Health-Care Savings Series—Day 2: Talk to your doc to save on prescription drugs

Last year, prices of name-brand drugs commonly used in Medicare Part D increased 7.5 percent last year, more than twice the rate of inflation, according to AARP. And consumers can expect to pay about 22 percent of drug costs out-of-pocket, based on data from 2006, the most recent year for which information is available.

In order to keep your prescription costs under control, plan a "brown-bag session" with your physician in which you bring in all the prescription medications, over-the-counter drugs, and any natural medicines or dietary supplements you use, even if infrequently, and even if prescribed by another doctor. It may turn out that you no longer need all the medications, or are taking more than one version of the same medication, or are at risk of harmful drug interactions. Your doctor might also identify brand-name medications for which an equally effective, but cheaper generic version is now available.

If your health plan has a prescription drug formulary, be sure to bring it with you so you and your doctor can see which medications are covered, and which ones are the best deals.

Don't be afraid to mention that cost is a concern for you; doctors don't necessarily take that into account when prescribing a drug.

A Public Library of Science study from 2007 concluded that "physicians' awareness of the cost of therapeutics is poor." The study found that doctors often underestimated the price of expensive treatments and overestimated the cost of inexpensive options.

Other topics for discussion with your doctor:

• Make sure you understand why the drugs are being prescribed. There should be a clear reason.
• Find out whether a drug is being prescribed off-label. It may well be beneficial, but off-label uses might also pose increased risks.
• Ask if you can save money by splitting pills. You might be able to find a higher dosage, for a similar price. Your doctor can instruct the pharmacist to split the higher dose so you can save money. But pill-splitting doesn't work for all drugs, so don't do it without consulting your doctor.
• Ask your doctor's staff look into pharmaceutical company drug-assistance programs for any prescriptions you can’t afford.

You can prepare yourself for the session by comparing prices and treatments for your condition through our Best Buy Drugs program or access that and other Consumer Reports resources by starting at our home page, ConsumerReportsHealth.org.

A new study published in the Health Services Research journal found that if all consumers followed the recommendations of Consumer Reports Best Buy Drugs, which assesses the cost and quality of various drugs within a therapeutic category (for instance, statins to lower cholesterol), the overall annual savings could be as much as $2.76 billion.

—Kevin McCarthy, associate editor

Tomorrow: Take Advantage of Free Screenings and Low-Cost Health Care Options

Comments

[Dorota Jarosz]

Few pharmacies, such as Walmart's and Sam's Club's and some local grocery chains, have a $4 generic prescription program. This means one can get a 30-day supply of any drug on their (generic and OTC) list for $4 and for $10 for a 90-day supply - no insurance necessary. This is often cheaper than filing with your insurance carrier, including mail order pharmacies. There are some Women's drugs at $9 per 30-day supply, such as tamoxifen cancer maintenance and alendronate for osteoporosis. Walgreen's 90-day supply costs $12 with $20 yearly membership in the Prescription Saving Club, but their list is more limited.

[Barbara Bryan]

You say "Your doctor can instruct the pharmacist to split the higher dose so you can save money." Currently, I split the pills myself. Does this mean that the pharmacist does the splitting of the pills?

I wonder how many doctors are going to be willing to take the time to discuss 5 or more medications in the detail that you suggest!