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Spend less on medicine

5 ways to save money and 3 traps to avoid

Consumer Reports Money Adviser: July 2012

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Paying for medication is a major budget concern for many people, even for those with prescription-drug coverage. Americans spend an average of $59 a month out of their own pockets for prescription medicines, according to a 2011 Consumer Reports national survey. And 12 percent of the survey respondents said they spend more than $100 a month, or $1,200 a year.

To help you slash your spending, we consulted the medical experts at Consumer Reports Best Buy Drugs, which provides unbiased information about medicines to help consumers make smart choices. They recommended these five ways to cut the cost of your medications without endangering your health.

1. Ask your doctor for generics

Generic drugs can cost up to 95 percent less than comparable brand-name ones, and nearly three-quarters of all medications are available in a generic version. The shape, color, and size of the pills might look different from the brand-name version, but the active ingredients are the same. The Food and Drug Administration regulates generics in the same way it does brand-name drugs.

Doctors don’t always consider a patient’s ability to pay for their medications when they prescribe them, according to our annual surveys. So be sure to speak up when your doctor is ready to prescribe a drug. Explain that cost is important to you, especially if you will have to take the medication for an extended period of time or indefinitely.

2. Check out discount programs

Chain drugstores, supermarkets, big-box retailers, and pharmacies at warehouse clubs have all offered so-called “$4 generic drug” discount programs for nearly a decade. (See the table below for details.) Prices can be as low as $10 for a three-month supply of medicine.

Most chains offer added perks, such as savings on flu shots. Kmart’s Pharmacy Savings Club gives discounts of 5 to 20 percent on brand-name drugs. Walgreens’ Prescription Savings Club members also get 10 percent off store-brand products and photo-finishing services.

Program details vary, so it’s important to shop around. When checking them out, ask the pharmacist on duty if your medications are covered and if you qualify for additional discounts.

3. Negotiate with independent pharmacies

Although many neighborhood independent pharmacies might not offer or widely advertise a discount generic drug program like their national competitors, store owners might be willing to match the prices of the big chain stores. It’s worth asking, especially if you expect to be on a medication for a long time, or even if you just prefer to shop at a neighborhood pharmacy.

In a recent Consumer Reports subscriber survey, independent pharmacies scored highest for providing faster service, making fewer errors, and being more likely to have medications ready for pickup when promised. Readers also liked mom-and-pop drugstores for their personal service and the accessibility of pharmacists.

Regardless of which type of pharmacy you decide to use, you should fill all your prescriptions at one place rather than shopping around for the best price on each medication. Aside from the convenience, having a single pharmacy that tracks all your prescriptions can help make sure you don’t experience drug interactions or other safety problems.

4. Order online (in the U.S.)

Last year Consumer Reports searched for the best prices on four widely prescribed brand-name drugs: Lipitor, Nexium, Plavix, and Singulair. The lowest prices were found on three websites:,, and Prices at were the same as at its walk-in stores.

Be careful choosing an online pharmacy. Those listed above are fine. But a recent analysis of more than 8,000 online pharmacies by the National Association of Boards of Pharmacy found just 3 percent appeared to be legitimate. Many sites didn’t require a prescription; others sold unapproved medication or were located outside the U.S. The problem with selling medications from other countries is that there’s no way to ensure their safety or legitimacy.

The FDA doesn’t regulate foreign versions of medicines bought over the Internet. Don’t assume a Canadian website is safe. Most online pharmacies claiming to be Canadian aren’t. And even legitimate Canadian online pharmacies shipping to the U.S. don’t fall under any government’s jurisdiction. In other words, no agency—U.S. or Canadian—regulates them, making it hard to know if drugs shipped from any online Canadian source are safe.

5. Follow your formulary

Insurance companies that cover prescription drugs and Medicare Part D plans have formularies that offer pricing advantages when you fill prescriptions from their “tier 1” list (usually generic drugs) and “preferred” medications (branded and generic). On private plans, the average co-pay for tier 1 drugs is $10, and $29 for preferred, according to a recent survey by the Kaiser Family Foundation. Co-pays for drugs on a plan’s “nonpreferred” list average $49, and $91 for very-high-priced medications or so-called “lifestyle” drugs, which are not medically necessary.

Some insurance plans might offer additional discounts if you choose to get your prescriptions through their mail-order service, which can be especially helpful for people with chronic conditions. Again, though, it’s best to use a single source for all your prescriptions if possible.

These 'savings' might cost you more

Although offers for free or nearly free brand-name drugs can be tempting, those promotions are usually for costly treatments that might not be the best first choice for your condition. And there also may be less expensive options available. Here are three potential traps to avoid:

1. Drug-manufacturer coupons. In advertisements on TV or in publications, drug companies offer to give away a free month’s supply or pay for part or all of your co-payment. The promotions are effective: 16 percent of Americans who regularly take a prescription medication have used coupons in the last year to save money, according to a 2011 Consumer Reports national survey. But the offers are usually available for a limited time, after which prices go back to regular. For example, the manufacturer of the cholesterol-lowering drug Crestor (rosuvastatin) offers a 30-day free trial, and then will pay up to $50 of your co-pay for 12 prescriptions filled within a 14-month period. After that you’ll be responsible for either the full co-pay or the entire retail price of the medication (about $175 a month), depending on your insurance coverage. And those with Medicare or Medicaid coverage are often not eligible for the deals.

