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How to Keep the Cost of Prescription Drugs Down

Prescription drugs are more expensive in this country than anywhere else in the world. An estimated 143 billion dollars worth were bought last year. Dr. Valerie Ulene, a preventive medicine specialist and co-author of the book How to Cut Your Medical Bills, offers some advice on keeping some of those costs down this year.


Interview with Dr. Valerie Ulene



Communication with your doctor is the first step in keeping prescription drug costs down. Asking your doctor if you actually need to take a drug in the first place is not a stupid question. For many conditions there are alternatives... an example is high cholesterol. There are very effective prescription drugs to help lower cholesterol, but lifestyle changes like good diet and regular exercise are also proven ways. As is the case with antibiotics, there is also a tendency to over-prescribe for conditions that do not warrant treatment. Sometimes it's easiest course of action, colds and flu aren't always bacterial and treatable with antibiotics, but the doctor prescribes anyway to placate patients.


The second step is to check with your doctor or pharmacist to make sure the prescribed medication is the best or only choice for your condition. There may also be alternative prescription drug therapies available that vary in cost. Many times the latest cutting-edge medication is also the most expensive, but there may be older medicines available that are cheaper. An example is ibuprofen versus the latest arthritis painkillers like Vioxx or Celebrex. Both do the same thing and it's worth trying the cheaper one first in terms of cost. Generic alternatives may also be available with some drugs. A doctor usually writes a specific drug prescription, but in most states the pharmacist can offer you a choice if you ask.


When it comes to shopping around for medication, the first step is to compare prices at a few local pharmacies. Prices vary widely and there may be significant savings to be had for a particular drug you need. The key is to get the lowest price that's also a practical choice given the location of the pharmacy in terms of travel time and cost of travel. Reputable online pharmacies can provide good savings, too, but in a practical sense are more appropriate for long-term chronic conditions but not immediate concerns where you can't wait for the shipping time.


Although many people are covered by insurance, the different plans take some navigating and although you may be restricted in your choices, you can still shop around. Some insurance companies have higher co-pay on brand names versus generics.


An important point in long-term savings is to use medication properly, non-compliance with taking your pills can lead to worsening of your condition, and perhaps other related conditions that require more medication and more cost.


Background Information on the cost of prescrition drugs

The retail price for prescription drugs increased from 1991 to 1998 at three times the rate of national inflation and about 50% more than overall medical inflation, according to the Kaiser Foundation. Global drug sales will top $ 360 billion in 2000 and 80% will come from the drugs that require a prescription. In the U.S. last year, prescription drugs accounted for half of the rise in health care costs. The National Association of Chain Drug Stores estimates prescription drug spending to have reached $143.5 billion last year.


Rising costs are partly attributed to the tendency of patients and physicians to move quickly to adopt the newest therapies--which often carry higher price tags. Average cost per day of drug therapy increased 8% per year from 1996 to 1999, according to the Brandeis University Schneider Institute for Health Policy, with most of the change due to patients' moving to different, higher-priced drugs.

Clearly it pays to comparison-shop for prescription prices. An example is the nonprofit World Share Prescriptions Program, a mail-order and phone-order pharmacy in Chula Vista, California. (800-542-1110, www.worldshare.org). Generic drugs are its bargain specialty. Take the blood-pressure medication Atenolol. While the name-brand Tenormin normally goes for $99 for 90 tablets (50 milligram), World Share was selling the generic version for $10.99 last month. Another example is the blood-pressure medication Enalapril, going for $19.49 for a 90-day supply of 10-milligram tablets, compared to $97 for name-brand Vasotec.


Several states have taken steps to make prescription drugs more affordable. Vermont allows uninsured residents to buy drugs at the same discounted prices available to Medicaid recipients. Maine recently became the first state to enact a form of price controls. A new Florida law created a discount prescription drug-pricing program for people enrolled in Medicare.


Drug Industry leaders say prescription drugs often save money in the long-run, and they point out that heart and blood-pressure medications that keep people out of the hospital. The industry also defends itself by saying that only one-third of drug inflation is the result of higher drug costs, the rest coming from higher sales volumes.

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