Working With A Pharmacist to Lower Your Prescription Drug Prices

When you think of getting your prescriptions filled, you may picture a person in a white lab coat counting tablets and sliding them into tiny bottles. But a pharmacist does much more than fill pill bottles. Taking full advantage of this valuable resource can help ensure safe and effective use of your medications. By providing information about your medical history and asking questions about proper medication use, you can work with your pharmacist to not only prevent medication mishaps but to improve the quality of your health care and avoid paying unnecessary drug and other health care costs.

The traditional, over-the-counter, pharmacist may not be the best option for you.
©2006 Publications International, Ltd.
Your pharmacist can be a great asset in
sorting out your prescription drug options.

Understanding the Pharmacist's Role

Before discussing the pros and cons of various drug channels, it helps to know what role the pharmacist plays in the health care process. A registered pharmacist is a licensed health care professional who has spent years learning about medications and their effects. Pharmacists can provide you with important information about prescription and nonprescription drugs, including their intended effects and side effects; other medications, foods, conditions, and activities that affect their actions; and how to use and store them properly to ensure safe, effective, economical treatment.

Your pharmacist can screen for duplication of medicines and dangerous drug interactions, which is especially important if you see more than one physician. Your pharmacist can work with all of your physicians and any third-party payers you may have, to make sure you get all the medications you need. And your pharmacist can also work one-on-one with you, explaining your drug therapy and even demonstrating how to use various drug products.

Understanding the steps the pharmacist goes through in filling your prescription, and knowing what responsibilities and opportunities you have for input along the way, can help you make the most of this resource.

The Single
Pharmacy Theory
It's generally advisable to use a single pharmacy (or single chain that has networked patient records) so the pharmacist can keep an up-to-date record of all your medications. Shopping around for the best prescription price may help you save a few dollars, but it also puts you at greater risk for medication problems if each pharmacy only has a piece of your total medication history on record. If you must use more than one pharmacy or drug channel, be sure each has your complete medication history, including a current record of every medication you take and any allergies you have.

Maintaining your medication record: The very first time you submit a prescription to a particular pharmacy (or, in the case of chain drugstores with linked computerized patient records, the first time you ever use one of their pharmacies), you will be asked for information about yourself. The pharmacist (or pharmacy technician) will ask for the correct spelling of your name, your date of birth, and contact information. You'll also be asked for information on any prescription insurance you may have, since the pharmacy may bill the insurance company directly and/or charge you only a copayment.

This information is used to create your medication record. Some pharmacies may ask additional questions about your medication history or give you a patient profile form to fill out. The medication record is one of the most valuable tools the pharmacist has to ensure your safety. It should be kept as accurate and up-to-date as possible, because the pharmacist will refer to it each time you request a prescription or refill.

At the initial visit, you should also inform the pharmacist of all the medications -- both prescription and nonprescription -- you currently take as well as all of the supplements, herbal remedies, and/or other alternative medicines you use. At each subsequent visit, tell the pharmacist if you have added or discontinued any medications or supplements so your record continues to be current. Also, inform the pharmacist of any allergies you have and any significant adverse drug reactions you have experienced.

The pharmacist will check the record each time you bring in a new prescription to make sure you are not being given a drug that contains any ingredients to which you may be allergic or that may conflict with any other medications or supplements you are taking. This can be a lifesaving service and may help you avoid costly visits to the emergency room.

Choosing generic medications: Your pharmacist is responsible for choosing a generic product to substitute for a brand-name drug if your doctor has indicated that substitution is allowed. Your physician generally indicates this on the prescription blank by checking the box marked either "Do Not Substitute" or "Substitution Allowed." If your doctor has okayed substitution, the pharmacist is free to substitute an equivalent, lower-cost generic and will use government guidelines to choose a generic that is considered equivalent to the branded drug.

When you submit your prescription to the pharmacy, be sure they know you want generic products where allowed. Some pharmacies have a policy of automatically filling all "Substitution Allowed" prescriptions with generics unless the patient requests the brand-name drug. Ask about your pharmacy's policy.

If your doctor allows substitutions, your pharmacist can fill your prescription with a generic alternative.
©2006 Publications International, Ltd.
If your doctor allows substitutions, your pharmacist can
fill your prescription with a generic alternative.

Verifying the prescription order: If you've ever tried to read doctors' writing, you can imagine what a challenge it must be for pharmacists, who read and fill countless prescriptions every day. But deciphering and confirming the drug name, dosage, and directions for use on your prescription blank is one of the pharmacist's most important tasks -- and one that has a vital impact on your therapy, safety, and pocketbook.

There are thousands of medicines on the market, many of them spelled similarly, which means your pharmacist has to be extremely diligent in deciphering your doctor's handwriting. After all, a misread or improperly filled prescription can have deadly consequences. If unsure, the pharmacist will contact your doctor directly to clarify. The same is true on occasions when other important information, such as dose, route, or quantity of medication, has been inadvertently left off the prescription blank. You, too, can help in this verification process by taking notes at the doctor's office and relaying your understanding of your therapy to the pharmacist.

