Sugar may help the medicine go down. But it won’t disguise the fact that you’re paying more for prescription drugs—recently about 8 percent more each year, according to the Henry J. Kaiser Family Foundation.

You’re probably feeling the biggest pinch if you’re one of the nearly 47 million Americans without health insurance, or if your plan offers only limited drug coverage or requires high co-payments. Likewise for seniors who land in Medicare Part D’s “doughnut hole” coverage gap. In 2008, standard Medicare drug plans will pay up to $2,510 for prescription drugs, but drop coverage until expenses reach $5,726, leaving beneficiaries with more than $3,200 in drug costs (the "hole") out-of-pocket.

Here are cost-cutting strategies that can help you save on medications without cutting corners on quality—or your health.

	Take advantage of membership perks
		If you're a veteran or belong to a union or other organization, you might be entitled to special drug discounts. The Department of Veterans Affairs offers low-income veterans free prescriptions. Veterans with slightly higher incomes can receive 30-day prescriptions for $8. To take advantage of this benefit, you have to be treated by a VA doctor. Unions typically offer drug discounts to members through their health plans, while other organizations, including alumni associations and AAA, often provide free prescription-discount cards with membership. Some groups, like AARP, offer drug-savings plans for a small yearly fee. (For more information, go to www.aarppharmacy.com/AARPnet.

Buy generics. If your medicine cabinet is brimming with brand-name drugs, consider switching to generics. As effective and safe as name-brand drugs, generics typically cost 30 to 80 percent less, says Mark Merritt, the president and chief executive of the Pharmaceutical Care Management Association, which represents pharmacy benefits managers (PBMs) that coordinate drug coverage for health insurers.

Patents are expiring on several major blockbuster drugs in the next three years, and that’s good news for consumers. But shop carefully: Generic prices can vary significantly from pharmacy to pharmacy.

Consider filling your prescriptions at discount retailers or wholesale clubs. Wal-Mart charges $4 for a 30-day supply of more than 360 generics. (For information, go to www.walmart.com or call 800-925-6278.) Target also offers $4 generics. (Go to www.target.com to view a list of available medications or call 800-440-0680.) And Costco charges $10 for 100 capsules of more than 250 generic drugs (www.costco.com or 800-774-2678.)

If your prescription plan is managed by a PBM, check for discounts. Medco (www.medco.com) offers people in small to midsized businesses a 90-day supply of most generic drugs for $10.

Use mail order. Whether your PBM has a mail-order service like Express Scripts (www.express-scripts.com) or you order from an online pharmacy like www.drugstore.com, you can often save 25 percent or more and, depending on your drug needs, delay your entry into the Medicare doughnut hole each year by an estimated 74 days if you also use generics, according to the pharmaceutical association.

If you opt for an online pharmacy, do your homework. Many aren’t licensed and might sell counterfeit or substandard medicine. The Food and Drug Administration (www.fda.gov/buyonlineguide) recommends purchasing only from Verified Internet Pharmacy Practice Sites, or VIPPS, which have a seal from the National Association of Boards of Pharmacy. For a list, go to www.vipps.info. The Medicare Rights Center, an advocacy group based in New York, also lists mail-order pharmacies that meet FDA criteria for safety (www.medicarerights.org/rxchart3.html).

Buying brand-name medications from Canada can boost your mail-order savings, sometimes up to 50 percent. Generics, however, are cheaper in the U.S. And drugs bought in Canada will not count toward your Medicare Part D deductible. While it’s illegal to buy drugs from foreign countries, including Canada, because of safety concerns, the FDA may refrain from taking legal action if you can provide your doctor’s name, address, and phone number, and confirm that the drugs are for personal use. If you wish to explore this option, look for pharmacies with the Canadian International Pharmacy Association seal. Go to www.pharmacychecker.com, an independent group that evaluates online pharmacies, for the highest-rated sites.

When buying drugs through the mail, factor in the cost of shipping. And plan ahead so that you have enough time to refill your medications before you run out.

Comparison-shop. Prescription prices are seldom fixed, so it pays to shop around. A recent Consumers Union report found that seniors in Broward County, Florida, were able to get lower prices than those offered through their Medicare Part D plans just by diligent shopping. For instance, a 30-day supply of the antidepressant Zoloft was $77.72 at a Sam’s Club, compared with $101.01 through a Medicare plan.

Ask about cheaper alternatives. Many high-cost drugs have name-brand or generic alternatives in the same category that are equally effective and considerably cheaper. Consumer Reports Best Buy Drugs (www.CRBestBuyDrugs.org) lets you look up medications in a particular class, such as cholesterol-cutting statins, to find the safest, most affordable Best Buys. Print out this information and discuss it with your doctor. Switching from more expensive medications to Best Buys can save you $1,000 to $2,000 a year.