13 ways to save on prescriptions

Though buying in bulk often results in savings, sometimes you might want to ask for less, particularly if you're not sure how you'll react to the drug or if it's a painkiller that might not be necessary.

"My daughter was prescribed Lortab after her ear tube surgery and she used two doses from a full bottle," Your Money poster "Table for 2" wrote. "So here is a $150 bottle of painkiller that she only used twice."

Ask for samples. If there's no generic equivalent, your doctor may be able to supply you with enough free samples of a prescription drug to at least reduce your costs somewhat. Most physicians have a closet full of prescription-drug samples, thanks to free-handed drug vendors.

Shop around. Once you've got your prescription in hand, a little time spent on the Web and on the phone can save bundles of money. By the way, you should put as much or even more effort into shopping for your generic prescriptions as you do for your brand-name ones. The price you pay for a generic can vary by 80% or more, depending on where you buy it, while a brand-name drug's cost typically varies by only 10% or so.

"We call around to different pharmacies when we start on a new long-term medicine," Your Money poster "pleroma8" wrote. "We have found that there is a big difference on cost when comparing one pharmacy to another one."

Seriously. One Houston physician who compared prices for a 90-day supply of generic Prozac found the cost ranged from a high of $117 at a chain pharmacy to a low of $12 at a warehouse club, according to Stephen J. Dubner, a co-author of the best-selling economics book "Freakonomics." And now you can get many generics for even less.

Take advantage of the generic-drug price war. Kmart and Wal-Mart kicked off the trend, and now it's spread to other big chains. Wal-Mart, Sam's Club and Target offer hundreds of generic prescriptions for $4 a month while Kmart offers more than 200 generic prescriptions for $15 for a 90-day supply.

Chain	Generic-drug cost	Included drugs
Kmart	$10 for 90-day supply	Drug list
Sam's Club	$4 for 30-day supply	Drug list
Target	$4 for 30-day supply	Drug list
Wal-Mart	$4 for 30-day supply	Drug list

Prices may be higher in some states; California, for example, has a law against pricing drugs below their cost, so some prescriptions on the list will be more expensive there.

Look for coupons and deals. Head to a brand-name drug's official Web site to see whether there are coupons or other rebates available.

Poster "alirae75," whose husband has diabetes, said his doctor usually has rebate forms for insulin and other supplies. "We also register on the sites so that we are updated, occasionally getting a rebate form or check in the mail," alirae75 wrote.

Use your flexible-spending plan. These workplace plans allow you to put aside pretax money to pay for health care and medicines. (Over-the-counter drugs are often included; ask your human-resources department for details.) You have to estimate in advance how much you'll spend, and you must use up the money before the plan's year ends, or you'll lose it. But every $1,000 you contribute saves you $250 in taxes if you're in the 25% federal tax bracket, so it's a great break for many families.

Discount prescription cards. If you don't have insurance, you may be able to use a drug discount card to get reduced prices on medicines. Some cards are free; others have monthly or annual fees. Check the card out carefully before you buy, though, because there have been some scams. You can find out more at the RxAssist Web site. A discount drug card that's free and accepted at 53,000 pharmacies nationwide can be found at PS Card. Some drug companies also offer free cards that provide discounts ranging from 15% to 40% on brand-name drugs, although eligibility may depend on income and other factors. Three to try: Pfizer, Together Rx Access and Merck.

Sign up for prescription assistance. If you're low income, you may qualify for discounted or free drugs from a patchwork of state, nonprofit and drug-company programs. One place to start looking is the Partnership for Prescription Assistance. Other resources include NeedyMeds, the American Society of Health-System Pharmacists, the Eldercare Locator and the Access to Benefits Coalition.

Go to Canada or Mexico. There's no question many drugs are significantly cheaper north or south of the border than they are in the United States. The problem is that it's against the law to "re-import" drugs made in the U.S. and sold outside our borders. (A "personal use" exception exists only for drugs that aren't approved for use in the U.S.) Of course, the legal restrictions don't stop millions of Americans from crossing the borders for drugs, but the U.S. Food and Drug Administration cautions that there are potential safety issues. Consider yourself warned.

Buy online. If you can't get to Mexico or Canada conveniently, you may be tempted to buy from a foreign-based pharmacy online. Again, there are safety and accreditation issues. Definitely don't buy from an online pharmacy that doesn't require a prescription. You can reduce your risk by using a site that carries the National Association of Boards of Pharmacy's Verified Internet Pharmacy Practice Sites (VIPPS) mark, but don't take the pharmacy's word for it; check at the national association's site to make sure the certification is legitimate. (Look for "Internet Pharmacies" in the left-hand menu.)

Liz Pulliam Weston's latest book, "Easy Money: How to Simplify Your Finances and Get What You Want Out of Life," is now available. Columns by Weston, the Web's most-read personal-finance writer and winner of the 2007 Clarion Award for online journalism, appear every Monday and Thursday, exclusively on MSN Money. She also answers reader questions on the Your Money message board.

Updated Aug. 20, 2008

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