An Expert Tip for Saving on Prescription Drugs

This is a guest post from Shiva, who wrote to offer some advice on how to shop for prescription medicine: don't assume that the new new stuff is better!

I am a general internist — a physician who provides primary care to adult patients — and am on the faculty of a medical school, where I teach medical students and residents. One of my interests is the excess marketing and use of expensive yet marginally effective prescription drugs.

I have found in clinical practice that the most effective medications tend to actually be “tried and true” ones approved over ten years ago with thousands of patient years of post marketing safety and efficacy data available. Rarely is the latest the greatest.

Unfortunately (this is hard for me to admit), my profession has been overrun by the pharmaceutical industry — you are very likely to be prescribed expensive brand name medications that are no more effective (in some cases less effective and/or less safe) than older, cheaper, and more thoroughly studied medications.

Here are two websites I recently found from Consumer Reports and Public Citizen that summarize the costs and benefits of various drugs prescribed for common conditions. They do it better than most reviews in the medical literature:

  • Consumer Reports Best Buy Drugs — “Free guidance for consumers on prescription medications.”
  • worstpills.org — “Your expert, independent second opinion for prescription drug information.”

While physicians should be looking out for their patients regarding out-of-pocket costs, the reality is most physicians don't even know ball-park prices of the medications we prescribe.

Given the underinsured status of many Americans — especially related to pharmacy benefits — meeting your doctor armed with information about the relative cost-effectiveness of the drugs for your condition is essential for both your physical and financial health. And in terms of drug advertising, I recommend ignoring the magazine, newspaper, and television ads. We can all become “branded” within the blink of an eye. Don't let the flashy advertising dollars sell you on what's best for your health.

Remember: Check for coupons and rebates before having your prescriptions filled.

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MillionDollarJourney
MillionDollarJourney
12 years ago

My biggest problem with the pharmaceutical world is that they create products that treat symptoms and not cure illness (besides antibiotics). The reason being? Profit!

Alya
Alya
12 years ago

This is why I try alternative medicine. I have some recipes and alternatives I had obtained from my mother and grandmother to curb any common cold, flu or fever.

Anything bigger than that, I have no choice but be a mercy of the big industry that takes advantage of me. I guess a blog on educating people in medicine is required….anyone fancy doing that?

Debi
Debi
12 years ago

Every patient should go to their doctor’s office with a copy of their formulary, the list of medications that are covered by your health plan, or a list of reduced-price medications available at Walmart/Target/wherever. While a doctor’s first instinct may be to prescribe the drug that the pharm rep just told him about over an expensive lunch, the doctor will also take a look at your list and prescribe something that will be covered for you, or at least be able to explain why (s)he is recommending something different. Most doctors are willing to work with you by trying things… Read more »

jtimberman
jtimberman
12 years ago

Or better yet, have a healthy lifestyle that leads to not having to see the doctor in the first place.

I see a chiropractor regularly and am making progress toward eating “raw”, instead of processed foods (its harder than you might think if you aren’t used to it).

I have seen a medical doctor once in the last four years as a result. The one time was for an emergency room visit after a motorcycle crash. Oops. 🙂

Frugal Goose
Frugal Goose
12 years ago

Old world remedies almost always work better for common ailments, listen to your grandma’s advice! Also stick to drug store brands for things like asperin and ibuprofen. These are really some of the best drugs of our time and have been perfected for the end user.

Shadox
Shadox
12 years ago

Direct to consumer marketing of prescription drugs should be banned.

In addition, doctors should be prohibited from accepting gifts, incentives, give aways and travel from the pharmaceutical companies.

Lastly: generic, generic, generic. It’s the same chemical formula with a less fancy name and less flashy packaging, and it’s just as carefully regulated.

Will
Will
12 years ago

I love how everyone takes the attitude that the Pharmaceutical industry is evil. I am a rep, and I hope you don’t throw out my comments with that statement. I also agree that many times generics can do the job, but there are people out there that can only benefit from newer meds. I have seen it a hundred times. As for generics – the 80 / 20 rule applies. As much of 20% of any generic drug can be different from its brand name – these are mostly binders, but can effect the efficacy of the drug – elimination… Read more »

60 in 3
60 in 3
12 years ago

I work in the pharma industry and I strongly agree with Debi. The formulary is what determines what your insurance covers and what it does not. You can have the next miracle drug but if it’s not on your formulary you won’t be covered for it and may not even get a prescription for it. There’s a reason the big pharma manufacturers pay a lot of money to get on formularies, it’s because this sells more drugs. So look at the formulary before you go to the doctor and before you pick a health plan.

