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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Overview

Following is a list of a variety of ways to save money on drugs, each of which are more fully described in other sections of this article. (After clicking to read more information, hit the back button to be returned to this part of the article)

  • Let your doctor know you are trying to save money on drugs and that out-of-pocket cost is important to you. Ask the doctor:
  • Look for free or low cost drugs. For example
  • Look for financial assistance.
  • Explore the possibility of obtaining medications through the health coverage of your spouse or domestic partner, or of a parent. 
    • Because of the Affordable Care Act (Obamacare), dependent coverage for young people extends until they reach age 26, 
  • When purchasing, consider the following money saving ideas:
    • Do not assume that getting a drug through your health insurance is the cheapest way to obtain a drug. You may be able to buy a discount generic drug at a store for less than the co-pay on your insurance policy. Ask the pharmacist. (How To Shop For The Lowest Price)
    • Purchase a test supply to see how the drug works for you before purchasing a full supply.
    • Once you know a drug works for you, consider purchasing a longer supply of a drug - for example, a 90 day supply instead of a 30 day supply. This is known as "bulk" purchases.
    • If the medicine comes in pill form, consider purchasing a larger version of the drug and splitting the pill (this does not work for drugs in capsule form)
    • Do not assume that a chain store price is the cheapest. Exception: Costco generally is the least expensive - and you do not have to be a member to use its pharmacy (though if you join you can get more discounts.)
    • Negotiate price with the pharmacist (just as you would when purchasing a car.)  You have nothing to lose
  • Look for discounts, including:
  • Shop for a low price
    • Comparison shop when you buy drugs. Once you do it, consider doing it again every six months. 
    • Check online pharmacies. Online pharmacies can be a great deal, especially if you take common generic drugs on a recurring basis. Still, do not assume that online pharmacies are less expensive than local.
  • Consider negotiating price if a drug is expensive or your annual drug bill is large (or asking a relative or friend who is good at negotiating to do it for you). 
    • At the least, ask for cheapest price the pharmacy offers. (An option: gather several people who together spend a substantial amount of money on drugs each year. Negotiate as a group.)  
    • As an alternative to a discount, or perhaps in addition to a discount, ask for freebies such as toiletries or other items the pharmacy stocks. One purchaser who spent a lot of money on drugs a year reportedly received a free week in the sun from his pharmacy.
  • If you are insured, do not assume that buying a drug through your insurance is the cheapest alternative for you. For example, you can purchase a month's supply of the generic version of Prozac at a big box store like Walmart's for only a few dollars - likely less than your co-pay.
  • If there are no other options for obtaining the drugs you need, consider the following - particularly if the drugs would be life saving, consider the following ideas:
    • See if you can take steps to qualify for Medicaid.(Medi-cal in California). (For example, give you assets away or convert them into assets that do not count for eligibility.)
    • Consider getting married, for instance, if you are living with some one, and his or her health insurance only covers spouses. Not all marriages, or domestic partnerships for that matter, are entered into solely out of love and devotion. 
    • Think about relocating to a state with programs for which you would be eligible. You may even wish to consider moving to a country that supplies free medical care - for example, Canada or England. Be sure to do your research because immigration laws vary widely and moving to a new country is not as simple as packing your bags and hopping a flight. There may also be residency requirements before free medical care starts.

*  If you have a fear of generic drugs, consider the following from Consumer Reports: "To get approval from the Food and Drug Administration, a generic-drug maker must prove that its product contains the idential active ingredient as its brand-name counterpart and that the drug is "bioequivalent," meaning that as much active ingredient enters and leaves the blood stream as fast or as slowly. Generics that meet those criteria should have the same therapeutic effect as brand- name drugs. The FDA regulates generics just as it does brand-name drugs and monitors them once they're on the market. To date, the FDA has found no difference in the rate of adverse reactions between generic and brand-name drugs."

