Cutting Health Care Costs: Drugs

11 Tips on Trimming Prescription Drug Costs Without Compromising Your Health

Medically Reviewed by Louise Chang, MD on December 09, 2008

(Editor's Note: This is the first in a three-part series ofarticles on trimming your personal health care spending.The otherarticles offer tips on reducing the costs of doctor visits and medicaltests and cutting the cost of children's care.)

Dec. 9, 2008 -- In these tight economic times, people are looking for waysto stretch their money. But when it comes to your medications, some cost-cuttingstrategies make sense, while others may be penny wise but pound foolish.

Here are expert dos and don'ts for cutting drug costs without compromisingyour health.

1. Do ask your doctor about generic drugs and over-the-counter drugs.

Many people "think they should be on brand-name medications," saysAdam Goldstein, MD, MPH, professor of family medicine at the University ofNorth Carolina Medical School.

But Goldstein tells WebMD that, with very rare exceptions, generic optionsare OK. For example, researchers recently reported in The Journal of the American MedicalAssociation that heart disease patients typicallydo 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 savemoney.

Ballantyne explains that high and low doses of drugs often cost the sameamount. So getting a higher dose and cutting the pills in half could make yourpills last twice as long.

For instance, Ballantyne says a patient who takes 20-milligram doses eachday of a drug that costs $100 per month could save $600 a year if his doctorprescribes 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 theAmerican 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 ifsplitting 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 beactually cheaper to get a higher dose and take them once a day," Goldsteinsays.

4. Do consider switching from a combination pill to separate pills.

"Physicians are very open to the issues if someone is having financialproblems," says Ballantyne.

Goldstein agrees. "A lot of my patients are being real frank aboutthings they can afford and cannot afford," he says. For instance, he sayssome patients have told him, 'I can only take three or four medications; whichones should I take?'

"That's when we really have to turn to nonpharmaceutical ways ofmanaging 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?' andsometimes they can; sometimes they can't. ... it doesn't hurt to ask."

For instance, Zive says at his own pharmacy, "if somebody has an issuewith a co-pay and they get paid at the end of the week, I say no problem, I'drather you take this medication and you pay me in a few days, or I'll give youa 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 varyfrom store to store, so it may pay off to research prices.

"Not all pharmacies are created equal," Goldstein says. "Itreally 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 forpeople who meet certain financial criteria.

"They're not always easy to navigate, and sometimes you need to fill outpaperwork or go see your doctor and usually, for legal reasons, they won'tdeliver 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 adisability, you can switch MedicarePart D plans each year from Nov. 15 through Dec. 31, so you may want toasses 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 asksomebody."

9. Don't store pills incorrectly.

Heat, moisture, and darkness can "reduce the potency of themedication," says Zive, who warns against storing pills in bathroommedicine chests because of the heat and moisture in bathrooms.

"What would happen if you spent, say, either $100 on medications or $50on a co-pay and you open up the vial and the medicines are all clumped togetherfrom 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 itcould 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'snot 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 developedanother condition that your doctor needs to know about.

"You could be doing more damage than saving a few dollars," Zivesays.

11. Be careful with promotions for expensive drugs.

If your doctor gives you a card offering a one-time deal on an expensiveprescription drug, you might want to remember that that deal won't help you ifyou refill that prescription.

Zive says he cautioned a customer about that recently when she used apromotional card to cover her co-pay for an expensive steroid cream. Zive sayshe asked her, "What about next time? You're going to have to pay forit."

Such promotions are "a good marketing tool, and I'm certainly notputting that down, but I think what you have to be careful of is what seemslike a great deal for free or inexpensive medication may or may not be,"Zive says.

Show Sources


Christie Ballantyne, MD, director, Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center; professor of medicine, Baylor College of Medicine, Houston.

Adam Goldstein, MD, MPH, professor of family medicine, University of North Carolina at Chapel Hill School of Medicine.

Joel Zive, PharmD, vice president, Zive Pharmacy, New York; spokesman, American Pharmacists Association.

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