2. Free drug samples. Drug-company reps give samples of brand-name products to doctors to distribute to their patients. But once the freebies run out, you’ll be stuck with the full cost of the medicine. Instead of taking the samples, ask your doctor to prescribe a generic.

3. Pricey drugs disguised as cheap generics. The best example of this is Pfizer’s cholesterol drug Lipitor (atorvastatin). When a generic version became available last November, Pfizer struck deals with some Medicare Part D plans to offer Lipitor as a tier 1 drug—the least expensive—with a co-pay similar to those charged for generics. Sounds good until you realize that your plan was charged the entire cost of the drug, not just the co-pay. Those charges put you closer to Medicare’s “doughnut hole,” which you hit once your prescription-drug costs total $2,930 in a calendar year, a risk for people who take multiple medications. Inside the doughnut hole, you’ll pay 50 percent of the cost of brand-name drugs and 86 percent of the cost of generics until you and Medicare together have spent $6,658. Once you’ve reached that level, you’ll pay 5 percent of your drug costs until the end of the year.

One plan we found, Cigna Rx1, charges participants a $3 co-pay for Lipitor but the plan pays $167 a month, the full cost of the drug. When we checked, generic atorvastatin was not even covered by the Cigna Rx1 Part D plan, though it’s getting even cheaper as more companies start to manufacture it, and it’s already on some formulary lists as a tier 1 co-pay. More than a dozen well-known drugs are scheduled to become available as generics in the coming months, and we expect that some manufacturers will follow Pfizer’s lead and strike similar deals with Part D plans.

Bottom line: If you’re enrolled in a Medicare Part D plan, beware of low co-pays on brand-name drugs. Check with your plan during open enrollment to see how well it covers all your prescriptions, since plan guidelines and drug prices change regularly.

Retailer discount-drug programs

Many pharmacies at national chains, big-box retailers, and warehouse clubs have programs that offer hundreds of discounted generic drugs for treating such common conditions as type 2 diabetes, high cholesterol, heart disease, and depression. Be aware that stores often change the medicines in their programs, and not all strengths and forms are covered.

Drug costs: Less than $10 for 90-day supply

Number included: 200 to 300 generic drugs

Enrollment fee: Free

Who can participate: Anyone. Costco membership not required

Other benefits: Costco members not using insurance or who are uninsured can join the free Member Prescription Program and save 2% to 40%.

Drug costs: $11.99 for 90-day supply

Number included: More than 400 generic drugs

Enrollment fee: $15 annually per person

Who can participate:  People not using insurance or who are uninsured

Other benefits:  Health Savings Pass members save 10% on flu shots and visits to in-store health clinics.

Drug costs: As low as $5 for 30-day supply; $10 for 90-day supply

Number included:  More than 500 generic drugs

Enrollment fee: $10 annually per person or household

Who can participate: People not using insurance or enrolled in public health-care programs

Other benefits:  Pharmacy Prescription Savings Club members get discounts of 5% to 20% on brand-name drugs, 5% to 35% on all other generic drugs, and 20% on flu shots.

Drug costs: $4 for 30-day supply; $10 for 90-day supply. For higher-cost drugs: $9 for 30-day supply; $24 for 90-day supply

Number included:  About 300 generic drugs

Enrollment fee: Free

Who can participate: Anyone

Other benefits: Earn points toward gas purchases at Kroger fuel centers and participating Shell stations.

Drug costs: $8.99 for 30-day supply; $15.99 for 90-day supply

Number included: More than 500 generic drugs

Enrollment fee: Free

Who can participate: People not using insurance or enrolled in public health-care programs

Other benefits:  Rx Savings Program members get discounts on thousands of drugs (such as 15% to 20% off if uninsured or underinsured).

Drug costs: $4 for 30-day supply; $10 for 90-day supply. For higher-cost drugs: $9 for 30-day supply; $24 for a 90-day supply

Number included: About 300 generic drugs

Enrollment fee: Free

Who can participate: Anyone

Other benefits:  Pharmacy Rewards members get 5% off all Target purchases made on a single day after filling 5 eligible prescriptions.

Drug costs: As low as $5 for a 30-day supply; $10 for a 90-day supply

Number included:  More than 700 generic drugs

Enrollment fee: $20 annually per person or $35 per family

Who can participate: People not using insurance or enrolled in public health-care programs

Other benefits: Prescription Savings Club members get discounts on thousands of brand-name drugs and save 5% to 20% off most immunizations.

Drug costs: $4 for 30-day supply, $10 for 90-day supply. Higher-cost drugs: $9 for 30-day supply, $24 for 90-day supply

Number included: About 300 generic drugs

Enrollment fee: Free

Who can participate: Anyone

Other benefits:  Retail Prescription Program members get free shipping on $10 90-day prescriptions.

Editor's Note:

These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

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