Google Answers: For knowledge_seeker-ga: Saving money on prescription drugs

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Q: For knowledge_seeker-ga: Saving money on prescription drugs ( Answered 5 out of 5 stars

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Subject: For knowledge_seeker-ga: Saving money on prescription drugs
Category: Health
Asked by: natalieemt-ga
List Price: $50.00

Posted: 16 May 2003 10:58 PDT
Expires: 15 Jun 2003 10:58 PDT
Question ID: 204687

Dear knowledge-seeker-ga,

Following up our our previous discussion, can I please ask you to
research the large question of "how to save money on prescription
drugs."  I present a tentative outline for the answer, but you are
welcome to organize it differently if you want.

As my underlying goal is to write a consumer-oriented article with
lots and lots of links for the consumer who wants to further explore a
particular aspect, I am interested in both quality and quantity.  The
target audience for this question is U.S. consumers, particularly
consumers who (a) do not have any health insurance, (b) do not have
any prescription drug coverage, (c) have prescription drug coverage
that still requires them to pay substantial amounts of money out of
pocket for prescription drugs.  (Those three criteria should cover
most of the U.S. population.)

1.  To begin with, I am interested in seeing an overall outline
("basically, there are X ways to save money on prescription drugs"). 
I anticipate that the ways will include discussing treatment and drug
options with your doctor, using generic drugs, price shopping between
pharmacies, buying a prescription drug card, buying drugs mail order
within the U.S., buying prescription drugs from abroad, and applying
to the drug companies' indigent care programs.  Please note that while
I do understand that many people have turned to alternative medicine
because conventional medicine has become affordable, I am specifically
NOT interested (at least not at this time) in having you explore the
"alternative medicine" alternative.

2.  Within each alternative, I'm looking for a set of links.  Some
should not need to much work.  For instance, I would bet that you can
easily find 5 articles making the general point that pharmacy prices
vary widely within a given town, so that it makes sense to price shop.
 Five really good articles supporting that point are entirely
sufficient.

3.  Please do focus some disproportionate effort on drug discount
cards.  How can people tell whether or not a given program is
legitimate?  What does legitimate mean, anyway, in this context?  Are
there particular companies that have been identified as scams or not
worthwhile?  Who regulates these companies?

I've set the price at $50 - will tip for fabulous results (you get to
keep the whole tip, right?)

Request for Question Clarification by knowledge_seeker-ga on 20 May 2003 16:22 PDT

Hi natalieemt, 

I just wanted to let you know that I've been working on this most of
the day (Tuesday) and am probably 90% done. I'm not sure I'm going to
be able to finish it tonight however. I'm going to take a break now,
and if I don't get back to it this evening, then I will certainly
finish it up tomorrow morning.

The research itself is going really well. There is plenty of
information out there. Again, it's a weeding process. I've got all the
data, now it's just a matter of putting it into logical sequence.

Will be in touch --

-K~

Clarification of Question by natalieemt-ga on 20 May 2003 19:22 PDT

That's fine . . . I am not going to really start working on it from my
end until Saturday.  It's probably a case of too much info, so time
you spend organizing it will save me time.  Thanks for the update.

Natalie

Answer

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
Answered By: knowledge_seeker-ga on 21 May 2003 09:42 PDT
Rated: 5 out of 5 stars