NOTE:

  • For the drugs you have, reevaluate expiration dates. As a general rule, stated expiration dates are much shorter than when a drug stops being effective.
  • Keep receipts in case you can deduct Medical Expenses. (To learn about deductible medical expenses, click here.)
  • As part of the real cost of drugs, also consider the following which can save money:
    • Minimize the cost of obtaining a written prescription. (To learn how, click here.) Maybe you don't need the expense of a a visit to a doctor.
    • Do your part to help minimize costly medical error relating to the drugs you take. To learn how, click here
    • Do your part to help avoid over medication which can also result in unnecessary costs and side effects which cost money to treat. To learn how, click here.  
    • Keep in mind that, contrary to our instincts about price, the cost of a drug does not necessarily relate to its effectiveness.
  • Consider eating well, exercising and getting rest. The better you treat your body, the better chance the drugs can do what you want. Maintaining your health to the best of your ability maximizes your body's ability to fight illness, to help maintain your immune system and ward off other common ailments and the costs that go with them.

Free Samples From A Doctor Or Other Health Care Provider

Representatives from drug companies often leave free samples of their products as an enticement for a doctor to prescribe a particular medication.

If the doctor doesn't have any on hand, he or she may be able to get some for you by asking the pharmaceutical company representative.

It has been reported that some patients are able to get six months' worth of free samples in one visit. If your doctor knows that you are having difficulty paying for your medications, she may be able to provide you with a generous supply of samples.

Caution: Free samples tend to be samples of expensive drugs. If the samples run out, do not automatically fill a prescription for the drug. Call your local pharmacy to get an idea of price. If it is expensive, call your doctor and ask if there is a less expensive alternative (or if she has more free samples).

Bulk Purchases Of Drugs You Take For An Extended Period Of Time

You may be able to get a discount if you purchase a larger quantity of a drug. For example, a 90 day supply may only cost 2.5 times more than a 30-day supply instead of 3 times as much.  Even if the drug is not cheaper when purchased in bulk, you will save money by only paying only one co-pay. 

Doctors are generally willing to write prescriptions for larger quantities unless they believe a patient may misuse a drug or the drug requires constant tweaking such as blood-pressure and thyroid medications.

If you buy in bulk, it is advisable to:: 

  • Watch the expiration date of your bulk purchases. Ask the pharmacist for the expiration date on the manufacturer's container rather than look at the date the pharmacist may put on the label you're given. The pharmacy label often indicates a short date, such as one year. However, the drug may be effective for a good deal longer. (To learn more about safety and expired drugs, click here.)
  • Be particularly careful about how you store large quantifies of drugs. (See How To Store Drugs Safely.)

Drug Expiration Dates

In theory, drug expiration dates are supposed to give you a date beyond which the drug could become harmful or ineffective.  In reality, manufacturer's expiration date on most medications is set at 2-3 years from when the pills were made. When pharmacies repackage medications, they usually label them with a recommended-use date one year from when the prescription is filled. This is the date consumers see. These dates serve to protect the pharmacies and manufacturers more than to tell you when the pills are no longer any good.

According to the Harvard Health Letter (July 2003):

  • Instances of pills becoming harmful are virtually unknown.
  • As to loss of potency (effectiveness): "Sitting in their vials in a dry, dark place like a medicine cabinet, most pills will stay effective for at least five years. Some medications have been shown to be stable as many as 30 years after they were made." 
  • Drugs in liquid form are not nearly as stable as those in capsules or tablets.

CAUTION:  If you want to use a drug beyond the expiration date on the container, speak with your doctor or pharmacist to find out whether:

  • The drug could harm you if you take it after the expiration date.
  • If the drug can't be harmful, what should you look for to determine whether it is no longer effective

NOTE: This caution is particularly true if the drug is used for a serious health condition.

To Learn More

More Information

Drug Expiration Dates

Test Supplies

If a new prescription is for an expensive drug, purchase the minimum amount that will get you through the initial period to determine whether there will be side effects from the beginning, and whether the drug will work for you - for example, for a few days or a week. You are only charged for the few pills instead of the cost of the entire prescription. You can pick-up the remainder of the prescription at a later date.

Ask your health care provider or pharmacist how long it will be before you'll know if the drug is working, and before side effects usually show up. It could be just a few days or one week or longer.

 NOTE: If you purchase the full amount prescribed and the drug doesn't work, or if there are unreasonable side effects, most states and pharmacies prohibit returning unused prescription drugs.