Xias
Xias
12 years ago

Great article! I haven’t had to take any prescription medications in well over a year *knocks on wood*

Thank you for the websites, they appear to be a great starting point for further research.

Cat
Cat
12 years ago

A suggestion for self-pay folks — Shop around. When I had to pay for my own Zoloft, I found that my monthly prescription could vary by $50 a month from pharmacy to pharmacy. Also, some pills are designed to be split – and having your doc prescribe a half pill of a 100 mg instead of a whole 50mg can be cheaper. Again, when I paid for Zoloft, 30 100mg pills ($105) were only $10 more than 30 50mg ($95) pills. Since I could split the 100mg, I got 60 days for a little more than the price of 30… Read more »

David
David
12 years ago

Please use your pharmacist as a resource as well. We dispense the same medications hundreds of times a month and can tell you, the patient, what we have seen working and what isn’t working. Your pharmacist is more accessible than the average doctor and would love to talk about savings and what drugs will work best in certain situations. Please note that retail pharmacies push generics because they are huge moneymakers and secondarily because they can save you money. The drug rep who commented above is correct in saying that generics can vary by up to 20% efficacy and still… Read more »

Don
Don
12 years ago

It’s worth staying on top of your costs even if you are on generics. I take the generic for prozac, fluoxetine, and if I don’t tell them explicitly “no insurance” when I request the renewal they run it as an insurance submission. The problem with that is, I have my doctor write it for me in 90 day supplies. Costco’s cash price for 90 pills was $18 the last time I filled it. My insurance, however, will only do 1 month supplies at a time and my co-pay is $10. By staying on top of the situation and cutting the… Read more »

Jane
Jane
12 years ago

What gets me is the commercials that make it seem like if you care about getting better, you’d be taking X drug – case in point, one I take: Humira. The Humira commercials make it sound like this wonderful drug can “fix” your rheumatoid arthritis, shows people dancing, knitting, doing all sorts of active things. In real life, though, this class of TNF blockers is not living up to the hype for very many of the users. The sad thing is, I’m afraid to stop taking it (although I also take an older less expensive drug with a track record)… Read more »

Mariette
Mariette
12 years ago

Good post. Yes, the best thing is to try to stay healthy, eat well, exercise, take good care of yourself and use alternative medicine for most common ailments. For the major stuff, you do need the doctors – like for cancer, or if you have a heart attack. Education on your options is key. With healthcare you need to be your own advocate unfortunately you can’t count on your doctor for this. So educate yourself about all treatment options, medicines, alternative practices, everything – and then take that info into your doctor and discuss it. Also important is to be… Read more »

Will
Will
12 years ago

I agree that cutting marketing costs would make alot of sense – especially as a rep I get 8-10 boxes a week of useless materials. I have heard it put a good way though – do you really think they would drop the cost of the drug – or would the CEO just get a bigger raise? I also agree with the above – pharmacy shop! I have seen some pharmacies have as much as a $40 difference on a $200 / mo product. Also, I forgot to mention the patient assistance programs. Virtually every pharma company has free or… Read more »

Mrs. Micah
Mrs. Micah
12 years ago

I’m trying to get on a generic anti-depressant like Don is. I’ve considered threatening my doctor with not being able to buy drugs, therefore not taking drugs. However, since I have no insurance I don’t have a doctor to threaten. I’m thinking of going to a clinic and seeing what they’ll do.

Ed
Ed
12 years ago

Talk to your pharmacist. That is it. S/he can give you alternatives to the brand names that you are taking. You can then ask your Dr. if S/he will authorize the change.
The brand name can also vary in active ingredient between batches.
The brand name companies have subsidiaries that make generics of their own branded products. Check it out.