Hi natalieemt, Ok here it is. I don't think you'll need a lot of explanation here, so I'll hand it over as is. As always, if anything isn't clear, if a link doesn't work, or if I've neglected anything major, just yell (via Clarification Request) and I'll get back to you poste haste. COUPLE OF NOTES – the CONSUMER REPORTS pages are sometimes slow to load. Be patient, they WILL get there. - Where my search terms netted me a large number of pertinent returns, I have included those returns for you to look over. --K~ ====================================== 12 WAYS TO SAVE ON PRESCRIPTION COSTS ======================================= 1 – Reduce the amount of medication you must take – Brown Bag Review 2 - Comparison Shop for pharmacies – prices vary! 3 - Control Quantities - use trial sizes, free samples, bulk orders. 4 - Use Generic and /or Less Expensive Brands 5 – Splitting pills 6 – Patient Assistance Programs 7 – Veterans Benefits 8 – Use of Compounders (* see my cautions) 9 – Join a Drug Cooperative 10 – Mail order (or online ordering) 11 – Purchase out of the country (Canada, Mexico) 12 – Health/Drug Discount Cards ================================ LISTS OF WAYS TO SAVE ================================= HOW TO SAVE MONEY ON PRESCRIPTION DRUGS http://saverealmoney.com/prescription-drugs.htm CONSUMER REPORTS - Saving money on prescription medicines http://www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=21751&FOLDER%3C%3Efolder_id=21135&bmUID=1053448364651 Before You Buy Prescription Drugs - Pediatrics http://pediatrics.about.com/library/weekly/aabyb102401.htm How to Save on Prescription Drugs http://seniorhealth.about.com/c/ht/00/07/How_Save_Prescription_Drugs0962933608.htm Cut the cost of prescriptions up to 70% - 14 ways http://www.savvy-discounts.com/media/r_drug.htm Options available for saving on drugs http://www.azstarnet.com/health/news/030126drugside.shtml A prescription drug guide http://ia.essortment.com/prescriptiondr_pyt.htm 7 ways to save money on prescription drugs in Southwest Florida http://www.sworcare.com/discount%20Rx%20program.htm ==================================== BROWN BAG REVIEW or ASSESSMENT ================================== Before even thinking about comparing drug prices and looking for discounts, consumers should make sure that what they are taking is really necessary. It is not unusual for patients to continue refilling prescriptions long after the need for the medication has passed. This is especially true of elderly patients. The best way to reduce the amount spent on drugs is to have your doctor conduct a "Brown Bag Review." Put all of your medications in a bag and ask your pharmacist or your doctor to review them and suggest any less expensive alternatives. Also determine whether or not all your medications are still needed. "… Sometimes, pharmacies and health plans hold "brown-bag" medicine reviews, when patients are invited to bring in all their medicines. Check with your pharmacy or health plan to find out when and where the next "brown-bag" review in your area will be held…" Medication Mistakes: Drug Errors, Drug Interactions http://www.healthscope.org/Interface/health_resources/choosing_drugs/medication_mistakes.asp Iowa Priority's Brown Bag Assessment Program Helping Members Identify Potential Medication Interactions, Duplications -- Members Averting Harmful Reactions, Realizing Savings http://www.iowapriority.org/newsrelease-brnbag.asp Most of the websites discussing Brown Bag assessments are geared towards doctors of elderly patients, not consumers, and they focus more on the safety aspect of knowing what drugs seniors are taking as opposed to any cost savings potential. Here are a couple of sites, but I'm not sure they are really appropriate for your article. DO FAMILY DOCTORS KNOW WHAT THEIR ELDERLY PATIENTS ARE TAKING? http://www.sergp.org/Educ2/CommunEduc/Do%20Family%20Drs%20Know%20What.htm HISTORY TAKING AND EXAMINING THE GERIATRIC PATIENT http://www.med.uc.edu/pages/courses/icp2/01-023-margolin.doc ========================= COMPARISON SHOPPING ========================= Pharmacies may charge widely different prices for the same medicine. Call around and get prices before filling your prescription. --------------------------- "Our reporter called a half-dozen independent, chain, and superstore pharmacies in the Washington, D.C., area to ask for the retail price of two top-selling medications: atorvastatin (Lipitor), used to reduce cholesterol, and quinapril (Accupril), used to reduce blood pressure …." "The time was well spent. Prices for quinapril ranged from $89.69 to $115.99 for a three-month supply. The potential saving from the most to the least expensive store is $105 for a year's supply. The price range for atorvastatin was even greater: $179.49 to $209.90 for a three-month supply-that's a potential saving of over $120 a year." SHOPPING AROUND: A HOMETOWN EXPERIMENT http://www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=21755&FOLDER%3C%3Efolder_id=21135&bmUID=1053530323816 ------------------ "Join a warehouse club and buy groceries in bulk…. Some big-ticket necessities--tires, prescription drugs, and eyeglasses, for example--can also give you a payback on the annual membership fee." CONSUMER REPORTS - SHOPPING http://www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=153459&FOLDER%3C%3Efolder_id=18151 ------------------ "The best deals generally come from online/mail-order pharmacies, although the prices at Costco Wholesale, a warehouse membership club, were nearly as low in October 1999....... However, many pharmacies are now willing to match the best prices from other sources…." "…it is corporate policy at Kmart, Rite-Aid, and Wal-Mart to match the lowest price available at pharmacies in the region. Kmart will even match Internet and mail-order pricing." SAVING MONEY ON PRESCRIPTION MEDICINES http://www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=21751&FOLDER%3C%3Efolder_id=21135&bmUID=1053530085362 ---------------- "The survey telephoned 201 pharmacies in Florida, Georgia and Alabama in mid-August to compare 30-day prescription prices on four commonly used drugs.." AS DRUG DEBATE RAGES, COMPARE PRICES http://www.sptimes.com/News/092200/State/As_drug_debate_rages_.2.shtml -------------- PRESCRIPTION PRICES RUN HOT AND COLD AT LOCAL DRUGSTORES http://www.noevalleyvoice.com/2003/May/Drug.html ---------------- PRESCRIPTION DRUG PRICES VARY WILDLY, SURVEY FINDS http://www.freep.com/news/mich/drugs5_20020305.htm ---------------- PRICES VARY WIDELY FOR PRESCRIPTION DRUGS IN SURVEY OF CAPITAL DISTRICT STORES http://www.consumer.state.ny.us/pressreleases/2001/jun202001.htm ------------------ MORE GOOGLE SEARCH RESULTS - survey prescription prices ://www.google.com/search?q=survey+prescription+prices&hl=en&lr=&ie=ISO-8859-1 ======================== CONTROL QUANTITIES ======================== There's nothing more wasteful than buying a 30-day supply of tablets, only to find after 7 days that the medication either doesn't work or has adverse effects. Asking the doctor for a short-term prescription for any new medication prescribes is a good way to prevent such wastefulness. "You can reduce medication waste by requesting a smaller quantity of pills for a new