How To Shop For The Lowest Drug Price

Drug prices are not standardized. In fact, you may be surprised by how different prices can be from different suppliers. The only way to find out about the drugs you take is to compare the various available sources which are described in other sections of this article.

Internet and mail order prices are generally less than local pharmacies -- but not always, so do your homework -- and consider doing it again every 6 months.

Internet prices: One web site which compares online prices is: http://www.pharmacychecker.com/ offsite link

Local drug store prices:

  • GoodRx offsite link coupons are useful at walk-in pharmacies. They are free at either GoodRx.com or via the GoodRx app.  At certain pharmacies, you can save up to 80% of the list price of generic drugs.  The web site and app also helps you compare prices at local pharmacies. GoodRx was founded by veterans of Facebook and Yahoo.  

Big box stores such as Walmart and Target offer drugs at a lower price. They also charge a minimal price such as $4 for a 30 day supply of many generic prescription drugs.

Every six months, it is advisable to repeat the process to compare the total cost for your drugs with other means of purchasing them. A few minutes of phone calls or typing on the computer keyboard can save you a lot of money.

NOTE: If the web sites mentioned above do not include all your options or a drug you are considering, we provide a chart to help make price comparisons. See How To Compare Prices -- A Chart.

P.S. It cannot hurt to ask your local pharmacist for a discount - particularly if you can show you can purchase the medication elsewhere at the lower price. Even if you don't have a price comparison, it 's worth asking - especially if you are a repeat customer.

Generic (or Sister) Versions Of A Drug

*A "generic" drug is a version of a drug which has the same active ingredients as a brand drug, but without the brand name.  When manufactured by the same company as the branded version, the drug is known as a "sister drug." For our purposes, these are all generic drugs.

Purchasing a generic version of a drug can be a big money saver. Generic versions of drugs are not like fake knockoffs of designer clothes and accessories. They are the real deal. The color, shape and size may be different, but the active ingredients are the same. In fact, generic drugs are regulated by the FDA the same way that branded medications are regulated.

The cost savings of purchasing a generic drug as compared to a name brand product can be as much as 95%. According to Consumer Reports, nearly 75% of all medications are available in generic version.

It is up to you to let your doctor know that money is a concern, and that you would like to be prescribed generic versions when possible. Doctors often do not take cost into consideration when writing a prescription. Due to habit, they often continue to prescribe a brand name drug long after a generic version is available. 

You can find out if there is a generic equivalent to a particular drug by any of the following methods:

  • Ask your doctor
  • Ask your pharmacist
  • The internet, for instance:
  • Generic Alternatives to Prescription Drugs (Basic Health Publications) is a handy reference that provides cost comparisons for more than 500 prescription and generic drugs.

IntegrityMeds.com offsite link is an online service that sells generics at cost. The site adds a $1 fee for each drug and a $10 order-processing charge (per shipment). Standard shipping is free.

If you have questions about generic drugs, contact the Generic Pharmaceutical Association at www.gphaonline.org offsite link.

NOTE: If your doctor won't prescribe a generic drug, or forgets, ask your pharmacist. In most states, a pharmacist can substitute the generic version of a brand-name drug.

Lifestyle or Therapeutic Substitutions

Sometimes there are different therapies which would have the same benefit for you as the one prescribed by your doctor. Even if the other therapy has the same retail cost as the prescribed drug, you may need less of it which would make it less expensive.

Lifestyle changes

Two examples of lifestyle substitutions are:

  • High blood pressure can be lowered by weight loss, exercise and salt reduction.
  • Cholesterol can be lowered by eating less saturated fat and more fruits and vegetables.

Non-drug alternatives

Sometimes home remedies and dietary supplements can be helpful - and much less expensive than drugs. For instance, vinegar soaks seem to work for nail fungus.

Therapeutic alternatives

To find out if a different therapy could work for you, ask your doctor or pharmacist, your insurance company, or look at a site such as www.drx.com offsite link (registration is necessary).

Older Alternatives For A Drug Or Over-The Counter Versions

Older drugs

In many situations, an older, less expensive, drug will do the same thing as a newer drug - but without the bells and whistles. Rather than pay extra for the newer drug, ask if an older drug will do the same thing.

