How to save on medicine

Medicare Part D has helped lower out-of-pocket drug costs for many seniors. Still, 43 percent of readers surveyed paid $500 or more on medicine this past year, and 20 percent spent at least $1,000. We have a prescription for people who pay out of pocket: Shop around.

From 10 online and walk-in pharmacies, we found the price we’d pay in cash for a 30-day supply of four brand-name drugs. (For each walk-in retailer, we contacted 10 shops across the country.)

The bills varied by up to 29 percent. Over a year’s time, that’s more than $2,000. On average, Web-based pharmacies were the least expensive. Costco.com’s prices were similar whether you buy online or at a store. And you usually don’t have to be a member ($50 a year) to use their walk-in pharmacies. Club members without prescription-drug coverage can reap extra savings on some drugs.

Prices for the same drug within the same chain sometimes differed by $30 or more. One Publix grocery, for example, would have charged $197 for a supply of Nexium; another, $234. Walmart’s prices were the least variable, independents’ prices the most. But on average, independents charged less than any walk-in store except Walmart.

Other ways to save

Consider generics

More than 20 of the chains in the Ratings (available to subscribers), including major retailers such as CVS, Walgreens, Kroger, Kmart, Walmart, and Target, sell hundreds of generics for as little as $4 for a 30-day supply, or $10 for 90 days. The average price of cholesterol-lowering Lipitor in our study is $119, and in many cases generic lovastatin is a suitable substitute costing $4.

For a list of safe and effective generic drugs that work as well as or better than brand-name alternatives, go to Consumer Reports Best Buy Drugs.

Apply for a discount card

Many pharmacies have programs that let consumers buy $4 generics or qualify for steeper discounts on other drugs and services. The programs are often free. Kmart has a discount program for customers 50 and older without prescription drug coverage.

Ask for a break

Posing as an uninsured cash customer, our reporter phoned drugstores for price quotes, but in fewer than 10 of 50 calls did the drugstores suggest how he might cut his bills. About all anyone ever said was, “You’re on the real expensive ones,” or, “Your doctor’s not doing you any favors.” When he asked specifically whether the store would match a competitor’s price or give him a price break, several druggists said they’d be willing to work with him.

Talk to human resources

Especially if you take a drug for a chronic condition, ask your benefits administrator whether your company uses a pharmacy benefit manager, a firm that helps companies cut the cost of prescription-drug coverage. PBMs have formularies (lists of preferred drugs), that they make available to members, usually via mail order, at reduced rates. A list of PBM Ratings is available to subscribers.

The price gap for brand-name drugs