Prices for everything from gas to food are going up—way up. And that includes prescription medications. The AARP reports that on average, manufacturer prices for the 153 prescription drugs most widely used by older Americans increased by nearly 54 percent between 1999 and 2006, compared with a general inflation rate of 20.1 percent. For a person taking four brand-name medications, the average increase was nearly $1,500 during the seven-year period.
So, now that more than half of insured Americans are taking medicines for chronic medical problems, according to a new study by Medco Health Solutions, what's a consumer to do to minimize the pain? "The most obvious opportunity is for people to use generic medications when they're available," says Janet Silvester, president of the American Society of Health-System Pharmacists.
Even when an exact off-brand replica of your drug doesn't exist, generic alternatives may include other drugs in the same class, says Steven Findlay, healthcare analyst at Consumers Union and managing editor of the group's Best Buy Drugs website. "What you're really wanting is to be talking to your doctor about this if you get prescribed something that is an expensive brand-name drug," he says. "There is usually an alternative [cheaper] drug in the same class for the same condition."
Other saving strategies:
Shop around. Big chain stores like Wal-Mart and Target offer some generic medications for $4 per month, with 90-day supplies available for $10 in some cases. There are also savings to be had at online retailers such as drugstore.com. "If you've got a condition where you need a brand-name drug, you would be advised to shop on the Internet," where savings may be as much as 10 to 25 percent compared with shopping in stores, Findlay says. Websites like DestinationRx may also be useful for finding cheaper drug alternatives and making cost comparisons.
Silvester advises purchasing drugs only from sites that display the National Association of Boards of Pharmacy's Verified Internet Pharmacy Practice Sites, or VIPPS, symbol. And don't buy from foreign retailers that sell medications online, she warns, because the drugs' active ingredients may differ and other countries may not have the same safeguards in place as the United States.
Stock up on your meds. "Talk to your doctor about prescribing 90-day supplies," Findlay suggests, since generally there's a discount when you order in quantity. And your insurer's mail-order service may allow you to get 90-day supplies for a cheaper copay.
Consider pill splitting. Often manufacturers give different dosages of a medication the same price, so that it's cheaper to get a larger dosage and then split the pill in half, Silvester says. For instance, a 30-day supply of the statin Lipitor costs the same amount—$119.99—for both the 20- and 40-milligram dosages on drugstore.com. One important caveat: Check with your doctor first before splitting pills on your own, experts advise. This option should be off limits to people with limited manual dexterity, and there are certain medications—like capsules, for instance—that should never be split.
Still, some medications are routinely split on the advice of doctors. For example, statins like Lipitor are sometimes split so that 10-milligram pills become 5-milligram dosages, Findlay says. U.S. News provided more detail on pill splitting in 2004.
If you opt to go this route, invest in a pill splitter; these start at about $2 on Amazon.com. Don't try splitting your pills with a knife or other tool, though, because pills can fragment if not cut properly.
Check into over-the-counter drugs. Some medications—like antihistamines and heartburn drugs—that were once prescriptions are now sold OTC. For example, it may be worthwhile to switch from prescription Clarinex, which costs $115.99 on drugstore.com for a 30-day supply, to OTC Zyrtec, which is $19.99 on the same site, or Claritin, at $22.99. Zyrtec was prescription only until November, when the Food and Drug Administration approved it for OTC sale; Claritin has been sold OTC for several years.
Investigate prescription drug assistance programs. Doing so may mean free or nearly free medications, if you qualify. The Pharmaceutical Research and Manufacturers of America started the Partnership for Prescription Assistance program three years ago with the goal of "taking the mystery out of finding help" paying for medications, says Ken Johnson, senior vice president at PhRMA. The group's site offers questionnaires designed to help patients, caregivers, and doctors determine if a person is eligible for the program. Johnson says that qualification requirements vary, but a general rule of thumb is that those below 200 percent of the federal poverty level usually qualify for assistance, which typically includes a family of four making less than $40,000, a family of two making less than $24,000, and individuals making less than $19,000.
Request a medication review with your doctor or pharmacist. This accomplishes a few things, including making sure you're not taking drugs you no longer need and evaluating possibilities for cheaper medication alternatives, Silvester says. This is particularly good for people who take medications prescribed by multiple doctors. "It's always good to re-evaluate with one person," she says.
Sign up for a flexible spending account. FSAs, like those offered to federal employees, allow you to use pretax dollars to pay for medications and other healthcare expenses. Check with your employer's human resources department to find out if your office offers FSAs.

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