Generally, older drugs are less expensive than new branded drugs. They also have the advantage of being time tested so there is a better understanding of the longer term effects of the drug.

At least one study found that doctors tend to prescribe newer drugs even if they are no more effective than older drugs. At least one doctor reported that he thought it would be unethical not to.

To find out if there are other drugs that would work for you, ask your doctor, ask your phamacist, or check a resource such as www.drx.com offsite link. Another resource is Consumer Reports' website that compares medications and lists the most cost-effective and safest ones for your condition. See: www.BestBuyDrugs.org offsite link

NOTE: Do not make a substition without checking with your doctor first.

Over-the-counter drugs

Over-the-counter drugs are generally less expensive than prescription drugs - but not always. First check to see if an over-the-counter version could work for you. If so, check the price compared to the prescription version.

Government Programs That Provide Drugs

Many states offer prescription drug assistance programs for their residents. These programs may be for people with limited income and/or assets or they may only be for people with a specific diagnosis or for specific segments of the population.

State programs vary widely as to:

  • Eligibility. For example, Minnesota's program is for married couples with incomes under $15,000 while New York's program pays for some of the cost of drugs for married couples with incomes of up to $50,000.
  • The amount you pay, if at all, for deductibles, co-payments or co-insurance.
  • Whether the drugs are paid for in part by the state or whether they are discounts.
  • Whether there is a cap on benefits.

To locate a state program which helps with drugs, consider the following: 

  • Medicare provides a list of state pharmaceutical assistance programs which offer help paying drug plan premiums and/or other drug costs. See: www.medicare.gov/pharmaceutical-assistance-program/state-programs.aspx offsite link. Select your state.
  • The Partnership for Prescription Assistance, an organization of America's pharmaceutical companies, doctors, other health care providers, patient advocacy organizations and community groups, has a site to help find a patient assistance program as well as public and private patient assistance programs. 888.477.2669, www.pparx.org offsite link
  • AARP has a list state-by-state of drug assistance programs. Go to www.aarp.org/bulletin offsite link and look under "exclusive Web resources."
  • If you have HIV, every state in the U.S. now has some form of ADAP (AIDS Drug Assistance Program) program. See State ADAP Programs
  • If you are under age 55: A list of State Drug Assistance programs and contact information can be found at http://www.rxassist.org/ offsite link or call the local Area Agency on Aging in your state. You can also find your agency via the Eldercare Locator at 800.677.1116 or look at the National Conference of State Legislatures Web site:www.ncsl.org/programs/health/drugaid.htm offsite link and click on "Public User"
  • Particularly if you are age 55 or over, to find programs for which you may qualify:

Patient Assistance Programs (Manufacturer Free Or Low Cost Drugs)

Most pharmaceutical manufacturers have patient assistance programs that provide medications either free or at a reduced cost for people who qualify for the particular program.

Eligibility: As a general matter, people who qualify have too much money to qualify for Medicaid, but not enough to be able to afford health insurance.

The eligiblity requirements vary from company to company.

Paperwork: Each company also has its own distinct application process.

With some companies, the application must go through your doctor. You are not allowed to submit your own application.

Be prepared to complete lengthy financial forms. The amount of paperwork is worth it.

Once your application is approved, you will usually receive a three month supply at a time. Some companies renew your prescription automatically. Others make you start from scratch. To make things even more confusing, companies periodically may also change their rules.

If your prescription is not covered by a patient assistance program, or even if you don't meet the requirements of a particular program, contact the manufacturer anyhow. The company may make an exception for you, particularly if you keep at it. If you can get some publicity about your situation, so much the better. Pharmaceutical companies are particularly aware of their public image. (To learn how to get publicity about your situation, click here.)

TO LOCATE PATIENT ASSISTANCE PROGRAMS

To help you find a patient assistance program, there are lists of the programs, as well as groups that will not only help you find an appropriate program, but also to help you through the application process.