prescription you are beginning. This time will determine if your body can tolerate the medicine. Paying for a month or more of medication only to find out it doesn't work for you can waste hundreds of dollars." SAVE REAL MONEY ON PRESCRIPTION DRUGS http://saverealmoney.com/prescription-drugs.htm But Avoid "free samples" if they lead to refills at higher prices. Usually only the newest name-brand drugs are promoted through free samples. Patients may be better off purchasing another lower-priced brand or generic equivalents if they are available. On the flip side of this, if a prescription is ongoing, then it may pay to order a larger amount at a time --- " Some HMOs have in-house mail-order pharmacies that will fill a two-month supply of a drug (usually generic) for the price of one; these are frequently not well advertised but still available" A PRESCRIPTION DRUG GUIDE http://ia.essortment.com/prescriptiondr_pyt.htm ======================================= GENERIC AND /OR LESS EXPENSIVE BRANDS ====================================== "Less Expensive Brands -- You can also save money by simply being aware of the cost differences between different brand name drugs in the same category. There are significant cost differences among antidepressants, cardiac drugs, antihistamines and many other drugs. While switching brands may not be an option for everyone, ask your doctor if your condition allows you to try a less expensive brand name drug." SAVE REAL MONEY – PRESCRIPTION DRUGS http://saverealmoney.com/prescription-drugs.htm GENERIC DRUGS VS BRAND NAMES http://www.bedford.org/a_drugs.htm WHAT IS A GENERIC DRUG? http://www.gphaonline.org/about/generics.phtml FDA ENSURES EQUIVALENCE OF GENERIC DRUGS http://www.fda.gov/fdac/special/newdrug/generic.html MORE GOOGLE SEARCH RESULTS brand name generic drugs ://www.google.com/search?q=brand+name+generic+drugs&hl=en&lr=&ie=ISO-8859-1 ======================== SPLITTING PILLS ======================= " Drugs cost about the same per pill, regardless of the dosage. As a result, patients who buy a larger pill that contains twice the dose they need can cut it in half and save as much as 50 percent.." Pill Splitting Can Save Money On Prescription Drugs http://www.ncpa.org/pi/health/pd080101d.html 10 tablets "approved" for splitting --- http://www.sworcare.com/discount%20Rx%20program.htm How To Save Up to 50% on Your Medication Costs by Pill Splitting http://depression.about.com/cs/drugindex/ht/Pill_Splitting.htm Medications That Can Easily Be Split http://depression.about.com/blpillsplit.htm Is Cutting Your Pills a Safe Way to Save Money? Types of medicines that should not be cut: http://www.consumer-health.com/services/cons_take18.htm Pill splitting lowers costs, but raises health concerns http://www.post-gazette.com/healthscience/20020430hsplit0430p5.asp MORE GOOGLE SEARCH RESULTS pill splitting save money ://www.google.com/search?sourceid=navclient&q=pill+splitting+save+money =============================== PATIENT ASSISTANCE PROGRAMS =============================== Some pharmaceutical manufacturers and some states offer a limited supply of free or low-cost medications to patients through PATIENT ASSISTANCE PROGRAMS. These programs are normally a "last resort" for patients who are unable to use other programs and who otherwise would not be able to afford needed medications. To be accepted into most of these programs, the patient's income must fall within the limits established by his particular sponsor. Other criteria are taken into account as well – for example AIDS, transplant or cancer patients in need of very expensive drugs are often considered even if their income range is higher than the program normally allows. FOR EXAMPLE --- " The other is a new osteoporosis drug called Actonel that retails for about $80 a month. … her doctor helped her enroll in a patient assistance program through Procter & Gamble, Actonel's manufacturer. … "I get a three-month supply by mail for free. I don't even pay for shipping," Henri said. " OPTIONS AVAILABLE FOR SAVING ON DRUGS http://www.azstarnet.com/health/news/030126drugside.shtml However, it should be cautioned, that although pharmaceutical drug plans may give discounts on their name-brands, consumers may find better prices through the purchase of generics. ORGANIZATIONS THAT HELP PATIENTS AND DOCTORS FIND ASSISTANCE PROGRAMS -------- -------------- "RxAssist provides physicians and other health care providers with the information they need to access these programs." Consumers may use the website to search for programs by drug name, company name or drug class. RX ASSIST - http://www.rxassist.org/default.cfm ------------------ DRUG ASSISTANCE PROGRAMS – BY STATE (Last Update 03/25/02) http://www.rxassist.org/pdfs/state_programs.pdf ------------------------- MEDICARE - Prescription Drug Assistance Programs (Zip Code search) Provides complete listing of resources including State and Community Prescription Assistance Programs and Medicare + Choice and Medigap health plans that include prescription coverage. MEDICARE - Prescription Drug Assistance Programs http://www.medicare.gov/Prescription/Home.asp ---------------------------- " Our function, in cooperation with the physician, is to assist patients who may qualify to enroll in one or more of the many patient assistance programs now available. These programs provide prescription medicine free-of-charge to individuals in need, regardless of age, if they meet the sponsor's criteria." THE MEDICINE PROGRAM http://www.themedicineprogram.com/info.html ---------------------- RX Hope http://www.rxhope.com/ --------------------- ======================== VETERANS' BENEFITS ========================= "Veterans can get prescription drugs at nominal cost at Veterans Administration outpatient clinics. And beginning in April, Medicare-eligible military retirees will be able to get prescription drugs at lower prices at local pharmacies and to participate in the Department of Defense mail-order prescription-drug benefit program." ------------------------ " The Veterans Health Administration (VHA) provides a broad spectrum of medical, surgical, and rehabilitative care to its customers. Our goal is to share information about these benefits and services to make it as easy as possible for you to receive the care you need." VETERANS HEALTH ADMINISTRATION http://www.va.gov/health_benefits/ FEDERAL BENEFITS* (122 pages) http://www.va.gov/pubaff/fedben/Fedben.pdf see page 11 for outpatient pharmacy services ------------------------- Simple instructions on how to apply – "A federal law entitles all veterans to purchase prescription drugs at significantly reduced prices. Each 30-day or less supply of medication for non-service connected prescription costs only $2." …there is a Prescription Drug Benefit especially for Veterans? http://bernie.house.gov/access/dyk-vadrugs.asp ----------------------- "The Veterans Administration (VA) provides free prescriptions for low income Veterans who have been honorably discharged from the military. Other veterans may obtain prescriptions for $7. Veterans must enroll with the VA, be seen by a VA doctor and receive the prescriptions from VA hospitals and pharmacies." PRESCRIPTION DRUG ASSISTANCE RESOURCES