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    How to save money on prescription expenses and get better health care.  What you should know and how to protect yourself:

    An independent information center recently released a national study of prescription drug use, which found that “Americans are using more prescriptions, at younger ages, for more conditions and are also substituting newer, more expensive medications for established products.”  The study concluded that spending increased by nearly 25 percent annually between 1996 and 1999.  

    The foreseeable future continues to look the same; drug spending will continue to escalate until a more aggressive approach is taken in understanding and controlling the dynamics behind this trend.  Some of the price increases are attributable to the introduction of new drugs, while a significant part is attributable to increases in the price of well-established drugs (to which few alternatives exist). 

    Large employers, Insurance Companies and HMOs have leveraged their position of size and strength to benefit their own interests.  Their purchasing power has enabled them to negotiate substantial discounts with manufacturers and retailers alike.  However, it is a rare occasion when the full impact of the discounts are passed onto health plan members.  HMOs and insurance companies retain most of the benefit of the discounts to boost their own profit margins.  Bottom line: Rx prices are going up and the consumer is going to pay more.   The biggest losers are the uninsured, the senior with or without Medicare and the self-employed.

    As a consumer, what can you do?

    As an individual consumer, you need to be more aware than ever of prescription medication price increases, and realize that there are ways you can reduce the impact of increasing prices and improve your chance of quality care.

    1. Take control of your own health care

    You are the ultimate decision maker for your own health care. While Doctors will diagnosis, prescribe and make recommendations for your care, you should always feel comfortable with the care rendered and costs involved.  It is entirely appropriate for to you to ask questions of your Doctor. It is appropriate to say, “I don’t feel comfortable with this treatment.”  And, it is reasonable to ask for less expensive treatment options and/or less expensive medications.  You have the responsibility for your own health care; you should make well-informed decisions.

    2. Understand your medical condition

    Modern medicine is wonderful, but can be detailed and complicated.  However, it is not unreasonable for you to ask questions to better understand your condition and the rational for the particular treatment plan your provider is recommending. Talk to your health professionals just as you would any other service provider and try to gain information from other resources as well.  The internet is the best source around.  At a recent pharmaceutical conference held in Dallas, Texas, a nationally renowned physician spoke on how the information age has changed medicine. The availability of information via the internet is rewarding as well as challenging to Doctors.   Patients are better informed and more involved and aware of their individual conditions.  He said, “Within about six hour’s time and an internet connection, the average consumer can speak authoritatively about his or her diagnosis, physicians today are more susceptible than ever before.”  Understand your medical condition and treatment plan intimately.

    3. Follow the treatment plan you and your doctor have decided upon and agreed upon.

    Exactness in the execution of your treatment plan is your responsibility.  If you do not completely understand what your doctor is saying, ask questions. Talk to your health professionals about your needs and concerns.  Be very specific.  As you proceed through your treatment plan take careful notes of how your body is reacting to the particular medication or therapy you are taking so that you can give your provider very specific information.

    Listed below are some specific questions you should ask your health care provider when a treatment plan is recommended:

    • What is the name of the medicine and what it is supposed to accomplish?
    • How much and when do I take the medicine?
    • What food, drinks, other medicines, or activities should I avoid, or include while taking the medicine?
    • What side effects may the medicine have, and what do I do if they occur?
    • Should I get a refill, and how often?
    • Is it a brand name medication and if yes, is there a generic available, and can I take the generic?
    • Are there any terms or directions I do not understand?
    • What do I do if I miss a dose?
    • If I feel better, can I stop taking the medication?
    • Can I have written information about the diagnosis and treatment plan to take home?

    Your health care provider wants you to understand all details in full so that the treatment plan prescribed will be successful.  Ask questions!

    4.  Use your pharmacist as a resource of information

    When you pick up your medicine, don’t hesitate to ask questions of your pharmacist. Try to use one pharmacy for all your medicine needs, consistency will help make your life easier.  If possible, take a few minutes to fill out a "profile" for the pharmacist listing all the medicines you take. This will help your pharmacist to better inform you of side effects etc.

    Pharmacists are aware of products that can help you succeed in your treatment.   For example, some products (often called compliance aids) can help in reminding you to take your doses on time and in keeping track of the doses you have taken. These aids include checkoff calendars, containers with sections for daily doses, and caps that beep when it is time to take a dose. Don’t hesitate in talking to the pharmacist about any options that he or she is aware of.

    5.  Ask the cost before you receive the service or medication

    Prior to World War II, health insurance coverage in our society was the exception rather than the rule.  In that time period, physicians had small “store fronts” and made “house” calls to their patients. Consumers paid for medical expenses out of their own pockets (sometimes even with a basket of eggs or a sack of potatoes).  It was entirely customary for patients to discuss costs and negotiate fees with their providers before the service was rendered. Subsequently, in the post World War II modern healthcare era, consumers have learned to feel a great deal of reluctance in inquiring about healthcare costs with providers. As insurance companies and HMOs began paying for the majority of care, the discussion over cost of service virtually ceased.  Physicians and consumers had forgotten about the price of care because neither party had to discuss, negotiate or even agree upon the issue up-front before the bill was to be paid.

