider your Medicare Part D plan.
If you're 65 or older, or have Medicare because of a disability, you can switch Medicare Part D plans each year from Nov. 15 through Dec. 31, so you may want to asses whether your current plan is still the best deal for you.
"You have to be very, very careful when you make these changes," Zive says. "If you're not sure, ask your pharmacist or ask somebody."
9. Don't store pills incorrectly.
Heat, moisture, and darkness can "reduce the potency of the medication," says Zive, who warns against storing pills in bathroom medicine chests because of the heat and moisture in bathrooms.
"What would happen if you spent, say, either $100 on medications or $50 on a co-pay and you open up the vial and the medicines are all clumped together from moisture?" Zive asks.
10. Don't share pills or save pills.
Sharing pills is a no-no, even if it's with a relative.
"People do ask me, 'Can I give this to my brother for a headache? It worked for me.' Well, maybe 80% of the time, that would be fine, but the 20% of the time it could be a disaster, so I would not normally condone that," Zive says.
What if you have pills left over and you get the same illness again? It's not a great idea to use those pills again without checking with your doctor, because that drug may no longer be right for you or you may have developed another condition that your doctor needs to know about.
"You could be doing more damage than saving a few dollars," Zive says.
11. Be careful with promotions for expensive drugs.
If your doctor gives you a card offering a one-time deal on an expensive prescription drug, you might want to remember that that deal won't help you if you refill that prescription.
Zive says he cautioned a customer about that recently when she used a promotional card to cover her co-pay for an expensive steroid cream. Zive says he asked her, "What about next time? You're going to have to pay for it."
Such promotions are "a good marketing tool, and I'm certainly not putting that down, but I think what you have to be careful of is what seems like a great deal for free or inexpensive medication may or may not be," Zive says.