http://www.ncdoi.com/Consumer/Shiip/Documents/PrescriptionDrugBrochure.pdf ---------------- As Congress Debates Prescription Drug Coverage, a VA Benefit is Available for All Veterans http://www.house.gov/frost/cols0102/col020419-prescriptiondrug.htm ====================== USE OF COMPOUNDERS ===================== Natalie, The call as to whether or not to use this is obviously yours, but this is a highly controversial practice being used by some companies to exploit a loophole in the FDA regulations. Compounding is when pharmacists or health care professionals prepare a specialized drug product to fill an individual patient's prescription when an approved drug can't fill the bill. The intent of the law is to allow a relaxation of the FDA definition of "approved" drug so that a doctor can mix or change ingredients of a drug to suit a particular patient. However, some companies calling themselves "small compounders" are instead mixing up large commercial batches of drugs using unregulated ingredients. "Whenever possible, FDA would recommend that patients use an approved drug. We have more data and reporting requirements on those to assure us of their safety and effectiveness." Pharmacy Compounding: Customizing Prescription Drugs http://www.fda.gov/fdac/features/2000/400_compound.html The Practice of Pharmacy Compounding http://www.fda.gov/cder/pharmcomp/default.htm --------------------- "…..In 2002, FDA researchers sampled 29 products from 12 pharmacies that market [compounded drugs] through the Internet. Nine products were not potent enough; one was contaminated; and three others failed an initial test but were not counted as failures because an inadequate amount was left for retesting. By comparison, 1% to 2% of drugs from manufacturers fail to meet standard assays…" The Misuse of Compounding By Pharmacists http://www.quackwatch.org/01QuackeryRelatedTopics/compounding.html -------------- " In recent years, compounded drugs have killed three people in California, another in Michigan, blinded two in Pennsylvania and hospitalized many others in other states.." "It's hard to believe. But while big pharmaceutical companies are tightly regulated by the Food and Drug Administration, if you call yourself a compounder, oversight is minimal." "They don't answer to the FDA, they minimally answer to their state pharmaceutical boards, and they're basically allowed to get by with making drugs and selling drugs that aren't regulated or tested by anyone," she says. Prescription For Disaster http://www.cbsnews.com/stories/2002/11/18/eveningnews/main529777.shtml ------------------- " Swift action by the California Pharmacy Board has led to the interim license suspension of a pharmacist from Docs Pharmacy. The Walnut Creek pharmacy is linked to three deaths from meningitis in the bacteria contamination of a compounded drug. The Pharmacist, Robert Horwitz has been ordered to stop work and his pharmacy has been ordered to stop dispensing any compounded drugs until the next hearing date" Pharmacy Operation Restricted By Action From The California State Board of Pharmacy http://www.dca.ca.gov/press_releases/20010717a.htm ============================= DRUG COOPERATIVES ============================== " You can now join discount clubs that offer members savings on prescription drugs. For example, one drug co-op advertises savings of "up to 40 percent on leading brand-name drugs" for members who pay an annual fee of $25 ($40 for a family membership). It offers the cholesterol reducer atorvastatin (Lipitor) for $10 a month lower than the lowest price we found in a local survey of pharmacies in Washington, D.C.—with free delivery included. Before joining a co-op, check on the availability and cost of the medications you need" CONSUMER REPORTS - Saving money on prescription medicines http://www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=21751&FOLDER%3C%3Efolder_id=21135&bmUID=1053448364651 EXAMPLES – ----------------------------- " DES MOINES - In a continuing effort to fight the high cost of prescription drugs for seniors, Governor Tom Vilsack today signed into law a bill that will pursue the feasibility of a multi-state prescription drug purchasing cooperative. “By expanding the number of seniors who participate in a prescription drug purchasing co-op, we should be able to negotiate volume discounts from pharmaceutical manufacturers. " Vilsack signs bill for expanding Prescription Drug Cooperative to other states http://www.governor.state.ia.us/news/2002/may/May1102._1A.html -------------------------- " SeniorScrips was established as a non-profit membership cooperative to allow seniors to pool monthly dues to partially subsidize the purchase of their prescription drugs. SeniorScrips was established by seniors, for seniors aged 55 and over. This non-profit co-op allows seniors to keep the cost of their prescription drugs at affordable levels. This is not an insurance plan." http://www.seniorscrips.com/ ------------------------ First HIV drug co-op cuts costs http://www.aegis.com/news/upi/2002/UP020401.html ---------------------- THE MEDS CLUB http://themedsclub.com/home.htm ----------------------- ======================= MAIL ORDER (ONLINE) ======================= Natalie, All of the same precautions that apply to ordering from pharmacies in Canada, apply here. Discerning the good from the bad will be a matter of assessing the licensing of the online pharmacy, the availability of a pharmacist to talk to your doctor, and of course price and availability of the drug. Check with the National Association of Boards of Pharmacy www.nabp.net to determine whether a pharmacy is licensed. Also look for web sites with a seal saying VIPPS, this means it's a Verified Internet Pharmacy Practice Site. http://www.nabp.net/vipps/intro.asp Online Pharmacies Can Save You Money (outdated, but still some good rules of thumb for assessing online pharmacies) http://216.239.37.100/search?q=cache:P22RMAKo2CQJ:www.kiplinger.com/columns/fitness/archive/2001/ff010620.html+licensed+online+pharmacies&hl=en&ie=UTF-8 FDA- Buying Medicines and Medical Products Online http://www.fda.gov/oc/buyonline/default.htm U.S. States Target Illegal Online Pharmacies (2000) http://www.ecommercetimes.com/perl/story/2870.html Online Pharmacies Settle FTC Charges http://www.ftc.gov/opa/2000/07/iog.htm --------------------------------------------------- ONLINE PRICE COMPARISON WEBSITES PRICE RX http://price-rx.com/ BEST-PHARMACY http://www.best-pharmacy.com/ MIXPILLS http://www.mixpills.com/ E-PHARMACY FINDER http://www.epharmacyfinder.com/ PILLRANK http://www.pillrank.com/ DESTINATION RX http://www.destinationrx.com/company/about.asp =============================== ORDER FROM OTHER COUNTRIES ============================== We've addressed most of this in the previous question on Canada. As far as Mexico goes, I think that's a topic that going to have to be a project of its own. As with the Canadian pharmacies, there will be legal and safety issues. =================================== HEALTH / DRUG DISCOUNT CARDS =================================== ------------------------------------- TYPES OF CARDS Non-Pharmaceutical Company Discount Cards Associations (eg AARP) Drug stores Retailers (eg Kmart) Pharmacy