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How to Cut Drug Costs With No Ill Effects

January 22, 2001|Jonathan Fielding and Valerie Ulene

The increasing cost of prescription drugs has left many people struggling to pay for their medications. Even without help from the politicians debating this problem, there are a number of ways to cut your costs without compromising the quality of your medical care. Some of these cost-cutting ideas, in fact, could even enhance your health.

The best way to save money is to avoid taking any medications that are not absolutely necessary. Though this may sound obvious, many people take medications for conditions that could be treated just as well--if not better--without them. Antibiotics, for example, are frequently prescribed for viral illnesses, such as colds and the flu. (The Centers for Disease Control and Prevention estimates that more than 50 million unnecessary antibiotic prescriptions are written each year for these types of conditions.) Though antibiotics may be an appropriate treatment in some cases, many times they offer no benefit and needlessly expose patients to the risk of side effects.

Sometimes the need for medications can be eliminated by treating the underlying cause of a person's symptoms. People suffering from recurrent tension headaches, for example, are often treated with pain medication when stress reduction techniques could prevent many of these headaches. Insomnia is sometimes treated with sleeping pills when behavioral changes, such as a regular bedtime and avoiding caffeine, would be more effective.

Ask your doctor if there are any nondrug alternatives to the medications they want to prescribe. Many people take a pill to lower their blood pressure, reduce their cholesterol or control their diabetes, when lifestyle changes may be a much better choice. A low-salt diet, along with weight loss and regular exercise, for example, can be an effective way to help bring down mild elevations in blood pressure. A low-fat, low-cholesterol diet can go a long way to reduce elevated blood cholesterol levels. (Even if you require medication, it can frequently reduce the dose you need).

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If you must take medications, you can help lower the cost in several ways. The most expensive medication is not necessarily the best. Ask your doctor if the drug is available in generic form. Generics, which must by law be therapeutically equivalent to a brand-name drug, can cost 30% to 60% less. About half of all brand-name drugs have a generic substitute.

Also ask if a less-expensive drug--not necessarily a generic one--might work just as well as the one your doctor wants to prescribe. For almost every medical condition, there are several drugs that can be used to treat it. There are dozens of drugs to treat high cholesterol, for example. While some of these drugs have nearly identical effects on your cholesterol, they are not identically priced.

You can often save a lot of money on drugs by shopping for the best price, because prices can vary at different pharmacies. To prove this, we informally surveyed about half a dozen pharmacies in Los Angeles to compare prices for the cholesterol-lowering drug Lipitor. We found, for example, that one pharmacy charged $1.50 more per pill than another pharmacy about two miles away. That could add up to nearly $500 more per year.

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If you need to take a drug for a prolonged period, you might save even more money by using a mail-order or online pharmacy. Though they are not an option for medications you need immediately, such as antibiotics to treat an infection, they may be a good choice for medications you have to take day after day, month after month. They also offer the convenience of delivery right to your door.

If you have prescription drug coverage, read your policy carefully to see which pharmacies your insurance company recommends. In most cases, they have already negotiated the best price for you.

Medicare beneficiaries who have high prescription drug costs should look into purchasing a supplemental insurance policy. Though expensive themselves, these policies may be able to save you money, particularly if you are taking several medications over long periods of time. Switching to a Medicare HMO is another option to consider, because prescription drugs (which are not covered under the fee-for-service Medicare plan) are covered by most HMOs.

Finally, always follow directions precisely when taking prescription drugs. Some people try to save money by reducing their dosage or skipping pills. This reduces the drug's effectiveness and increases the likelihood of medical problems that, in the long run, may cost you more than the money you think you saved.

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Dr. Jonathan Fielding is the director of public health and the health officer for the Los Angeles County Department of Health Services. Dr. Valerie Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. They can be reached at ourhealth@dhs.co.la.ca.us. Our Health runs the second and fourth Mondays of each month.

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