  • Partnership For Prescription assistance lists patient assistance programs. See http://pparx.org offsite link or call 888.477.2669.
  • The Pharmaceutical Research and Manufacturers of America (PhRMA) sponsors www.HelpingPatients.org offsite link, Tel.: 888.477.2669 which lists the eligibility requirements of the pharmaceutical companies' various patient assistance programs. It also offers a free directory of patient assistance programs which can be viewed online at www.PhRMA.org offsite link. You may also contact PhRMA to request the current Directory of Prescription Drug Patient Assistance Programs. Write to: PhRMA Public Affairs Division, 1100 15th St., NW, Suite 900, Washington D.C., 20005. or call Tel.: 800 762 4636 or 202. 835.3400
  • A free directory of pharmaceutical company programs as well as other patient assistance program, including enrollment forms, is available from the Association of Community Cancer Centers at www.accc-cancer.org offsite link. Click on "publications", then "Patient Assistance Guide."
  • A free directory is available at www.helpingpatients.org offsite link, Tel.: 800.762.4636.
  • A listing of programs is available at NeedyMeds - a non profit organization::800.503.6897  www.needymeds.com offsite link
  • The federal government lists patient assistance programs through www.medicare.gov offsite link. Click on prescription drug assistance programs.

Groups That Help Find And Apply To A Patient Assistance Program

To help find a program for which you may qualify, consider:

  • Free Medicine Program has as a stated goal to find the appropriate Patient Assistance Program(s) for you. It also helps guide you in the application process. There is a fee of $5.00 for each medication, which is refundable if they don't find you free drugs. www.freemedecineprogram.org offsite link Tel.: 800.921.0072
  • The Medicine Program will do the research for you, forward the documents you need, and assist in obtaining the drugs for $5.00 per application.www.themedicineprogram.com offsite link Tel.: 573. 996.7300.
  • www.medicinebridge.com offsite link for a set up and monthly fee, will:
    • Help you identify the free medicines you qualify for and the appropriate pharmaceutical companies which manufacture them.
    • Complete the paperwork for you and your doctor.
    • Review your paperwork before submitting it.
    • Keep you updated with your free medicine refill and ensure your on-going refill paperwork for free medicine is done far enough in advance for you to receive your free medicine refills so that there are no gaps in your medicines.
    • Keep up with changing eligibility requirements.
  • www.ipsc.cc offsite link, IPS (formerly Indigent Patient Services), a division of Clinical Communications, Inc., charges a one time registration fee of $25 ($40 for couples) no matter how many drugs you need. IPS:
    • Helps complete the paper work.
    • Do the follow up with the doctors and the pharmaceutical companies.
    • Help with refills for a cost of $20 per application per refill.
  • www.rxoutreach.com offsite link is a patient assistance program that provides more than 50 FDA approved generic medicines. A three month supply costs $18; a 6 month supply costs $30.
  • FreeMedicineFoundation helps locate free drugs for a cost of $5.00 per prescription www.freemedicinefoundation.com offsite link.

Most drug manufacturers (pharmaceutical companies) provide free or low-cost drugs to people with low incomes, and sometimes to people with not-so-low incomes.

  • To find programs for which you may be eligible, see: http://pparx.org offsite link or call 888.477.2669.
  • To find the name of the manufacturer of a drug in which you are interested, see: www.PDRhealth.com/drugs/drugs-index.aspx offsite link. When you click on the name of the drug, scroll down to the picture of the drug. It will include the name of the manufacturer.
  • For a general overview of the program of a particular manufacturer, see www.OncPracticeManagement.com offsite link - search on "Patient Assistance" (without the quotes)

The following are patient advocacy groups that will help patients find free or low-cost drugs:

  • The Free Medicine Foundation.( A onetime fee of $10 is reimbursed if the foundation does not find free drugs). www.FreeMedicine.com offsite link or Tel.: 888.812.5152.
  • Indigent Patient Services Inc. (Registration fee plus cost per drugs). www.ispc.cc offsite link or Tel. 727.328.1404

Pill Splitting

According to Consumer Reports On Health: "The Food and Drug Administration ... called splitting pills a "risky practice" and does not encourage it unless it has specifically approved a drug for that purpose.  Still, our analysis of the research has found that many drugs can be safely split as long as you do it carefully and with the guidance of a medical professional." 

