In this report
Overview
What this guide can do
The science behind BBD
The generic advantage
11 Rx drug strategies
How much you could save
Free resources

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March 2009
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What this guide can do

We published the Best Drugs for Less magazine to give you a source of science-based, comparative drug information that is free of all hype and commercial influence. You won't find any drug ads among these pages because, like all Consumer Reports publications, we accept no outside advertising.

Our advice is premised on three core beliefs: First, that drug makers should not be the sole source of information for consumers about their products; second, that consumers should play an active role alongside their doctors in evaluating treatment options; and, third, that informed consumers are more likely to choose the right medicines—and, in general, to get better medical care. This publication is also about saving money. New drugs are often more expensive than they used to be, and employers and insurers are asking you to pay more out-of-pocket for those medicines. Co-pays for brand-name drugs can now run $25 to $50 per month compared to $5 to $10 for generics. And some really expensive drugs—those costing $1,000 or more a month—may be put in a special "tier" requiring you to pay a percentage of the cost, typically 20 to 25 percent. If you don't have any insurance, the price of such medicines can be prohibitive.

The problem is especially vexing if you're among the 25 million U.S. adults who take three or more drugs regularly. Even with reasonable coverage, you may find your prescription costs growing beyond your means. So it's important to be just as smart about shopping for medicines as you would be about, say, buying a new car or big-screen TV.

Here's the first step: Know that if you have health insurance, your health plan and its pharmacy benefits manager (PBM) govern which medicines are covered and what you pay for them. Make it a habit, when you get a prescription, to visit your plan's or PBM's Web site or call their toll-free numbers to find out:

  • Which other drugs are covered on your plan's "formulary," which is its list of approved medicines;
  • Which "tier" the drug is in and what your out-of-pocket co-pay will likely be;
  • Whether the plan has special arrangements with certain pharmacies that could save you money;
  • How your drug is priced relative to others in the same class;
  • Whether you can save by buying through a mail order plan, on the Web, or by phone;
  • How you can order larger supplies (90 to 120 days) of the drug, since doing so may reduce how much you spend in co-pays;
  • How to switch to a less expensive generic, if one is available; and
  • How to appeal if your plan says it won't cover the drug.

This advice is especially important if you are covered by Medicare, and get your medicines through the new Part D insurance program. Then, switching to lower cost alternatives can help keep you out of the dreaded "doughnut hole" when your coverage temporarily ceases. If you need guidance on Part D, visit the independent Medicare Rights Center Web site.

Keep in mind that insurers may have an interest in steering you to a drug or pharmacy that saves them money, but may not be best for you. But we found that this practice has declined in recent years. Today—more often than not—what saves your insurer money will also save you money without putting your health at risk.

If you are uninsured or have no drug coverage, make sure to tell your doctor. Don't assume he or she knows your insurance status. And ask about pharmacy assistance programs. These are run mostly by drug companies. While useful if you qualify, many have stringent income cut-offs at around $20,000 for a family. For more information, check out RxAssist, Partnership for Prescription Assistance, BenefitsCheckUp, or NeedyMeds.

Another way to save money, whether you are insured or not, is through pharmacy discount cards. These are essentially store "loyalty" cards, like other discount cards at clothing and book stores. There are no eligibility criteria, and typically they save you 10 to 20 percent.

That's nothing to sneeze at, obviously, but you may save even more just by shopping around. The pharmacy marketplace is changing rapidly, and large discount stores like Walmart and Costco now compete vigorously for your prescription business. A recent nationwide comparison by Consumer Reports found Costco's prices were lowest for a sampling of four widely prescribed drugs, but Walmart was not far behind. The comparison also found prices varying by from 20 to 50 percent for the four drugs we checked. For example, the drug Detrol—used to treat overactive bladder—cost about $390 for a 90-day supply at Costco stores but about $500 at Rite Aid.

Contrary to what you may have heard, you don't have to use a Canadian or international Web site to save money when buying medicine online. Check out sites such as costco.com, cvs.com, drugstore.com, familymeds.com, homemed.com, walgreens.com, and walmart.com. Online pharmacies are particularly convenient if you take several medicines regularly. You can also compare drug prices by going to the Web sites of the major pharmacies or some of the sites listed in our "Free resources" section. Or go to destinationrx.com, which lists prices from multiple U.S.-based online pharmacies (full disclosure: Consumer Reports Health uses destinationrx information on our own site.

One caution: Beware of fly-by-night sites, where your risk of getting counterfeit or tainted drugs rises. Stick to sites that carry the "VIPPS" seal (it stands for Verified Internet Pharmacy Practice Site, and is awarded by the National Association of Boards of Pharmacy). And never buy drugs from sites that send you spam e-mail.

You may also want to check whether your state has a drug-cost comparison site. About a dozen states now do, including myfloridarx.org, nyagrx.org, and rxforindiana.org, to name a few. These sites typically pick a list of widely used, mostly brand-name drugs and then compare their prices at for all or almost all pharmacies in the state.

Medicine is changing fast, and that includes the way drugs are prescribed and sold. The good news is there's more information than ever to guide your selection. The bad news is there's so much more to learn. We hope this guide will make it easier for you and those you care for to find the safest, best, and most affordable drugs.

 
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