With the cost of prescription drugs continuing to skyrocket, you need to stay savvy regarding the use of money-saving strategies. According to the Employee Benefit Research Institute, prescription drug expenditures, in Texas as well as throughout the U.S., grew at double-digit rates during almost every year since 1980.



Senior citizens who depend on Medicare, which doesn't cover outpatient prescriptions, shell out the most. But even people whose health insurance pays for medications sometimes find they have hefty co-payments or deductibles. The prescription drug costs of private insurers are rising even faster than the overall total costs. The following are tips to help you stretch your prescription-drug dollar:

First, and most importantly, if you get your prescriptions from a variety of sources, remember to provide a complete list of ALL your medications - including over-the-counter - you're taking to each pharmacist. This allows them to check for possible dangerous drug interactions.

Make Sure Your Doctor Knows. If you pay for prescriptions out of your own pocket, make sure your doctor knows. In many cases, there are less expensive medications that can be used to treat the same condition, and your doctor should be able to prescribe the most economical ones.

Go Generic. Instead of brand name medications, ask your doctor if he or she will prescribe generic equivalents. You can save between 30% to 50% or even more. Also inquire about over-the-counter medications that might be able to meet your needs.

Know Your Plan. Before signing up for an individual health insurance plan, check your co-payments for prescription drugs, as well as the maximum amount the plan pays annually. Also find out whether your health plan has a formulary - a list of drugs they'll cover. A health insurance plan with a closed formulary pays only for certain pre-approved drugs. If the one you need is not on the list, you pay the entire cost of the drug. Open formularies offer most drugs, but the prices may vary. If your plan has a closed formulary, you may be able to request an exception by having your doctor fill out a form. But with HMOs, you may have to go through an appeals process.

Compare Prices. Shop around for a pharmacy that offers the best prices on prescription drugs. For example, some pharmacies offer cheaper prices but no extra services, such as home delivery or pharmacist consultations. It may also be worthwhile to compare prices on a prescription-by-prescription basis, since stores sometimes offer specials on popular drugs. In addition, your pharmacist may match the lower price, if you find a cheaper price on-line.

Bulk Up! If you're prescribed a drug for a month or longer, ask your physician if you can order it in a bulk supply. It'll cost less than buying the prescription weekly. Bulk purchases work to your benefit if you are insured. Most insurers charge the same co-pay whether you buy a 10 day or 30 day supply of a medicine. Furthermore, the co-pay for a 90 day supply, particularly if you order by mail from the insurer's mail order drug supplier, is usually less than three times a 30 day supply.

Order Online or by Snail Mail. According to the Pharmaceutical Care Management Association, mail-order pharmacies now make up 10 to 12 percent of the total prescription market. Ordering by mail can lower your co-pays if you are insured or can save you 10% to 15% of the total cost if you are uninsured. It's perfect for patients who take medication regularly and can place orders in advance. If you are insured, ask your insurance company for mail order information. Otherwise, some resources that offer discounted mail-order drugs are: Medi-Mail, 800-331-1458; and the American Association of Retired Persons (AARP), 800-456-2279.

While you can save money by purchasing online, be careful. Many web sites are not reputable and are selling medications without any authorization. And avoid pharmacies outside the U.S. - you may not get the proper formulation of the drug or the drugs you need. Also, some shady Internet pharmacies are set up overseas to avoid U.S. law. The National Association of Boards of Pharmacy (NABP) developed a system to verify licensure of Internet Pharmacies - the Verified Internet Pharmacy Practice SiteTM (VIPPS) certification. NABP is located in Park Ridge, Illinois. The organization can be reached at (847) 698-6227. For more information, check out The Food and Drug Administration's site on buying medical products online, www.fda.gov/buyonline.

Split the Difference. You can get certain prescriptions at double their appropriate dose and then split the tablets in half. This can result in a 50% savings. It's no wonder some health care providers ask or even require their patients do it. To find out if pill splitting is right for you, ask your doctor or pharmacist. Some drugs are in a time-release formulation, so they should not be split because you might get a full dose all at once. Also, since pill splitting can often result in uneven dosages, your doctor may not like the idea, especially if you need a very precise dose. But once you're given the okay, you can purchase a pill splitter to help make the cutting easier and more accurate.

Manufacturer Aid. Many major drug companies now have programs to cover patients who can't afford medications they need. Program details vary widely depending on the manufacturer, but all of them require that your doctor put the application in for you. If your primary care physician is unfamiliar with these kinds of programs, he/she should call the Pharmaceutical Manufacturers Association (202-835-3400) and ask for a program guide. You will not be able to get this information on your own.