Siena
Siena
12 years ago

It’s clear the pharmaceutical industry has made a fortune on drugs. They are in it for the profits–their employees may not be, but the company’s bottom line is making money. That being said, I have saved switching to Target or Walmart’s (both offer it) $4 prescription plan. Two of my prescriptions (I paid $20 for one and $30 for the other) are on that list. I save $42 a month or $504 a year–and I already had my presciptions at Target so I didn’t have to do anything to get the lower price. I’ve made everyone I know switch. Between… Read more »

mark
mark
12 years ago

For most of my ailments I use herbs, that I pick on my own in the local hills. It’s surprising how affective they can be. Even for emotional/mental issues like depression (St. John’s Wort) or anxiety (Valerian, Lemon Balm). Then again this is Europe and even big pharma (Sandoz for instance) usually have a number of herbal remedies in their selling repertoire.

Rob in Madrid
Rob in Madrid
12 years ago

As an interesting aside, in Canada socialist healthcare (in this case correct use of term as Canada is the only major country to ban private healthcare completely proper term is single payer system or universal healthcare) doesn’t pay for drugs so most prescriptions are paid as part of work benefits so most people don’t really care “what they cost” as 85% of the price is covered. For those without benefits most doctors will give away free samples or recommend the generic brand to save money. In Germany prescriptions are paid for your health care provider and recently subject to a… Read more »

Mrs. Micah
Mrs. Micah
12 years ago

I would, Ed, but people seem very skittish about changing one’s antidepressants. I think they’re afraid that if they do, I’ll suddenly kill myself.

Prasanth
Prasanth
12 years ago

As a general internist, during my residency, we often would work in the clinic where patients had little or no insurance. One way I was able to save patients money is actually to give patients prescriptions for half tablets. For example, Lisinopril, which is a common anti-hypertensive medication, costs 31.99 for 90 tablets for both 20 mg and 10 mg doses(prices from drugstore.com). If you can work with your doctor to figure out which of your medications can be cut then it can cut your costs by half on some of the meds. One caveat is that the medication can’t… Read more »

Lisa Braithwaite
Lisa Braithwaite
12 years ago

One of my doctors suggested I check the prescription prices on Canadian Pharmacy Online: http://www.rxnorth.com/, because many of them are lower than a typical co-pay. And for meds that aren’t covered by my insurance, the savings can be quite large. I haven’t used it yet, but once hubby and I are both self-employed, this might be another good option to add to the ones mentioned above.

Lily
Lily
12 years ago

I found a discount card that has GREAT savings on older drugs. It’s at http://www.rxdrugcard.com. You can check drug prices on the website before you sign up. The monthly membership fee for a family is only $4.95. Check it out!

Carrie Valentin
Carrie Valentin
12 years ago

I thought it was illegal for Americans to buy pharmaceuticals from Canada?…Can’t the post office seize the packages?

Carrie Valentin
Carrie Valentin
12 years ago

i just left a post asking if it was legal to oder from foreign sources…I guess it is but I looked at the FDA.gov website and ran across the following. “FDA Test Results of Prescription Drugs from Bogus Canadian Website Show All Products Are Fake and Substandard” here is the address for this article: http://www.fda.gov/bbs/topics/news/2004/NEW01087.html
“Caveat Imptor” is the phrase of the day I guess…”Buyer Beware”

Justin Palmer
Justin Palmer
10 years ago

Excellent advice Shiva.

Another commonly used tips is to try a discount drug card. Even though these cards are intended for people without insurance, I’ve personally found that it can be cheaper than my insurance’s copay for certain drugs.

A google search for “drug cards” will bring up dozens of different programs. Here’s a few free ones that I’ve used:

http://www.medsavercard.com
http://rxfreecard.com

Max
Max
8 years ago

I use a free discount drug card that I got from http://www.Medicationcoupons.com

Redfeather
Redfeather
6 years ago

I have found that diet and life style plays a big part on how healthy one stays. Processed food, junk food, sugar, carbs is a no no. Eat a plant based diet. Green Tea or water. If you need a sweetener use only Steevia. You will stay healthy, loose weight, and stay out of the doctor’s office. Western Medicine has too many side affects. Learn about alternatives like Herbs. Most herbs do not have side affects. Don’t forget to exercise. Just walking one half hour everyday. If Winter keeps you from walking outside then go to Walmart. My Doctor has… Read more »

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