April 22, 2015

Cost-Saving Tips for Prescription Drugs

I've spent some time lately checking advice on reputable healthcare sites about saving money on prescription drugs. The guidance I’ve found is sometimes confusing. A site might recommend online searching, then later counsel to stay with the same pharmacy for all prescriptions. Another site might suggest asking the doctor for free samples, and then later warn that Big Pharma gives doctors those samples to promote expensive meds.

In a post last week, I tried to untangle some confusing recommendations regarding discount drug programs. Today I want to share cost-saving tips that seem generally accepted.

Talk to your doctor about costs. Unless you bring it up, your doctor might assume that money isn't a factor for you. Many doctors think only about results, not costs.

Ask your doctor for generics. Generic drugs can cost up to 95 percent less than comparable brand names. Nearly 80 percent of all medications now have generic versions. The FDA regulates generics and brand names in the same way. I've been surprised how often doctors have prescribed brand names without letting me know generics were available. It pays to ask. Even if there’s no generic for the specific prescribed drug, ask whether another generic in the same class might safely and effectively do the trick.

Buy a pill splitter. Saving money can be as easy as buying a $3 pill splitter. You may often be able to save money if you fill a prescription for pills that are twice the dose you need, and then cut them in half. The FDA has called pill splitting a "risky practice" and does not encourage it unless the package insert specifically indicates that splitting is OK. However, the medical advisors for Consumer Reports have condoned splitting if 1) your doctor agrees, 2) you learn how to do it properly, and 3) you only use the practice on pills that can be split. Don't use a knife or scissors; those devices could create unequal halves and dangerous outcomes. Pills should only be split in half, not into smaller portions.

Don't fall for free samples, but… Drug companies give freebies to doctors as marketing tools for high-priced meds, although they might not be the best treatment for you. But sometimes free samples can be a good deal. My former neurologist sometimes gave me free samples of carbidopa-levodopa, the gold standard med for Parkinson's. I got the impression I could have received freebies on every visit if I had asked for them.

Shop online carefully. Experts generally recommend filling all prescriptions at one store to reduce the risk of dangerous drug interactions. But sometimes you might be tempted to shop online for a very expensive drug. Brand-name drugs appear less expensive on websites that claim to be based in Canada or Europe, but don't be fooled, Most of those foreign websites are illegitimate, and the drugs they promote are often counterfeit and carry way too big a risk.

Shopping on American websites can pay off. Last year, Consumer Reports searched for the best price on four widely prescribed brand-name drugs. The lowest prices were found on three websites that CR claimed were OK to use:
But a recent analysis of more than 8,000 online pharmacies conducted by the National Association of Boards of Pharmacy found that only three percent of them appear to be legitimate.

Check out drug discount programs at drugstore chains and big-box retailers. For almost a decade, big pharmacies have been selling select generic drugs for as little as $1 for a week's supply. You've probably seen ads for similar drug programs at big retailers and supermarket chains. The rules governing eligibility vary greatly. My CVS pharmacy restricts membership in its Health Savings Pass plan to people who are uninsured or underinsured. Such restrictions are common. But Walmart's program, open to all, has a copay of $4 for a 30-day supply of about 300 generic drugs. Participants get free shipping on 90-day supplies for $10. Pets also qualify for $4 generics and for the home delivery program.

This just in! I was ready to publish this post but decided to check my email first. Lo and behold, there was an email from UnitedHealthcare, which hosts my AARP/Medicare plan, with the headline: "You could save 20% or more on your prescription co-pays with the Preferred Retail Pharmacy Network."

I checked the "find a pharmacy" link, entered my ZIP Code, and found that a participating Rite Aid is almost as close as my CVS.

The CVS is next to the Safeway where I frequently shop. The Rite Aid is in a local medical office building where my urologist has his office, but I only see him twice a year. So, convenience or cost? It's a choice we all frequently face. These days, convenience tends to win out (as does lethargy).

I don't know why I haven't done this before (lethargy again), but I just called CVS and asked for the copayments on my three prescription drugs. Here they are:
  • lisinopril: $3.81
  • carbidopa-levodopa: $27
  • Azilect: $45
My copay total is $75.81. The UnitedHealthcare offer indicates "savings of up to 20 percent." So my maximum possible saving from switching from CVS to Rite Aid would be $15.61. Care to guess what my decision is?

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