13 ways to save on prescriptions

By Liz Pulliam Weston

You don't have to be uninsured to worry about the cost of prescription drugs.

Increasingly, employers are boosting co-payments and placing restrictions on what medicines are covered under company insurance plans. And though Medicare Part D has helped pay for millions of prescriptions, many seniors still struggle with the cost of their medications.

Yet people find ways to rein in the cost, and some pharmacies, drug companies and Web sites are helping their efforts. Here's what you need to know to get started on trimming your medicine bills:

Check your policy, if you have one. If your health insurance covers prescription drugs, it may have lower co-pays for generic drugs. A typical co-pay is $10 or $20 for a generic prescription and $30 or more for a brand-name version.

Many insurers have arrangements with mail-order pharmacies that allow patients to get three-month supplies of many "maintenance," or long-term, medications, either at a discount or with lower co-pays -- one or two months' worth of co-pays, for example, instead of having to pay for all three months. Your policy also may cap how much it will pay out annually for prescriptions or pay only for drugs on its formulary, which is a preferred list of medications.

Enlist your doctor and your pharmacist. If you want to cap your drug costs, you need these professionals as allies. Your physician knows your medical history and can discuss alternative therapies with you, while your pharmacist may be more aware of the specific costs of those alternatives. Also, pharmacists tend to be more clued in about what prescription drugs are about to be available over the counter.

Ask whether a prescription is necessary. There are plenty of over-the-counter medications that often work as well as their prescription counterparts. Some of these OTC remedies, such as Claritin for allergies or Prilosec for heartburn, were once prescription-only.

Other OTC medicines have a long history of effectiveness. Consumer Reports recently noted, for example, that nonprescription drugs containing antihistamines -- such as Benadryl, Nytol, Sominex, Tylenol PM and Unisom -- can be just as helpful for occasional sleeplessness as more heavily promoted (and expensive) prescription medications such as Ambien, Lunesta, Rozerem and Sonata.

Or maybe the answer isn't a drug at all. Maybe what you really need is to take better care of yourself. Your Money message board poster "umich24" reports saving about 50% on drug costs simply by asking whether a drug is actually required.

"I always ask the doctor if the prescription is REALLY necessary, or if extra sleep, some vitamins, or a home remedy will do the trick," umich24 wrote. "You'd be surprised what the answer is the majority of the time."

If you're overweight, don't get enough exercise, eat a lousy diet or constantly are stressed, fixing those issues also can save you a bundle in the long run.

"I know that some people simply have uncontrollable high blood pressure, diabetes, etc., but if your doctor warns you about (being) pre-diabetes . . . take him seriously and make the lifestyle changes," poster "BerryBlack" wrote. "It might not work -- some people are going to have these conditions no matter what they do -- but it's better to avoid the problem to start with rather than pay for meds after things have gone to hell."

Ask about drug alternatives. If a prescription is necessary, find out first if there is a generic version that might work for you. Generics are basically former brand-name drugs whose patents have expired. The average prescription for a generic cost $29.82 in 2005, according to the National Association of Chain Drug Stores, while the average brand-name prescription cost $101.71.

Web sites such as Rxaminer, founded by a cardiologist, can help you explore potential alternatives to many brand-name drugs. Obviously, you'll want to discuss the options with your physician.

There isn't always a generic equivalent. That's where "pill splitting" can come in handy. Since increased dosages of a drug often don't cost substantially more, your doctor can in some cases prescribe a larger pill that you can slice using a splitter available for $5 at most pharmacies.

Someone taking a 10-milligram daily dose of the high-cholesterol medication Lipitor, for example, would pay $1,020 annually for the medication. If she took half of a 20-milligram pill, by contrast, she could lower the cost to $732, according to Rxaminer.

Not all pills can or should be split, though, and this is not a do-it-yourself project. Talk to your doctor first.

Your doctor also may be able to write the prescription in a way that takes best advantage of your insurance policy's co-pays. Your Money poster "Loomatic" used to face a $30 co-pay for each six-pill box of Relpax, a migraine medication Loomatic bought six times a year.

"The last time I went to the doctor, I mentioned that I was going to switch to our mail-order plan to try to save money," Loomatic wrote. "So she wrote my prescription for 36 pills, and I mailed it in. I got all six boxes at once, with only one co-pay of $30. And it is a huge relief to know that I won't be running out of migraine medicine anytime soon!"

Continued: Generic prices can vary widely

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