Reducing Medication Costs

Topic Overview

How can you lower your medicine costs?

Trying to make some changes in your lifestyle might help reduce your need for medicines. Many chronic illnesses, including diabetes, high blood pressure, and low back pain, require fewer medicines if you can increase your activity level, lose weight, and improve your diet. Also, counselling, support groups, and other therapies may help with illnesses such as depression.

How can you save money on prescriptions?

Generic medicines are less expensive copies of brand-name medicines. Ask your doctor or pharmacist if you can take a generic equivalent for the brand-name medicine that you take now. Generic equivalents are made according to the same strict Therapeutic Products Directorate (TPD) standards as brand-name drugs and therefore have the same quality, strength, purity, and stability as their more expensive counterparts.

Unfortunately, generic equivalents are not available for every brand-name medicine. If there is not an equivalent, ask your doctor if there is a similar medicine in the same class that may be less expensive or that has a generic equivalent. For example, Flomax, which is used to treat an enlarged prostate, is a relatively expensive medicine that does not have a generic equivalent. But another medicine that also is used for enlarged prostate, Hytrin, does have a less expensive generic equivalent.

Always shop around for the best deal on medicines. The retail cost can vary widely from pharmacy to pharmacy. While finding a good deal is important, it's also important that your pharmacist (or pharmacists) knows your medical history, including all the drugs—both prescription and over-the-counter (non-prescription), as well as dietary supplements and herbs—you take, even if they are not dispensed at that particular pharmacy. That way he or she can provide valuable advice about any potential for drug interactions, side effects, or other problems.

Also, compare costs of buying medicines online. Some large drugstore chains have Web sites that offer savings.

Pill splitting is another strategy that can help you save money without losing drug effectiveness or safety. Some tablets are available at double the dose and at the same or almost the same cost as lower doses. By splitting the larger dose, you can essentially get two doses for the price of one. But many medicines should not be split, including timed-release pills and capsules. The chart below lists 10 commonly prescribed medicines that researchers have determined can be split safely and effectively with significant cost savings.¹

Medicines that can be split to save money

Medicine	Most commonly prescribed for:	Savings
Atorvastatin (Lipitor)	High cholesterol	33%
Citalopram (Celexa)	Depression	46%
Clonazepam (Clonapam, Rivotril)	Panic disorder, epilepsy	41%
Doxazosin (Cardura)	Hypertension	46%
Lisinopril (Zestril)	Heart failure, high blood pressure	38%
Olanzapine (Zyprexa)	Schizophrenia, bipolar disorder	31%
Paroxetine (Paxil)	Depression	46%
Pravastatin (Pravachol)	High cholesterol	23%
Sertraline (Zoloft)	Depression	46%
Sildenafil (Viagra)	Erectile dysfunction	50%

Ask your doctor or pharmacist if any of your prescription medicines are sold at higher dosages and if it's possible to split them. Talk to your pharmacist about how to split pills with an inexpensive, easy-to-use pill splitter.

Buying prescriptions in bulk can also save you money. Ask your doctor to write a prescription for several months' supply of medicines that you take consistently. Keep in mind that your insurance company may limit the amount of medicine you can get at one time. Sometimes the cash price for a 3-month supply of medicine is less costly than if you were to pay an insurance copay each month for three months. Mail-order services can often save you money on large orders. But make sure to use only trusted, reliable pharmacy Web sites.

If you are trying a medicine for the first time, don't get more than a 30-day supply. In fact, you may want to get only one week's worth of medicine. If the medicine has to be changed later, you will have saved paying for more than you needed.

How can your provincial health plan help you save money?

Take time to find out about how your provincial health plan covers medicine costs. Provincial health plan prescription coverage varies from province to province. Some plans may cover only generic medicines if they are available. With some provincial health plans, you may have to pay more for medicines that are not on the plan's list of preferred medicines. Your provincial health plan also may not pay for certain medicines such as weight-loss and hair-growth drugs. Ask whether your medicines are covered, whether you need to buy at participating pharmacies, and about your copayment. Your provincial health plan may list this information on its Web site.

Check what (if any) your copayment for prescription drugs will be, the most the plan will pay in a year, and other details. When buying medicines, find out which payment option will be the least expensive. Some things to consider include whether there is a generic version of a preferred medicine and whether an over-the-counter equivalent is cheaper than your copayment. Remember, having the right information can save you time and money.

Are prescription medicines always necessary?

There may be an over-the-counter alternative for your prescription medicine. Generic versions of over-the-counter medicines can save you even more money. Often non-prescription equivalents of prescription medicines come in lower strengths, so get instructions from your doctor or pharmacist on how to take them.

In the case of antibiotics, recent research has found that they are not always needed. For example, up to 80% of ear infections get better without antibiotics.² Likewise, up to two-thirds of people with acute sinusitis improve on their own without antibiotic treatment.³ Your doctor might recommend that you take a wait-and-see approach before buying expensive antibiotics.

How can your doctor help?

To enlist your doctor's help, tell him or her that your prescription medicine bill is a financial burden. Ask for drugs that are less expensive but just as effective. Often, several medicines can be used to treat the same condition, and your doctor may be able to prescribe the one that is the most economical. For example, researchers have found that older, less expensive antibiotics such as amoxicillin work better than newer antibiotics for children who need treatment for middle ear inflammation.⁴

Drug companies often give doctors medicine samples free of charge. You might ask your doctor if he or she has medicine samples, especially when you are trying out a new medicine to see whether it will work.

What other resources are available?

See whether the pharmaceutical company that makes your medicine has a patient assistance program. Many pharmaceutical companies offer free or discounted drugs for people who cannot afford them. These companies often require that your doctor contact them first about your case. In any case, your doctor will need to be involved, and the application process can be complex. You may need to provide documentation to verify your income.

If you have a rare disease, contact the Canadian Organization for Rare Disorders. This organization help people who have rare diseases find better and more affordable access to medicines. For more information, see the organization's Web site: www.cord.ca.

If you are a veteran, you may qualify for prescription drug coverage through Veterans Affairs Canada. For more information, see the agency's Web site: www.vac-acc.gc.ca/clients/sub.cfm?source=services/healthcare.

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Author:	Nancy Bateman Debby Golonka, MPH Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated: November 26, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Theresa O'Young, PharmD - Clinical Pharmacist Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
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