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How to Pay Less for Prescription Drugs

Working With Your Doctor to Lower Your Prescription Drug Prices

©2006 Publications International, Ltd. Your doctor can be your greatest ally in lowering your prescription drug costs.

The doctor's office is often your first stop on the road to treating a medical problem. It's also the place to begin when you're looking to trim drug costs. By communicating openly with your doctor, you can help increase the likelihood your problem will be diagnosed and treated correctly the first time, saving added rounds of doctor visits, medical tests, and drugs. Your doctor(s) is a partner with you in your health care. And each visit is an opportunity to fine-tune your medical care to ensure that you're getting not only the best but the most cost-effective treatment. It's an opportunity you can't afford to miss.

If you want to save money and get good medical care, you need to understand and get involved in each step of the prescribing process. Your input, questions, and feedback along the way can help your doctor determine which treatment is best suited to you, your medical condition, and your pocketbook.


Get Involved in the Process

Diagnosing the problem: To properly diagnose your medical condition, your doctor needs as much information as you can give about your current health status and symptoms and about your medical history. Do your best to be prepared for this initial visit.

Write down, in as much detail as you can, what your symptoms are, what they feel like to you, when they occur, what seems to make them better or worse, and how long you've been experiencing them. By thinking about and writing down this information before you enter the doctor's office, you help the doctor pinpoint the problem and decide on a treatment.

Another important element in proper diagnosis and treatment is making sure your doctor has your up-to-date medical history. The term "history" can be a bit confusing here, since it includes not only your past medical treatments and any history of diseases in your family but also any other conditions you are currently being treated for. Your medical history should also include a medication history.

You should inform your physician of all the medicines you currently take as well as those taken in the past, noting any adverse drug reactions and drug allergies you've experienced. Also mention any use of nonprescription drugs, herbal and alternative medicines, vitamins and supplements, tobacco, caffeine, alcohol, and recreational drugs.

Setting treatment goals: You and your doctor will need to discuss the goal of treatment. Is it to simply diminish symptoms or to provide a cure? You may have no symptoms but may still require treatment, for high blood pressure or high cholesterol levels, for example. There are many possible goals of treatment, and you should have input in setting those goals. By knowing the goals, you'll also be better able to follow treatment instructions and recognize whether or not a given treatment seems to be benefiting you.

Sizing up treatment options: Generally speaking, your doctor can choose one or more of the following four treatment paths: simply providing information or advice; recommending nondrug treatment, such as lifestyle changes; prescribing one or more medications; or referring you to a specialist or other health care provider. The doctor must decide not only which treatment is the most effective, safe, suitable, and cost effective for a particular condition but for you in particular.

This decision must take into account many factors, including your age; gender; pregnancy or nursing status; kidney, liver, lung, and heart function; other health problems; currently used medicines; success or failure with past treatments; allergy history; ability to self-administer the treatment; and ability to pay for the medicine. Once again, an up-to-date medical history is truly helpful here. In addition, your doctor should discuss with you what the possible treatment options involve, so that your preferences, abilities, and needs are taken into account. After all, a treatment regimen that you cannot stick to is not going to do you any good.

Understanding the treatment: Once the specific treatment plan is chosen, the physician should discuss it with you and provide an explanation of why it is important. Usually the explanation is brief, so don't be afraid to ask questions. If the physician uses words you don't understand, ask for an explanation in simpler language.

Make sure you don't leave the office until you have a full understanding of what the medicine is for, how to take it, and possible side effects. For example, if you have a cough and your doctor prescribes a cough medicine with codeine, you should be informed that codeine will suppress the cough, that it may take two to three hours to start working, that it may cause constipation, that it may affect your ability to drive or operate machinery, and that you should not consume alcohol while you are taking it. You should be advised to come back if the cough does not go away within one week, if you develop a fever, or if unacceptable side effects occur. Finally, you should be advised to follow the dosage schedule and to not take more than prescribed. Take notes, or ask your physician for a written copy of the instructions. You should be able to summarize, in your own words, the key information, to be sure you understood it clearly. You may, therefore, want to repeat it to your doctor to confirm it before you leave the office.