Talk with your doctor or pharmacist before splitting a pill. Not all drugs are safe for splitting. . 

Pill splitting saves money.

  • A tablet twice the content often costs close to the same as a tablet with half the same medication.
    • If you pay a percentage of your drug costs, the percentage you pay will be calculated on a lower medication cost.
    • If you pay a flat dollar co-payment for your prescriptions, your co-payment will be cut in half.
    • If you pay for drugs yourself, your costs will be cut in half.
  • Some tablets are scored. Others require a tablet splitter available at most pharmacies for $5 - $15. Insurance does not usually cover the cost of the splitterbut your savings in one month usually make up for the cost.
  • In order to receive a larger size pill, your health care provider will need to write you a new prescription for the higher strength tablet that can be split.
  • Caution: Ask your doctor or pharmacist whether the pill is safe to split.

It is not safe to split all pills. For instance, it is not safe to split:

  • A time released (sustained-release action) pill.
  • A pill with a coating that can't be broken without compromising the drug's potency -- which could be true even if the pill is scored.
  • Drugs with substantial toxicity or where the correct amount of the drug is absolutely critical. For instance, heart medications where critical dosages should not be changed arbitrarily.

Pill splitting is not recommended for people who may have difficulty organizing or performing the pill splitting task. For instance, pill splitting is not recommended for people who have manual dexterity problems, are frail, are confused or who have poor eyesight.

The fact that most pills do not split precisely in half is generally not a problem

  • A study in 2002 indicated that when pills are split, more than 40% of the resulting split tablets deviated by 10% or more from the target weight, and more than 10% of the split tablets deviated by at least 20%.
  • Some health insurers do not promote the practice because they say it is a patient-safety issue. On the other hand, Kaiser Permanents encourages the practice. It's CEO in 2004, George Halvorson, said that "therapeutically I have not heard of any negative issues."
  • Also, before it became a cost-saving tool in the 1990s, pill splitting was an accepted practice for patients prescribed odd-size doses, such as a tablet and a half a day.

How To Split A Pill

It is best to use a pill splitter rather than using a knife or scissors. Studies have found that pill splitters come closest to dividing medication into equal halves. There are even pill splitters for oddly shaped pills.

You can find pill splitters at drug store for very little money. Some insurance companies even offer splitters free of charge. 

Do not split pills in advance.

It is preferable to split a pill on the day you take the first half.  Take the second half as your next dose. This procedure helps keep the drug from deteriorating due to exposure to heat, moisture or air. It also helps to insure that any deviation in the size of one dose is compensated for in the next dose.

How to test if pill splitting works for you

Begin with a trial dosage of the size the doctor wants because pills don't usually split exactly down the middle so the dosage will be slightly uneven. If you start with the prescribed dosage, you will be sure the medication works for you. Once you know the pill works for you, consider a trial dosage such as a 30-day supply to see if pill splitting is right for you since pill splitting can be a hassle, and it's unlikely the split will be even. With the change in dosage, is the drug still effective? Are there side effects? If pill splitting doesn't work for you, you can return to the previous prescription in regular form.

To Learn More

More Information

Pill Splitting

Pharmacy Discount Programs

Many national chain pharmacies and warehouse clubs have programs that offer generic drugs at a steep discount. Some charge as little as $4.00 for a thirty day supply.

NOTE: Do not expect the pharmacist to tell you about cost-cutting information spontaneously. Consumer Reports' secret shoppers have found that pharmacists rarely offer cost-cutting information spontaneously.

When checking out a store, note:

  • Which medications are included, and in what quantity
  • Cost (per pill)
  • Enrollment fee, if any
  • Who can participate

The following chains have programs that are worth checking out. For most of the programs, thre is no annual fee - just a deeply discounted price for generic drugs and a discount on some brand-name drugs. The list is not a complete list.

  • Costco
  • CVS (and Caremark)
  • Kmart
  • Kroger
  • Rite Aid
  • Sam's Club
  • Target
  • Walgreens
  • Walmart

If you are under the care of a hospital-based doctor, are being treated at a hospital clinic, or belong to a health organization that has a pharmacy, you may be able to purchase drugs from the hospital or organization pharmacy at a discount.