Benefit Managers Pharmaceutical Company Discount Cards (NOT the same as Pharmaceutical Assistance Programs) State-Sponsored Discount Card Programs ------------------------------------------ ISSUES TO CONSIDER WHEN SHOPPING FOR CARDS Membership fee Price of drugs Availability of the drugs needed Age and income restrictions Quality Assurance (24/7 pharmacist) Privacy State or federal regulation --------- SUMMARY The review of Prescription Drug Discount Cards is best summed up by the below statement from this report. (The report is 48 pages long – I have summarized pertinent points later in my discussion – they will be labeled "KAISER Report" and will reference specific page numbers for you) Kaiser Foundation Report – February 2002 (48 pp) Prescription Drug Discount Cards: Current Programs and Issues http://www.pbs.org/newshour/health/prescriptions/kaiserreport.pdf "From the consumer’s perspective, while these programs have the potential to offer substantial savings, the plethora of discount card options presents a formidable landscape to navigate. Comparison shopping among these options can be tedious and confusing. In fact, for consumers who typically fill prescriptions only when experiencing an acute condition, comparison-shopping is probably not feasible. They may also place a higher priority on accessing the prescription immediately and forego the deeper discounts that may be available from mail-order services because of the time delay in shipping. Consumers lacking access to the internet are even more disadvantaged in their efforts to evaluate card options." ------------------- Due to these and other reasons, Consumer Reports specifically recommends against the use of Prescription Drug Discount Cards BE WARY OF HEALTH DISCOUNT CARDS (MAY 2002) http://www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=153399&FOLDER%3C%3Efolder_id=18151 ---------------------------------------------- DISCUSSION OF PRESCRIPTION DRUG DISCOUNT CARDS How They Are Suppose To Work – Consumer pays a monthly fee and is promised reduced rates at participating pharmacies, hospitals, and dentists' and doctors' offices. " The sponsors of the cards can offer those price breaks because they pool together the purchasing power of lots of customers. As a result, they're able to negotiate lower dispensing fees from pharmacies and sometimes lower drug prices from pharmaceutical manufacturers." " pharmaceutical companies like Pfizer and Merck have also brought out cards that offer seniors discounts on the medications those companies produce…." PBS - PRESCRIPTION DRUG DISCOUNTS http://www.pbs.org/newshour/bb/health/jan-june02/rxdiscounts_6-3.html --------------------- Why they don't work as well as you might expect ----- They are NOT insurance Doctors, hospitals, and pharmacies may not honor the cards. Not regulated by most states Sellers may not be licensed or health-care professionals. Hard to comparison shop. Discounts not obvious. No control over how companies use the private medical information. Users may lose benefits provided by other patient-assistance programs Savings may be perceived but not real (eg - generic equivalent may be much cheaper) BE WARY OF HEALTH DISCOUNT CARDS (MAY 2002) http://www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=153399&FOLDER%3C%3Efolder_id=18151 ---------------------------------- USING MULTIPLE CARDS Consumers are not limited in the number of prescription discount cards they can own. In order to maximize savings and have all pharmacies and prescriptions available to them, it might be necessary to have multiple cards. " Mr. and Mrs. Shapiro are currently spending about $16,000 a year for the drugs that they're taking. What we found in the seven options we looked is that from any one option, the best they could do would give them savings of about 5 percent over what they're currently spending…." SUSAN DENTZER: And if the Shapiros use several different discount card and mail order options to get the best prices on each of their drugs, they could save as much as $1,700 a year. " PBS ONLINE NEWS HOUR - PRESCRIPTION DRUG DISCOUNTS http://www.pbs.org/newshour/bb/health/jan-june02/rxdiscounts_6-3.html Interactive -- See how much Penny could save http://www.pbs.org/newshour/health/prescriptions/index.html# ------------------------------------- Kaiser Foundation Report – February 2002 (48 pp) Prescription Drug Discount Cards: Current Programs and Issues http://www.pbs.org/newshour/health/prescriptions/kaiserreport.pdf NOTES: All excerpts are verbatim(in case I missed some quotation marks) Page numbers precede excerpts Page number means - as numbered within the report Pdf page count means – document page number when you scroll through (easier to find pages). [KAISER Report page 1 -- pdf page count 10] "This report provides information on prescription drug discount card programs that already exist in the private market or are being sponsored by states or by statewide nonprofit organizations. The purpose of the report is to provide a baseline of information that can help inform the policy debate about the advantages and disadvantages of promoting discount cards as an option for helping Medicare beneficiaries pay for prescription drugs. The report highlights issues of importance to consumers." [KAISER Report page vii -- pdf page count 7] "The most favorable option for any individual will depend on a number of factors including the: • number and type of medications needed; • duration of the drug regimens; • convenience and accessibility of the outlet; • acceptability of mail-order services; and • value of professional pharmacist counseling. Thus, a single option is unlikely to be optimal for all consumers…. [KAISER Report page viii -- pdf page count 8] "The only way a consumer can determine whether or not a particular card program will give them value is to obtain specific price quotes on the set of drugs they use. … Comparison shopping among these options can be tedious and confusing. Typical problems encountered by consumers in assessing card options may include: • non-comparable prices due to the lack of a standard method for describing discounts; • pricing quotes limited to a subset of available drugs; • discounts expressed as an average from undisclosed prices; • frequent price changes; • specific drug price availability only after enrollment in the card program; • availability of mail-order prices only; and • retail pharmacy discount prices available only from each store. ------------------------------------ QUALITY ASSURANCE. [KAISER Report page 19 -- pdf page count 28] " The most common quality function in programs reviewed for this report is the provision of information about the appropriate dosage, possible side effects, and adverse drug interactions to the consumer." "The programs with the most limited services in these areas are those that rely exclusively on the procedures of local participating retail outlets and their pharmacists. Cards associated with PBMs generally provide drug utilization reviews, toll-free access to pharmacists, and product use and side effects information. A few cards offer a broader range of patient education and counseling services that can be valuable to consumers." ------------------------------------- STATE