Sticker shock at the pharmacy counter

Two-thirds of consumers don't know how much their prescription medications cost until they pick them up at the drugstore, according to a nationally representative survey of 2,004 adults conducted by the Consumer Reports National Research Center in January. And only 4 percent of consumers find out those prices from their doctor. But don't be fooled: They are worried about drug costs.

Nearly 70 percent of the survey respondents who regularly take prescription medications took steps to afford their drugs in the past year. And 28 percent resorted—without their doctor's or pharmacist's knowledge—to at least one potentially dangerous measure to do so. Specifically, they:

• Failed to fill a prescription (16 percent).
• Skipped a dose (16 percent).
• Took an expired medication (11 percent).
• Cut pills in half (10 percent).
• Shared a prescription (4 percent).

People under 65 without prescription drug coverage were especially likely to take those risky steps. (So were Hispanic Americans, according to a companion survey conducted in December 2008. It found that 51 percent of Hispanic respondents tried to save money by doing many of those same things.)

Many people also cut back on necessary purchases or resorted to dubious financial practices in order to afford their prescription drugs. For example, they:

• Spent less on clothing (30 percent).
• Cut back on groceries (23 percent).
• Relied more on credit cards (23 percent).
• Postponed paying other bills (15 percent).

That last step was particularly common among people who earned less than $40,000 a year or were under age 65 and lacked prescription drug coverage.

And while many survey respondents regularly took low-cost generics, those who could benefit most from them—people spending more than $50 a month on prescription drugs—were among the least likely to take them. And they were among the most likely to harbor misconceptions about generic drugs.

Overall, nearly half of consumers reported reservations about generics. They said that the medications have different side effects (27 percent), aren't as effective (22 percent), don't meet the same federal standards (18 percent), and aren't as safe (16 percent) as brand-name drugs. But, as we explain in our Worried About Generics? report, those concerns aren't justified.