    As we know, times have changed.  Consumer behavior has to change as well.  Health plans are paying less and health services and medications cost more. Patients are expected to pay more for the cost of care.  It is time for patients to speak up about both quality of care and cost.  

    6. Gamesmanship at the pharmacy

    Several large retail pharmacy chains have recently announced (to insiders) a program that will insure themselves a higher profit margin.  They will require “minimum pharmaceutical card co-pays.” This will require you, the consumer to pay a minimum cost (even if the prescription drug retail price is less than your co-pay.)   For example, you may want to purchase a prescription of Deltasone, which retails for approximately  $2.00. The health plan you belong to may have a $10 Rx co-pay.  Rather than charge you the retail price of $2, the pharmacy chain has announced to insiders that they will charge you the $10 co-pay, and consequently pocket the difference.   Informally, this practice has been used for many years, but in an effort to counteract price pressure from large payors, these specific pharmacies will engage in this practice formally.   As a consumer, you have the right to use your pharmaceutical card, or pay for the medication out of your own pocket.  In order to ensure that you are getting the best price possible, always ask what the price would be if you pay cash. If the cash price is less, buy it. You always have the right to choose.

    7. Generic alternatives

    The use of generic medications can cut your pharmaceutical expenses dramatically.  However, unless specifically asked, a lot of physicians simply do not prescribe generic medications.  As a consumer, you must take the lead and seek lower cost generic medication alternatives.  Your pharmacist, again, is great resource. In many cases pharmacists are more aware of new generic alternatives than your physician. Once you have determined that a generic equivalent exists for the drug you have been prescribed, you must have your Doctor review and prescribe the alternative. 

    As an example, my wife recently went to our local doctor for sinus discomfort and congestion.  The doctor prescribed a wonderful “designer” antibiotic that is taken only once a day for 5 days.  This was very appealing to a busy mother of 4 children, until she went to the cash register to pay!  This antibiotic was going to cost approximately $90 for the five-day supply.  After “regaining” her senses, she asked the pharmacist if there was a generic equivalent, and sure enough there was, for only $8.00, a difference of $82.00!   She then called the physician to request the generic instead of the original medication.   Unfortunately, the generic drug was less convenient and had to be taken three times a day for 10 days but, the cost was phenomenally lower!  Again, you have the right to choose.

    8. Splitting dosages

    This is the quickest way possible to cut your drug costs in half.  Some tablets can literally be cut in half in order to achieve the desired dosage.  For example, your doctor may have prescribed a 40 mg dosage.   You may purchase the 80mg dosage and cut each pill in half, which would give you the ability to take the 40 mg prescription properly.  The wonderful thing to this strategy is that there is very little difference in price between the 40 mg dosage verses the 80 mg dosage.  And, in most instances the pharmacy will cut the drug in half for you (some may want to charge to cut your pills in half).  Be sure to discuss this strategy with your doctor, as it will not work with all medications.  You should also discuss this strategy with your pharmacist.

    9. Expiration date myth

    As good consumers, we have been instructed to adhere strictly to the expiration date that appears on virtually all prescriptions (labels and bottles).  Recently, several consumer groups reported that the rigid expiration dates that appear on prescription packages are a myth; that in fact, the medication is viable long after the stated expiration date. Millions of dollars worth of perfectly good medication is being thrown away needlessly each year. More information on the “expiration myth” is beginning to hit the market. Check with your pharmacist and your physician before using expired medications.

    10. Samples, just ask.

    Many pharmaceutical companies are anxious to have you try their medications. So anxious that that they supply physicians with large quantities of samples to dispense to their patients (you). How can you get the free samples? Just ask.  Some physicians will give you enough medication to treat you for the entire duration of your illness (short term illnesses).  Samples are a good idea if there is the possibility that your body will not tolerate the medication.  Samples will provide the opportunity to test the medication before you invest in a large quantity at the pharmacy. Don’t be shy.  Samples are there for you to try.  Many Doctor’s have large areas of their offices (cabinets and rooms) dedicated to the proper storage and dispensing of samples.

    11. Real life example, HUGE SAVINGS on prescriptions

    A good friend recently approached me regarding the high cost of her parent’s prescriptions. It seems they had been using a discount card “sold” to them by their insurance agent, but were still paying a tremendous amount of money for their medications. Upon examination of the specific medications they were taking, I calculated what they could have saved if they had used the RxDrugCard.comdiscount program. By simply using the program, theycould have saved an additional  $109.00 per month or 25.87%.

    If you are paying for your own prescriptions, you must have the program. This program gives you, the individual consumer, the same level of discounting that the HMOs and insurance companies enjoy. The program has proven to be an effective tool in lowering the impact of high prescription costs.


    Managing healthcare costs requires individual responsibility and accountability for the services and medications you receive.  You need to inform yourself by using all available resources, and then make educated and informed decisions relating to your health care.   Accepting the responsibility to save money while maintaining high quality health care can and will set a trend for your future health care needs.  For those of us who pay our own way, the effort is worth the energy expended.

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