SPONSORED PROGRAMS [KAISER Report page 20 -- pdf page count 29] "Over half of the states have implemented pharmaceutical assistance programs that provide some degree of subsidized drug coverage for the low-income who do not qualify for Medicaid. In addition, in order to help those with higher incomes, a number of states have instituted programs intended to provide discounts to those who otherwise pay full retail prices for their drugs." "….We limited our review of state programs to those that provide discount card-type programs that do not have an insurance coverage or subsidy component through a Medicaid waiver or other state subsidy mechanism." ---------------------------------- "Basic differences among the existing pharmaceutical cards in existence in July 2002… There are reportedly hundreds of prescription drug discount cards available on the market. None of the cards are regulated … ..These cards offer discounts on the cost of prescription drugs, though the cards have a variety of requirements and restrictions. " Includes a chart: COMPARING PHARMACEUTICAL DISCOUNT CARDS NY CONGRESSWOMAN CAROLYN MCARTHY - Discount Cards http://www.house.gov/carolynmccarthy/discountcards.htm ---------------------------------- AMERICAN ASSOCIATION OF RETIRED PERSONS AARP - State-by-State, Plan-by-Plan List of Pharmacy Assistance Programs http://www.aarp.org/bulletin/departments/2002/money/0510_money_1.html Rx Drug Discount Programs Offered by Major Drug Companies http://www.aarp.org/bulletin/departments/2002/money/0510_money_6.html#rx -------------------------- COMPARATIVE CHART OF PHARMACEUTICAL MANUFACTURERS’ DRUG DISCOUNT CARDS ( Last update 1/15/03 ) * note – All programs compared in this chart require that applicants be Medicare recipients and have no other prescription coverage. These drug discount cards have no enrollment or annual fees. http://www.rxassist.org/pdfs/Comparative_Chart_of_Drug_Discount_Cards.pdf --------------------- THE NATIONAL CONFERENCE OF INSURANCE LEGISLATORS (NCOIL) NCOIL REPORT ON PRESCRIPTION DRUG DISCOUNT CARDS April 2002 http://www.ncoil.org/news/DrugCards2.doc ====================================== OTHER COMPREHENSIVE RESOURCES ===================================== Prescription Drug Assistance - A Guide To Programs And Benefits http://www.state.me.us/dhs/beas/medbook.htm
Request for Answer Clarification by natalieemt-ga on 21 May 2003 14:45 PDT Hello knowledge_seeker-ga, A humongous answer (as I expected)! It's going to take me a couple of days to digest it. I can promise you now that I'll be giving you 5 stars and a $100 tip. However, I'm going to leave this question unrated while I work my way through it, so that the "request for answer clarification" avenue of communication stays open. I really like the "12 ways" outline. As I see them, they all make sense, but the first and most basic one (the brown bag idea) was not in my thinking at all. It did, however, prompt this question in my mind: "Are there inappropriate methods that people use to try to save on prescription costs?" As an example, I know someone who tries to save on her blood pressure medication by taking it every other day, rather than the "once a day" that her doctor prescribed. Could you dig up a couple of links on (a) other inappropriate ways of trying to save on drugs (if any), and (b) the sorts of dangers associated with cutting back on your prescription without consulting with your doctor? I noticed in my first quick skim through that you did highlight the danger of fraudulent drug discount cards. That's an issue that I am particularly interested in (how can people distinguish between good plans, less good plans, and fraudulent plans). I may have a clarification request in that area after I have reviewed the material. Also, if you go back to the "purchasing prescription drugs from Canada" question, you will see that I requested a small clarification there, using the comment section. I don't know whether you receive an email alerting you to comments on questions that you have answered. Thanks! Natalie
Clarification of Answer by knowledge_seeker-ga on 22 May 2003 14:57 PDT Hi Natalie, YOU ASKED: "Are there inappropriate methods that people use to try to save on prescription costs?" The short answer is YES and the main method is NON-COMPLIANCE, both in terms of not purchasing the drug that a doctor prescribed, or in taking the drug in a different manner or dosage than the doctor prescribed. Of course the other main issue is with consumers purchasing drugs from unsafe sources, either from other countries that don't have quality and safety measures in place or from online sources. I've outlined these and several other ways in which consumers put themselves in danger when trying to save on prescription costs. DANGERS ASSOCIATED WITH TRYING TO SAVE MONEY ON PRESCRIPTIONS ================================================== 1- NOT PURCHASING THE PRESCRIPTION AT ALL ================================================== " Today, in the United States, one out of five Americans are not taking the medicine that their doctors are prescribing for them because of the high price of that medicine." Pharmaceutical Reimportation from Canada http://bernie.house.gov/statements/20030403171059.asp --------------- " Nearly one-quarter of all seniors (22%) said they did not fill a prescription because it was too expensive or skipped doses of their medications to make them last longer. Not surprisingly, these numbers are even higher among seniors who lack coverage—35% of whom skipped doses or did not have prescriptions filled." NEW SURVEY OF SENIORS IN EIGHT STATES FINDS NEARLY ONE IN FOUR SKIPPING DOSES OR NOT FILLING PRESCRIPTIONS DUE TO COST http://www.kaisernetwork.org/health_cast/uploaded_files/7.31_PressRelease_SeniorsRx.pdf ========================= 2 – OTHER NON COMPLIANCE ========================= This Harris study outlines the types of non-compliance that consumers employ to save money on prescription drugs, and the potential outcomes of that non-compliance. " It seems probable that if people are not taking the medications they need to control their blood pressure, their cholesterol, their diabetes or their arthritis (to name just four very common conditions) that the impact of non-compliance is very serious and will lead to significantly higher levels of mortality and morbidity. Higher Out-of-Pocket Costs Cause Massive Non-Compliance in the Use of Prescription Drugs, and This Is Likely to Grow http://www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2002Vol2_Iss22.pdf ---------------- This Harris Report outlines WHO tends to be noncompliant – " Noncompliance is much higher among low income groups and people with disabilities…" " The problem is worse in the U.S. than in other countries.." Out-of-Pocket Costs are a Substantial Barrier to Prescription Drug Compliance http://www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2001Vol1_iss32.pdf ------------------------------- SAVING DRUGS FOR "NEXT TIME" AND SELF MEDICATING This method is used often by people taking antibiotics. They take 5 or 6 days worth of a 10-day dose, and save the rest for the next time they have a sore throat or even for the next family member with similar