For similar information, see: Drug Discount Cards and Clubs

State Or County Purchasing Groups To Help Residents Save Money

Most of these groups were formed to purchase drugs from Canada where they are generally less than in the U.S. For example, see www.westchesterrx.com offsite link 800.771.9196.

Whether you have cancer or not, check with your local cancer organization or a social worker to find out if your state has such an entity.

Be aware that if you purchase drugs from out of the country, it may be illegal.

Drug Discount Cards and Clubs

Discount cards and Discount Clubs may offer below-market prices on prescription drugs and other medical services.In some cases, it is less expensive to pay a discounted price than to pay through a health insurance policy. 

Discount Cards

Discount cards may be offered by pharmaceutical companies. For instance, Pfizer has a Pfizer for Living Share Card. See: pfizersharecard.com offsite link

Discount Clubs

Discount Clubs operate like any other discount buyer's clubs, such as clubs for groceries or other household items. They generally require membership which is open to anyone who pays a small annual fee. Many, such as BlinkHealth and GoodRX are free. As a member you would have access to drugs as well as other services and products at discount rates through specified providers.

Some of the larger discount groups are:

NOTES

  • Check your health insurance pjlicy. You may not get credit against a deductible for amounts spent for drugs outside your plan:
  • Medicare rules require that consumers always get the lower price of their set co-payment and a pharmacy's cash price.

Before joining a discount club:

  • Make certain that the medications and dosage you take are among the medications and dosage that the club offers at a discount
  • Ask what the discount for your prescriptions will be.
  • Find out about restrictions. For example, some programs are only offered to people without insurance or for medications that are not covered by insurance.
  • What is the enrollment fee, if any?
  • Make an alert to check the list of drugs offered every few months to be sure your medication is still available, and for new medications that are offered.

Other

There is at least one web site that gives free discount coupons (in addition to helping you compare prices at local phamarcies.) The site is GoodRx. offsite link

NOTE:

Online and Mail Order Sources Of Drugs

NOTE:

  • If you have a flexible spending account or a health savings account, it is more convenient if the pharmacy accepts payment directly from your benefits card rather than require you to pay up front and then submit your receipt to your FSA or HSA account for a refund.
  • An online pharmacy may not be for you if your list of medications is complicated or are less common, you take them infrequently, they require refrigeration or other special handling, or you need them quickly.
  • Take care when choosing an online pharmacy.  Many are not legitimate. There are red flags to look for. For example, if the site does not require a prescription. (For more red flags, click here.) If there are such flags, be VERY careful.  It is preferable not to deal with such sites - not matter how good the deal looks. 

Local Pharmacies Including Hospitals

  • A study in New York City found that local independent drug stores were less expensive than chain stores.
  • Price differences between two pharmacies on the same block can be substantial. Different stores in the same chain may charge different prices. When comparing prices, go to local chain and independent stores, and check the internet.
  • If you are under the care of a hospital-based doctor, are being treated at a hospital clinic, or belong to a health organization that has a pharmacy, you may be able to purchase drugs from the hospital or organization pharmacy at a discount.
  • Store brands for common over-the-counter drugs may be substantially less than brand name or generic drugs. 

NOTE: It you purchase different drugs from different pharmacies, be sure that at least one pharmacy has a list of all the medications you take, including over-the-counter medications. The entire list is important to check for negative interactions.

Military Benefits

If you are an active-duty service member, reserve member, retired uniformed armed services member, family member or survivor, check to see if you are eligible for low cost or free drugs. The three programs to consider are:

  • The Veterans Administration provides low-cost prescription drugs to honorably discharged veterans. 
    • To find out if you qualify for the VA drug program, fill out a form 1010EZ which is available at www.va.gov offsite link. Then take a copy of the completed form and a copy of your DD214 to a local VA hospital, enrollment section. They'll let you know if you qualify.
    • For general questions about the VA coverage of prescription drugs, call 877 222 8387.
  • CHAMPVA (for family members of a veteran who has a permanent disability or who died in the line of duty or due to a service-connected disability: www.va.gov offsite linkor Tel. 877.222.8387) 
  • TRICARE (for active-duty service members, reserve members, retired uniformed armed services members, their families and survivors: www.tricare.mil offsite link or Tel. 800.538.9552).  People who qualify for TRICARE can obtain medicines for for very little money through the National Mail Order Pharmacy. There is no enrollment for Tricare. Participants only need to have a military identification card.
    • Drugs are ordered by completing a Patient Profile Registration form and sending in the money.  Forms are available at www.tricare.mil/forms offsite link or by calling 800.903.4680.
    • It is also possible to purchase drugs under this plan from a local pharmacy if the pharmacy participates in the TRICARE network. Cost is higher when purchasing drugs through a TRICARE related pharmacy.
    • Drugs are free if you go to a military treatment facility pharmacy. 

Clinical Trials

You may be able to qualify for a clinical trial that will provide the medication you need at no cost.

A clinical trial is a carefully controlled study to answer specific questions about a new drug or treatment or a new way of using an old drug or treatment. It is a myth to think that people who participate in clinical trials are used as "guinea pigs."  Trials are conducted by scientists and researchers who believe that a treatment may be superior to standard treatment. All clinical trials are under federal regulation which requires that each study be subject to an instituional review board (IRB) which reviews and monitors the study. One of  the major criteria IRBs watch for is patient safety.

To learn about clinical trials, click here.

NOTE: When considering a clinical trial to obtain access to a drug, be sure to find out what the trial will or will not cover. Also find out what happens when the trial ends.




Outside Of The United States

More and more people are purchasing prescription drugs outside of the U.S. because the price difference can be substantial, even for drugs which are manufactured in the U.S. and exported to the foreign country. According to one published report, the savings can be up to 70% of what we pay here.

Legality: 

  • Unless there are facts which justify the purchase, it is not legal to do either of the following:
    • Bring drugs purchased outside the United States back with you into the U.S. 
    • Receive by mail order- foreign made versions of U.S. made drugs.
  • Saving money is not considered to be legal justification for buying a drug from outside the country.

Reality:

  • Despite the law, the reality is that neither the Food and Drug Administration (FDA) or U.S. Customs take steps to prevent Americans from crossing the border with a personal supply of prescription drugs (particularly when you have a valid prescription from your U.S. based doctor) or from receiving a personal supply of drugs by mail order.
  • Since the FDA's position is only a guide line, customs officers may stop a drug from entering the country. While there have been reports of some seizures of mail-order packages, by and large mail-order packages that are for personal use have not been confiscated.
  • Generally a personal supply is considered to be three months' worth of a drug bought for your own use.
  • According to recently published reports, the pharmaceutical companies are taking steps to stop foreign pharmacies and mail order companies (particularly Canadian) from selling U.S. made drugs back to U.S. residents. However, even those efforts apparently do not involve enforcement activities against individuals who obtain prescription drugs for personal use.
  • NOTE: If ordering drugs through the mail, check to learn about storage requirements. For instance, some drugs such as insulin need to be refrigerated or lose their effectivness. Other drugs should not be exposed to extreme heat or extreme cold. If you are concerned about the manner of shipping, contact the supplier.

Before purchasing drugs from outside the U.S., keep in mind:

  • Prices may not be cheaper. Be sure to compare before purchasing.
  • The lack of FDA supervision. The FDA has no control over drugs produced outside of the U.S. As a practical matter, this means:
    • The safety and usefullness of the drug has not been subjected to the FDA's rigorous standards.
    • The FDA has no control over drug manufacturing outside the U.S.
    • There is no assurance that what you are getting isn't a counterfeit knock-off of the real drug.
    • NOTE: Even for drugs manufactured in the U.S., the FDA has no supervision over storage or handling of the drug.
  • There is a procedure to authorize import  of a limited quantity of drugs for personal use to treat serious illness when the drug is not available in the U.S. If you wish to purchase medication from outside the United States for treatment that is not available here, and want to assure there will be no difficulties importing the drug, speak to your doctor about applying for Investigation New Drug (IND), Compassionate IND, or Treatment IND exemptions to the import regulations.To learn more, see the FDA webs

NOTE: If you are going to go to a neighboring country to purchase prescription drugs, click here for Canada, here for Mexico.