How to Save Money on Medicines

    Obviously, the best way is to stay healthy and not need to take medications. To stay healthy, in addition to good luck: Handout on health maintenance / early disease detection 

A General
1)    Reassess your medicines intermittently, perhaps yearly. You might be able to reduce, stop, or change medicines (to less expensive ones) in addition to changes that might benefit your health. While some medicines in some people probably need to be taken indefinitely, some can be reduced or stopped over time, especially with changes in conditions that affect the need for medicine. For example, blood pressure medicines - people who lose weight, increase exercise, reduce stress may not need as much blood pressure medication. CAUTION/WARNING: “don’t try this at home.” In other words, don’t change your medicines without talking with your physician first - there are some medicines that should not be stopped and there are others that should be weaned (gradual dosage reduction) rather than stopped suddenly.
          As an aside, it is important for your physicians/pharmacists to know exactly what medicines/doses you are taking. If you don’t have this memorized you might want to write them down (or better yet put them on a computer file that you can update when changed and print out) and carry around with you especially to doctor’s appointments and when you go to the pharmacy. A medicine list should include prescription medicines, OTC (over the counter), vitamins, herbs, etc. and both medicines you take regularly and as-needed.
2)     Generics - Using a generic, when available, instead of the brand medicine usually will save money, often significantly. I believe generics work as well as brands in most situations. Some medicines (such as thyroid, warfarin [brand: Coumadin]) that require blood test monitoring may result in differences when switching from the brand to a generic or from one generic to another. This doesn’t mean you can’t use generic but: a) after changing you should have your blood level checked (thyroid or pro-time), and b) try to stay with the same generic (some medicines have generics made by many different pharmaceutical companies - stay with the same one). Usually a pharmacy will carry only one company’s generic for a medicine so staying at the same pharmacy should accomplish this. Obviously you should discuss this with your physician and notify him/her when you change from a brand to generic or from one generic to another.
     For more information about generics: Generic Pharmaceutical Association: http://www.gphaonline.org/#
     To find out if your medicine is brand/generic: http://www.rxlist.com/script/main/hp.asp Choose a letter (A-Z) then find your medicine and click on it - on the page that comes up the brand name is usually in CAPITAL letters and bold, the generic name usually is in small letters in parentheses
     To find out if there is a generic available for a brand medicine - http://www.accessdata.fda.gov/scripts/cder/ob/default.cfm select “Search by Active Ingredient” - enter the generic name. If you see listing for more than one manufacturer there are probably generics available (when the “proprietary name” is the same as the active ingredient that is usually a generic).
     FYI - prescriptions usually have two lines where the physician signs his/her name. One will allow generic substitution (in the state of Washington this is on the left and reads “Substitution Permitted”) and one does not allow substitution (Washington: on right, “Dispense as Written”). When the physician signs to allow generic substitution this allows you and the pharmacist to choose either brand or generic. When written to not allow substitution generics can not be substituted.
3) Check prices at different pharmacies - you may find significant differences in prices for a medicine at different pharmacies; if may be worthwhile to call around and ask how much they charge for a prescription (tell them name of medicine, strength, and number of pills). If you are on more than one medicine, you might find that one pharmacy offers a better price on one of your medicines and another pharmacy offers a better price on another of your medicines. The down side of this is the inconvenience of going to more than one pharmacy and not having one pharmacist who would know all medicines you are taking. Getting medicines from a Canadian pharmacy might be considered if this option is available/legal.
4) Using half pills - some pills can be cut in half which can save money. Let’s say you take 10mg of a medication that comes in 10mg and 20mg strengths. If the price for 10mg and 20mg is the same (or if the 20mg costs less than twice the price of 10mg) by cutting a 20mg in ½ you would save money compared to taking a 10mg pill. Some notes on this:
  - check with your pharmacist whether your medicine could be cut in half and if this would save money
  - some tablets may be difficult to cut in half - get a “pill splitter” (available at pharmacies usually) to help; don’t cut a capsule in half or try to open and use ½
  - be sure to let your physician know exactly what you are taking (also on your medicine list) - in this example, medicine ABC 20mg ½ pill once/day. Some people will tell us they are taking 10mg when they are really taking ½ of 20mg -- this could possibly lead to confusion/problems as the next prescription could be written or called in for 10mg and if they take ½ then they’d only be getting 5mg
  - some recommend that you split one pill at a time, taking the other half the next day
5) Use OTC (over the counter) medicine instead - in some cases there may be OTC (no prescription required) medicines that can be used instead of prescriptions that can save money. Sometimes they may even be less expensive than your co-pay for a prescription medicine. Some OTC medicines were originally prescription medicines so you are essentially getting prescription medication. OTC medicines also have generics which can cost less than brand OTC. As in other situations you should discuss this with your physician and be sure to let them know what OTC medicines you take. (Keep in mind that OTC medicines can cause side-effects.) Some examples:
Allergy - the “non-drowsy” (actually, less likely to cause drowsiness) antihistamines - Alavert, Claritin Allergy handout allergy.pdf
Anti-inflammatory medicines - ibuprofen, Aleve. Arthritis/pain treatment handout arthrits.pdf
Stomach - For heartburn/reflux, in addition to antacids there are H2 blockers and PPI (proton pump inhibitors). Allergy handout
PPIs: prescription: Aciphex, Nexium, Prevacid, Prilosec, Protonix; OTC: PrilosecOTC, Nexium
Hyperacidity/Reflux handout  
6) Buy more than one month at a time - if you can afford to, buy two or three months at a time. When you pay for a prescription medicine there are two portions to the charge - the charge for the medicine and the charge for the pharmacist to fill it for you. The pharmacist’s charge is usually the same no matter how many pills you get. Thus it is less expensive to buy 60 pills once than 30 pills on two separate days. Note - if you insurance covers your medicines they may only allow you to get 30 days at a time (but see below regarding mail in pharmacies).

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