symptoms. See my answer and article here for the dangers of antibiotic misuse: The rise of the super bug antibiotic resistant bacteria http://answers.google.com/answers/main?cmd=threadview&id=188676 RACING THE RED QUEEN http://members.rogers.com/kmgerson/Page%20Gallery/Non-Fiction%20Pages/Non-Fiction%201.htm ------------------ SKIPPING DOSES With some drugs, the "every other day" technique can be uncomfortable at best and dangerous or deadly at worst. "Sylvia sometimes skips doses of arthritis medication, causing her pain to increase, her mobility and her quality of life to decrease.." Prescription Drugs - Nevada Health Reform Project and the Nevada Nurses Association. http://www.nevadawomenslobby.org/About%20NWL/issues/prescriptiondrugs.htm ----------------- "Skipping doses, not filling prescriptions and unauthorized pill splitting are some of the measures consumers take in the wake of rising drug costs. Unfortunately, these cost-saving measures can also prolong the illness or medical condition as well as the expense of the treatment. "Improvised remedies that run counter to doctors' orders are a prescription for disaster," NEW AARP "CHECK UP ON YOUR PRESCRIPTIONS" CAMPAIGN TO HELP CUT PRESCRIPTION DRUG COSTS AND IMPROVE HEALTH http://www.aarp.org/press/2002/nr041802.html ---------------------------------------------------------- EXAMPLES OF MEDICATIONS THAT CANNOT SAFELY BE SKIPPED OR REDUCED ---------------------------------------------------------- " Medications need to be taken as scheduled, at the same time every day. Medications should not be stopped or changed without first consulting with your doctor. Continue taking the medication even if you feel better; stopping medications suddenly can make your condition worse." Heart Disease Medication Tips http://my.webmd.com/content/article/45/4044_104?z=4044_4 ---------------- " It is important that you take quinidine regularly on the exact schedule prescribed for you, even if you have to wake up during the night to take it. Do not skip doses because irregular heartbeats may develop.." What You Need to Know About Quinidine http://www.clevelandclinic.org/health/health-info/docs/0700/0728.asp?index=4921 -------------------- " This medication works best when there is a constant level in your body. Therefore, it is important that you take it every 12 hours. Try to take your doses at the same times each day. Do not skip doses or take less or more of the medication than your doctor prescribes. Even if you feel well, do not stop taking this medication without consulting your doctor…" What You Need To Know About Flecainide http://www.clevelandclinic.org/health/health-info/docs/0600/0686.asp?index=4834 ===================================== 3 – INAPPROPRIATE PILL SPLITTING ===================================== Pill splitting can be inappropriate with certain drugs or with certain format medications (eg: capsules). See my links in the PILL SPLITTING section of the main answer. ========================================================== 4 – USING LOW COST BUT UNRELIABLE SOURCES FOR PRESCRIPTIONS =========================================================== Consumers who do not do their homework and use pharmacies or OTC sources that do not have real medical staff and do not review prescriptions properly are putting themselves in danger of wrong or dangerous prescriptions. ---------------------------- Dangers include: Fake, unapproved, outdated, or sub-standard products Little or no quality control (packaging, purity of ingredients, storage) Possibility of an incorrect diagnosis (i.e., those sites that inappropriately diagnose and prescribe online) Obtaining an inappropriate medicine (e.g., inappropriate for condition, interaction with other drugs) Lack of assurance of confidentiality and security issues. POTENTIAL DANGERS OF ORDERING DRUGS ONLINE http://www.buy-viagra-and-prescription-drugs-online-potential-dangers.com/buy-viagra-online-dangers.html PRECAUTIONS TO TAKE WHEN ORDERING DRUGS ONLINE http://www.buy-viagra-and-prescription-drugs-online-potential-dangers.com/buy-viagra-online-precaution.html ========================================================== 5 – ORDERING MEDICATIONS WITHOUT A PRESCRIPTION OR TRYING TO SAVE MONEY BY BYPASSING THE PHYSICIAN ========================================================== Web prescriptions alert http://news.bbc.co.uk/1/hi/health/778645.stm ----------------- Likelihood of Purchasing Drugs Online Without Visiting a Doctor "Fully, 51% of Americans and 69% of Japanese cyberchondriacs say they would be at least somewhat likely to do this if they could, compared to 33% in Germany and 32% in France…" "… These differences may well reflect higher drug prices in the U.S.A…." The Future Use of the Internet in 4 Countries in Relation to Prescriptions, Physician Communication, and Health Information http://www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2002Vol2_Iss13.pdf ==================================== 6 – USING COMPOUNDERS ==================================== See my cautions in the Answer. =============================================================================== 7 – ORDERING FROM DIFFERENT PHARMACIES TO SAVE MONEY ON MULTIPLE PRESCRIPTIONS. ============================================================================== When a customer orders some drugs from one pharmacy and other drugs from another, there is no central database that is keeping track of all the medications the person is on. This can result in dangerous combinations of drugs and side effects, especially if the prescriptions are from different doctors. It adds a measure of safety when a consumer has a relationship with one pharmacist ---- " When you went to get your new prescription filled, the computer alerted the pharmacist that you should still have medications left from your old prescription. PPK has guidelines in place which look at early refills to make sure you were following the doctor's instructions correctly and not taking more than the amount prescribed or more frequently than prescribed. Therefore, your pharmacist had to call us for approval of the early refill." PRESCRIPTION DRUG PROGRAM – COMMON QUESTIONS http://www.phsystems.com/members/html/prescription_program/questions.php ======================= OTHER INFO FOR CONSUMERS ======================= AARP: USE MEDICATIONS WISELY Be Safe. Be Smart. http://www.aarp.org/wiseuse/ ============================= So, that's it until I hear from you again. ( Did you say you were writing an article or an entire book? ;-) ) Actually, I have enjoyed this research knowing that it's all going towards some final product – your article. I've done lots of my own research for articles I've written and I can see that it must be a nice treat to be able to have someone else do the legwork for a change. Let me know how this works out for you – K~ PS – Notice, I did reply to your comment in the previous question.
Clarification of Answer by knowledge_seeker-ga on 02 Jun 2003 07:17 PDT Hi Natalie, I just wanted to check in with you and see if there was anything else you needed from me. I know there was a lot of information there, so I figured you'd need some time to go through it all. When you get a chance, let me know how it worked out - -K~

