Clark's Big Book of Bargains (14 page)

• Internet •

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* PRESCRIPTION DRUGS *

With prescription drug prices going through the roof, people have found a cost-saving alternative north of the border. Yes, Americans are buying their prescriptions, at much lower prices, in Canada.

People who live in cities such as Seattle, Detroit, and Buffalo can simply drive across the border and visit a Canadian pharmacy. But the rest of us can get the same discounts, from 30 to 70 percent off, online. One Web site, www.canadameds.com, has been so deluged with orders that it has had customer-service problems, including delays in shipping.

All you do is fax in your prescription and a few forms, plus your credit-card number, and your medicine arrives about two weeks later. The United States limits your supply to three months at a time, so you have to plan ahead. Obviously, this isn’t a good idea if you need medicine for an emergency.

One of my listeners, Bill, was saving $2,800 a year by buying medicines for himself and his wife from Canada. He was buying arthritis medication for $27 instead of the usual $85, and his wife’s cholesterol medicine for $67 instead of $141—for the same medication. It works because of Canadian price controls, and a good exchange rate between the Canadian and U.S. dollar.

It’s completely legal, although controversial, because pharmaceutical companies and research hospitals believe that if consumers pay less for prescriptions, there’ll be less money to fund research and development of new medicines. But the reality for many people is that if they don’t find a more affordable way to buy their medicines, they won’t be able to buy them.

If you are sixty-five or older, or your parents are that age, you can take advantage of a number of discounts being offered by the drug companies. The offers are changing constantly, but there are two basic types. One is a cooperative effort from the industry to provide discounts to people who are over 65 and whose income doesn’t exceed certain limits. Then there are programs from individual manufacturers, which are offering discounts only on medicines they make. With some programs you get a big discount; others let you pay a flat fee for your medicines, and still others provide them essentially for free. Since the offers are changing constantly, check my Web site, www.clarkhoward.com, for details.

The industry has adopted these programs because drug manufacturers are terrified that the federal government will impose price controls.

If you’re not eligible for the discounts, you don’t want to deal with Canada, or if you need a prescription on short notice, it’s time to visit your favorite warehouse club, because they have by far the lowest prices on prescriptions. We checked prices for the ten most-prescribed drugs and found Costco had the cheapest price on eight of them.

• The Ten Most-Prescribed Drugs •

(prices at Costco, CVS, and Walgreens):

1. Hydrocodone w/APAP (10/500 tablet, quantity 60)
CVS—$31.09
Walgreens—$30.99
Costco—$39.39

2. Lipitor (10 mg tablet, quantity 90)
CVS—$207.99
Walgreens—$198.09
Costco—$176.39

3. Premarin (0.3 mg tablet, quantity 100)
CVS—$64.99
Walgreens—$70.39
Costco—$54.57

4. Atenolol (100 mg tablet, quantity 100)
CVS—$27.19
Walgreens—$23.99
Costco—$16.37

5. Synthroid (100 mcg tablet—quantity 100)
CVS—$45.09
Walgreens—$44.99
Costco—$31.29

6. Zithromax (250 mg z pack tablet, quantity 6)
CVS—$49.39
Walgreens—$49.99
Costco—$42.49

7. Furosemide (40 mg tablet, quantity 100)
CVS—$16.99
Walgreens—$8.99
Costco—$8.49

8. Amoxicillin (500 mg capsule, quantity 30)
CVS—$14.59
Walgreens—$13.99
Costco—$8.17

9. Norvasc (10 mg tablet, quantity 100)
CVS—$230.99
Walgreens—$176.79
Costco—$181.27

10. Alprazolam (1 mg tablet, quantity 90)
CVS—$27.89
Walgreens—$26.29
Costco—$9.39

Wherever you buy, and whether or not you have health insurance that covers prescription drugs, you have to decide whether to buy generic or brand-name drugs. Many generics are exact pharmacological copies of brand-name drugs. Others are chemically different, but are supposed to treat the medical condition equally well. If the medicine is pharmacologically identical, you should have no problem choosing the generic, and saving money. If the generic isn’t exactly the same as the brand-name, talk to your doctor about whether you should try it. And tell your doctor you may not be able to afford the brand-name drug.

About a third of all prescriptions are not filled at all because people can’t afford them. The pharmacist will say, “That’s eighty-two dollars,” and the person will decide not to buy it. It makes more sense to try a generic than to not use any medicine at all.

Sometimes doctors will prescribe an expensive drug without realizing that another drug that would do just as good a job costs a lot less. The Internet now gives you the ability to compare different drugs and choose a cheaper alternative. You can check the drug your doctor prescribes at www.rxaminer.com, find a cheaper alternative, and see if your doctor will agree to prescribe the less-expensive drug. This is especially helpful with drugs you take regularly.

You can save on some medicines by getting a stronger dose and cutting the pills in half. Believe it or not, some medicines cost almost the same whether you buy, say, a 20-milligram or 40-milligram pill. So if you buy one hundred 40-milligram pills and cut them in half, you’ll get two hundred 20-milligram doses for almost the same price. You’ll cut your prescription prices almost in half.

Finally, you can lower your drug costs by using a plan your employer may offer called a cafeteria plan, or a flexible spending plan. You can use a flexible spending plan to help pay medical or child-care costs. You ask your employer to take a specified amount of money out of each paycheck, and you use that money to pay for medicines, deductibles, copayments, and other medical costs that aren’t paid by the company health plan. The advantage is you can pay those costs out of gross, or before-tax, dollars. Since $200 off your gross pay often will equal $120 to $140 of your net pay, you get a substantial discount.

The downside is you can’t tell your employer to take out more or less money during the year, and you lose any money that’s left in the account at the end of the year. So if you have $1,000 taken out and draw only $600 from the account, you lose $400. That’s the reason I generally don’t favor using flexible spending accounts for medical care, except for known expenses like a prescription medicine. If you don’t budget well, you can lose. However, because of the discount, you can lose a little money in the account and still come out ahead.

If you think you’ll have $1,000 in prescription drug expenses in a year, try having $750 of your pay diverted to your flexible spending account. If you exceed the $750, pay the rest out of your net pay, and increase your contribution to the flexible spending account next year.

• Tips on Prescription Drugs •

• Save by ordering your regular prescriptions online from Canada.
  

• If you are 65 or older, or your parents are that age, check to see if the drug manufacturers offer senior discounts on the drugs you need.
  

• If you need a prescription on short notice, buy from your local warehouse club for the best prices.
  

• Check the drug your doctor prescribes at www.rxaminer.com, find a cheaper alternative, and see if your doctor will agree to prescribe the less-expensive drug.
  

• With some medicines, you can get a double-strength dose at a similar price and cut the pills in half.
  

• If you have access to a flexible spending plan at work, consider using that to pay your uninsured drug costs and copays with pretax dollars.