Marilyn Taylor had a secret weapon in her personal drug war. Faced with huge bills and the loss of insurance, the 62-year-old Manchester, Maine, woman simply quit most of the medications she needed for her asthma, arthritis, depression and high blood pressure. When she fessed up to her physician, Daniel Pierce, he found a clever way to solve her dilemma. He switched some of her prescriptions to cheaper generics. Then he loaded her up with free samples of the brand-name products and helped her join a drug company's prescription-assistance program.
Pierce has helped many patients cut their bills that way, and he has yet to harm anyone's health. These measures are stopgaps, not solutions, to the drug-cost problem. But the truth is, almost anyone can safely reduce her medication bill. All it takes is a willingness to ask questions.
Until recently, state pharmacy-assistance programs were aimed almost exclusively at the neediest Americans. Many still are. But lawmakers have discovered that you don't have to be destitute to be hobbled by high drug costs. In Massachusetts, for example, moderate-income seniors with high out-of-pocket drug expenses are now eligible for a state-subsidized insurance program. Premiums, deductibles and co-payments are on a sliding scale, based on income, with verification required. Once an enrollee's deductible has been met, the program foots the bill for all prescription drugs. To find out what your state is doing to help out, contact the AARP or your department of health.
The drug companies themselves are another source of relief. More than 50 of them sponsor prescription-assistance programs. Eligibility requirements vary by company, but most firms will lend a hand to anyone lacking insurance. Assistance comes in the form of free or steeply discounted medications. Application is generally through your physician. For a list of participating companies and eligibility criteria, contact the Washington, D.C.-based Pharmaceutical Research and Manufacturers of America (phrma.org) or the Health Care Financing Administration, which lists both public and private programs (medicare.gov).
Assistance isn't the only way to reduce your drug costs. "Lots of Americans think if something's cheaper, it can't possibly work as well," says Dr. Joseph Raduazzo of Brockton Hospital in Massachusetts. But when you buy generic brands, cheaper can be just as good--despite what the direct-to-consumer drug ads would have us believe. For example, you could pay up to $180 for a month's supply (10mg, twice daily) of Vasotec, a brandname treatment for hypertension and congestive heart failure. Its generic equivalent, enalapril, will do the same job for $55. If ulcers are your problem, a 90-day supply of prescription-strength Tagamet will set you back about $135, while generic cimetidine will cost $20. Some of the newest brand-name drugs--Vioxx and Celebrex for arthritis, Claritin and Allegra for allergies--have no generic alternatives, and won't until their patents expire. Also keep in mind that some medications--those for epilepsy and arrhythmia, for example--are not generically interchangeable. Substituting one for another can be dangerous.
If your medication has no generic equivalent, don't despair. There may be a cheaper brand-name drug that works just as well. For example, both Zocor and Baycol are brand-name cholesterol medications. But for many patients taking the higher-priced Zocor, Baycol will have the same effect--while saving $55 per month. Other products with lower-cost alternatives include Prozac (Celexa costs less), the heartburn drug Prilosec (Protonix is cheaper) and the blood-pressure drug Zestril (ask about Mavik). A good source of online information about these and other cost-cutting measures is Rxaminer.com, founded by Michigan cardiologist Joseph C. Rogers. But as Rogers himself stresses, you should consult your own doctor before making any changes.
For patients who want to save without switching, pharmacies like PlanetRx.com, CVS.com and Drugstore.com make comparison shopping easier. Or click on destinationrx.com, which searches other online drugstores for price and product information. For the most part, online-pharmacy shopping is safe, especially if you stick with familiar names. But as the market has grown, so has the potential for abuse. To make sure the site you're shopping at is legit, look for the VIPPS (Verified Internet Pharmacy Practice Sites) seal of approval from the National Association of Boards of Pharmacy.
Mail-order meds can also cut your prescription costs. You save by purchasing in bulk, which works especially well if you're treating a chronic condition such as diabetes or asthma. But if you shop by mail, be wary and ask questions. How long will your order take to reach you? And what safeguards does the company use to prevent extreme humidity or temperatures during shipping? One way to lessen such risks is to join a warehouse club, such as Costco, that will fill bulk prescriptions on the spot. None of these tips will save you as much as quitting your pills. But they're a whole lot safer and smarter.