natalieemt-ga rated this answer: 5 out of 5 stars

and gave an additional tip of: $100.00

Dear knowledge_seeker-ga,

A stellar answer (I expected no less)!  Thank you for all your
efforts.  I'll find a way to let you know how the final article turns
out.

Sorry for the delay in getting back to you . . . a bunch of "stuff"
happened and I got very busy.

Comments

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
From: cynthia-ga on 16 May 2003 12:56 PDT

knowledge_seeker,

I have a book on this, my Mom takes way too many prescription drugs.
There's a couple methods that natalieemt didn't list above. Here's a
nearly inclusive list of what to explore:


1) Generic (of course)

2) Splitting pills (eg: cost is nearly the same for 50mg & 100mg pill,
you split a 100mg pill to your 50mg dose).

3) Compounders (order in bulk from a licensed compounder)

4) Purchase out of the country (Drive to Canada/Mexico).

5) Manufacturer's Discounts (certain drugs have low-income programs
-earnings may be as high as $50,000 annually in some cases -NOT A
TYPO).

6) Pharmacy co-op groups (same as bulk, but no need to find a
compounder).

7) Prescription drug "insurance" (read the fine print of each policy).

8) Mail order - US and "out of the country" (very risky).

Hope this helps!

--Cynthia

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
From: redhoss-ga on 16 May 2003 14:57 PDT

If you can qualify, and it is pretty easy to do. Most drug companies
have what are called "Patient Assistance Programs" which provide many
drugs absolutely free. This is not advertised and apparently not
widely used, but is actually a very easy way to obtain free
prescription drugs. If you are interested, I think the link is:
www.needymeds.com

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
From: cynthia-ga on 22 May 2003 16:02 PDT

Another note about Compounders. Some Compounders will fill regular
prescriptions, charging a lot less by eliminating the middle man
(pharmacy). Not all do, but you may be able to find one in your area.
Basically, they buy the drugs and filler in powder form and make the
tablets. You would need a large prescription to make this worthwhile,
and you could freeze the bulk of the pills. If you want to check it
out, tell your Doctor what you are doing and ask him what the biggest
prescription is that he could give you so you have a starting point
when talking to the compounders.

~~Cynthia

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
From: knowledge_seeker-ga on 05 Jun 2003 08:12 PDT

Thank you Natalie!

I would love to see your final article! If it's online and appears
before this question expires, you can post a comment and a link here
and I'll see it. Otherwise, you could post a link in a $2 question
addressed to me. (It will only cost you 50 cents because I won't
"answer" it. :-) )

If it's in a print journal or magazine, just give me the bibliography
and I'll track it down.

It's been a pleasure working with you -

-K~

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
From: rkm100-ga on 05 Jul 2003 02:46 PDT

check out http://www.ecure.info, price comparison of over 15 online pharmacies. :)

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
From: meyer18-ga on 15 Jul 2003 12:32 PDT

There is a number of ways to save on the cost of prescription drugs. 
 
Canadian Pharmacies is one of the http://www.affordablerx.com is one
of the best that I know.
 
But there are other resources right here in the states: 
 
http://freemedicineprogram.com - Free prescription drugs are available
to those who qualify regardless of age through patient assistance
programs. Free Medicine Program assists you with the application
 
http://www.discountrxmart.com 
http://www.peopleschoicerx.com 
http://www.free-prescriptions.org

Subject: Re: For knowledge_seeker-ga: Saving money on prescription drugs
From: restigate-ga on 15 Aug 2003 12:46 PDT

I totally agree with meyer18-ga that to go with Canadian Pharmacies is
the best choice. My Grandpa ordered his mediciation from
http://www.canadianpharmacylink.com which is located in Canada.

If you think that site has high prices you might want to try
http://www.canadianpharmacygroup.com or
http://www.canadianpharmacynetwork.com because my grandma ordered from
there because they had cheaper prices than the first one.

I know of couple more health related websites that might interest you
guys.
http://www.cyberpillsnetwork.com

This one is in Canada and they have cheap prices.
http://www.canadaexpressrx.com
http://www.buygenericviagra.biz
http://www.viagraimproved.com

I hope this post will help you out on what ya need

Good luck with your search!

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