Monitoring the treatment: Once you get the medicine home and begin treatment, you will need to do your part by following the instructions for use as closely as possible and being alert to side effects and changes in your condition. If you are having trouble following the directions for use -- maybe the dosing schedule is too complicated or the taste of the pills is intolerable -- or you have questions about the medication you didn't think of before, contact your doctor or pharmacist (as you'll learn in the next chapter, your pharmacist can prove invaluable in the treatment process).

If you have any unexpected problems while using your medicine, write down a description of the problem and alert your doctor immediately. If your symptoms don't improve, your doctor will need to consider whether the diagnosis, treatment, and adherence to treatment were all proper. In fact, the whole process of diagnosing and prescribing may start again. In some cases, of course, drug therapy may be ongoing, such as in controlling diabetes. Even so, your doctor will monitor your condition and will likely re-evaluate your treatment regimen from time to time to be sure it continues to be the best and most cost effective for you.

Ask About Generics

Whenever your doctor prescribes a medication for you, ask if a less-expensive generic version is available and appropriate for you. If not, ask if there are any similar medications with generic equivalents that might be an option for you. Be honest and up front with your doctor about your financial concerns.

But remember that in addition to a medication's cost, your doctor must consider the safety and effectiveness of that drug for you, based on your specific medical history, your current health condition or disease, and other medications you may be taking. A generic medication may have a cheaper price tag, but it could end up costing you more money, sick time, or worse in the long run if it is not the best medication for you.

In some cases, the least-expensive medication will do the trick. In the case of high blood pressure, for example, recent medical studies have shown the benefit of inexpensive thiazide diuretics (water pills) as a first-line treatment for some patients, with the newer, more-expensive blood-pressure medications reserved for when diuretics prove ineffective in controlling the disease.

Many people who have high blood pressure will eventually require more than one medication to control their condition, but if lifestyle changes and a simple water pill can keep their blood pressure under control for a while at least, the amount of money they end up saving can be tremendous.

In other cases, however, it may be more economical overall to use a pricier medicine that is more targeted in its actions, more effective for your condition, and/or more likely to get the job done better or faster, with fewer unpleasant side effects.

There are also certain medical conditions, such as epilepsy, in which very precise dosing is required, and brand-to-brand switching or generic substitution may not be recommended. (In such cases, your doctor will indicate on the prescription blank that substitution is not allowed.)

©2006 Publications International, Ltd. A healthy lifestyle can prevent illness  and, naturally, cut down on prescription drug costs.

Practice Prevention

Yet another immensely important step you can take to keep your medication and health care costs down is to seek out and use information from your doctor (and other reputable sources) about preventing disease and injury. Healthy lifestyle changes such as quitting smoking, starting a regular exercise program, and improving your diet and eating habits can go a long way toward reducing your need for medications in the first place. Indeed, for some medical conditions, altering unhealthy habits and getting weight under control can often reduce, delay, or even eliminate the need for medication.

Getting regular medical checkups and following the advice of your health care partners are also essential. And, of course, habits such as always using seatbelts, never driving under the influence of alcohol, and avoiding illicit drugs can help prevent injuries that require a lot more than medications to repair.

Certainly, it can take some serious effort on your part to make the lifestyle changes that can improve and protect your health. But putting in that kind of effort can pay off in the long run by saving you money on medications and other health care costs.

Once you and your doctor are on the same page about saving money on prescription drugs, it's time to work on your pharmacist. In the next section, we'll show you how to save money when you get your prescription filled.

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.

The brand name products mentioned in this publication are trademarks or service marks of their respective companies. The mention of any product in this publication does not constitute an endorsement by the respective proprietors of Publications International, Ltd. or, nor does it constitute an endorsement by any of these companies that their products should be used in the manner described in this publication.