Screening for potential problems: The pharmacist uses your medication record to screen for potential drug interactions and duplications each time you present a new prescription to be filled. This is an extremely valuable step in the process, especially if you have more than one doctor.

Drug interactions can occur between two or more prescription medicines, a prescription and a nonprescription medicine, a medicine and a food, or even a medicine and a disease. Some drug interactions may simply need monitoring or are minor and not considered serious as long as you can tolerate them. Others are serious and indicate that you should not take the drug.

Drug duplication can occur if you are prescribed two medicines that have the same ingredient or two medicines that have the same purpose. There are times when two drugs from the same class of medicines are purposely used together for the combined benefit they provide. But other times, drug duplication is a mistake. Such unplanned drug duplication not only exposes you unnecessarily to an increased risk of side effects and toxicity, it also wastes money. And the more doctors you see, the higher the risk of duplicate prescribing.

So make sure your medication record includes all of the prescription medications you take. And be sure your pharmacist knows about any and all over-the-counter medications, supplements, and remedies that you use.

Your pharmacist will also use your medication record to make sure none of your prescriptions have negative interactions.
©2006 Publications International, Ltd.
Your pharmacist will also use your medication record to make sure none
of your prescriptions have negative interactions.

Checking your regimen: Your "drug regimen" refers to the dosage, route of administration, frequency of use, special instructions, and duration of treatment of the drug, or drugs, you take. Your pharmacist checks that all of these components, as prescribed by your doctor, are appropriate for your condition. In addition to the information on the prescription blank, the pharmacist relies on the information you supply, based on your understanding of the treatment.

But this is also where the pharmacist's knowledge, skill, and experience can play an important role. If a component of the written drug regimen is not consistent with standard practice or just seems incorrect, the pharmacist will call your prescriber to clarify any unclear components and confirm the regimen.
 
Once the prescription is filled (which may be done by a pharmacy technician), it is the pharmacist's responsibility to double-check the prescription label for accuracy, confirm that the dispensed medication is the correct one, and see that your medication bottle carries appropriate warning labels. These are all critical last steps to ensure that you get the right medication with the proper directions for use.

When you receive the prescribed medication, you should do your own check. Confirm that what is written on the label matches what the doctor told you. If it is a drug you take on an ongoing basis, check if the pills in this refill look like those you've been taking. Ask your pharmacist about any discrepancies.

Patient counseling: There's one step more that you and your pharmacist should take together to increase the likelihood your medication will work for you and decrease the risk you'll waste money or jeopardize your health. That step is the patient consultation.

Before you leave the pharmacy with your medication, you should understand how to use your medicine properly for the greatest effect and without waste and know what signs to watch for that might indicate a problem. Here is the list of questions you should ask the pharmacist:
  • Am I allowed refills? How many? How often?

  • What should I do if I accidentally miss a dose of this medication?

  • Do I follow the dosing schedule around the clock, or do I only take the medication during waking hours?

  • Can I take this new medication at the same time I take my other medications?

  • Should I take it with food or between meals?

  • Is there anything I can do to prevent or minimize side effects?

  • How should I store this medication?

  • Can you provide me with a written copy of the instructions for using this medication?
Making sure you get this information can be one of the greatest money-savers available to you. If you don't take your medicine correctly, you risk not only wasting money but undertreating your condition (which may prolong your illness) or overdosing on your medication (which may have tragic consequences).

If Your Drug Goes OTC
When a product goes from being prescription only to being available over the counter, your insurance company may stop covering it, even if you began treatment when the drug was only available by prescription. Contact them to find out, and ask if there is any other form of the medicine that is still covered. Also, see if your copay for the prescription form of the drug will be higher than the price you would pay out of pocket for the over-the-counter form.

Fortunately, a major part of the pharmacist's job is patient consultation and education. Your pharmacist is there to answer your questions and provide advice on using medications safely and wisely. The pharmacist can explain and demonstrate proper use of medications and medication-delivery systems, such as eye ointments, eardrops, skin patches, sprays, nebulizers, and inhalers. (And before you leave the pharmacy, you should demonstrate back to the pharmacist the steps you should take in administering your medication and repeat your understanding of how and when to take the medication, to make sure you can do it properly once you're home.)

The pharmacist can also help you work out a medication schedule and demonstrate the use of a medication organizer to help you better manage your drug therapy. Your pharmacist is also an excellent source of information and advice on nonprescription drug products.

You can even ask your pharmacist for a more in-depth counseling appointment -- a special time set aside for a "brown-bag session." For this meeting, bring a bag filled with all of the medicines you are taking, including prescription and nonprescription drugs, herbs and/or other alternative remedies, vitamins, minerals, and any other supplements.

Make sure you bring with you all of your medication containers and all of the dosage forms (pills, creams, ointments, eyedrops, sprays, skin patches, etc.) of the drugs and supplements that you use. During the session, you should review each one with the pharmacist to make sure you are only taking what you need and are doing so properly.

Getting the most out of your pharmacist is not your only consideration when lowering prescription drug costs. You must also learn how to choose the appropriate pharmacy. We'll help you make this decision in the next section.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.